Some patients need more than just 20 minutes a month. They need you to check in, adjust care, and keep them on track. CPT Code 99458 makes sure that extra effort counts, covering each additional 20 minutes RPM treatment management beyond your first 99457 billing. It’s about real conversations, smart decisions, and steady support that help patients stay healthy between visits.
At RPM & CCM Health, we make CPT 99458 billing simple with time tracking, EHR integration, and compliance, so you focus on care while we handle the details. This guide shows you how.
What Is CPT 99458?
CPT Code 99458 as an add-on to 99457.
99457 covers the first 20 minutes of RPM treatment management every month, and CPT code 99458 means covering an additional 20 minutes of RPM spent on the patient in that same month.
This includes interactive communication with the patient and caregiver. Apart from this, they also carry out reviewing RPM data, making any necessary decisions, and documenting everything.
Basically, CPT Code 99458 takes things up a notch by doing more than the minimum touchpoints. This especially applies to patients with many chronic conditions or those with ups and downs in their health status.
When to Bill CPT 99458
You can only bill CPT Code 99458 if you’ve already billed 99457 for that month, so think of it as the “next step” in your RPM care.
Start by doing the first 20 minutes of work under 99457. After that, if you spend another 20 minutes helping your patient, you can use 99458. It takes more than just looking at numbers on a screen. You have to talk to your patient, check in with them, and make sure they’re doing okay. If you do more than one extra 20 minutes in the same month for the same patient, you can use 99458 for each extra block of time.
For patients who need deeper reviews, extra calls, or ongoing coordination, CPT 99458 billing makes sure the care you’re giving is both recognized and reimbursed.
Medicare Reimbursement
On average, CPT Code 99458 reimburses around $40–$45 per additional 20 minutes RPM treatment management. Rates can vary slightly depending on your region and Medicare Administrative Contractor.
To qualify for Medicare RPM CPT add-on payments:
- Your additional time must be clearly documented and auditable.
- Activities must align with the patient’s active care plan.
- The additional time must be medically necessary,not just “nice to have.”
Given that many complex patients require more than 20 minutes per month, billing 99458 accurately ensures you’re compensated for the real work you’re doing while keeping compliance airtight.
Qualifying Services
Not all RPM activity counts toward the extended RPM time code. During this, you will have to carry out essential patient care like keeping track of their blood pressure, sugar levels, or weight. According to those readings, you will then have to make changes to their medicine or treatment.
This also includes making regular calls, doing video chats, or sending messages to show your concern, and even talking to other doctors or nurses to make sure everyone’s on the same page.
It’s part of remote care, where you’re helping and making decisions for the patient.
Documentation Requirements
Proper documentation is key in CPT 99458 billing. Missing or making inaccurate entries can cause claim denials, so keep these in mind.
- Maintain time logs showing every minute beyond the first 20 minutes of 99457.
- Include detailed notes on continued care coordination and patient interaction
- Record the communication method (phone, video, messaging) and its duration
- Timestamp all updates to the patient’s care plan.
By meeting these requirements, you ensure compliance with RPM reimbursement codes and make audits straightforward.
Maximize RPM Time-Based Billing with RPM & CCM Health
We know tracking every extra minute for CPT Code 99458 can be tedious, especially when juggling a large patient panel. That’s where RPM & CCM Health steps in.
- Automated Time Tracking – Every patient touchpoint is logged in real time.
- Audit-Compliant Documentation – We capture every detail needed for successful claims.
- Seamless EHR Integration – No double entry or switching between platforms.
- Engaged Care Teams – We proactively connect with patients so you don’t have to chase them down.
- Scalable Programs – As your RPM population grows, our systems scale with you.
Schedule a Consultation today to see how we can help you outsource your RPM program while keeping every CPT Code 99458 claim clean, compliant, and fully reimbursed.
Related RPM Codes
- CPT 99457 – Covers the first 20 minutes of RPM treatment management.
- CPT 99454 – Device supply and data transmission for RPM.
- Get more information about our Remote Patient Monitoring services.
FAQs
Can CPT 99458 be billed more than once a month?
Yes. You can bill CPT Code 99458 multiple times per calendar month if you meet the additional 20-minute threshold for each billed unit.
What qualifies as additional RPM management time?
Any medically necessary, patient-focused activity beyond the first 20 minutes, such as reviewing new data, adjusting treatment, or follow-up communication, qualifies.
Can you bill 99458 without 99457?
No. CPT Code 99458 is an add-on code and must be billed in conjunction with 99457 for the same patient in the same month.
What documentation is required for 99458 billing?
Detailed time logs, interaction notes, timestamps, and care plan updates are essential for CPT 99458 billing compliance.
Ready to Get the Most from CPT Code 99458?
Extra care time should mean extra recognition and reimbursement. With CPT Code 99458, you can ensure that each additional 20 minutes of patient care is properly billed and compliant. Let RPM & CCM Health handle the heavy lifting, from documentation to claims, so you can focus on your patients.
Book a demo today and see how easy it is to capture every minute of value in your RPM program.
