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Getting Paid for Your RPM Services

4 min read

Remote patient monitoring programs are a win-win for primary care practices and the patients they serve. Billing for remote patient monitoring generates additional revenue for medical practices that allows providers to improve their quality of care. To successfully bill for RPM services, you’ll need to know the various CPT codes associated with RPM services and understand how different insurers reimburse for these services. This article covers each RPM billing code individually, explaining how and when to use it, and concludes by reviewing RPM coverage guidelines for patients on Medicare and private insurance.

Remote Patient Monitoring Billing Codes and How to Use Them

Accurate insurance billing is one of the most important ingredients to running a profitable primary care practice. Knowing how and when to use RPM CPT codes will enable you to fully bill for all allowable RPM services, ensuring a more robust and reliable revenue stream.

CPT 99453

Use CPT 99453 to bill for the initial setup of connected health devices used to monitor patient health parameters like respiratory flow rate, blood pressure, and pulse oximetry. Services under this code include device set-up and patient education on the proper use of equipment. The 2022 national average for Medicare reimbursement when using this billing code is $18.48 per patient for a one-time initial setup.

CPT 99454

Use CPT 99454 to bill for at least 16 days of remote patient monitoring services per 30-day period. This code requires that the RPM device supply readings or deliver programmed alerts that transmit during at least 16 days within the 30-day period. The 2022 national average for Medicare reimbursement when using this billing code is $55.77 per patient per month, or $668.64 per patient annually.

CPT 99457

CPT 99457 is used to bill for remote physiologic monitoring treatment management services of 20 minutes or more of a clinical staff/physician/other qualified healthcare professional time. In order to use this billing code, there must be at least one interactive communication between the patient and their healthcare provider per month. The 2022 national average for Medicare reimbursement when using this billing code is $50.18 per patient per month, or $602.16 per patient annually.

CPT 99458

CPT 99458 carries the same description and requirements as CPT 99457 but allows providers to bill for a second interactive communication during the month being billed. The 2022 national average for Medicare reimbursement when using this billing code is $40.84 per patient per month, or $490.08 per patient annually.

Medicare Insurance Guidelines for RPM Services

The Centers for Medicare and Medicaid Services (CMS) have four requirements for practice billing for remote patient monitoring services. Documenting that these guidelines have been followed will streamline the reimbursement process and ensure you have adequate proof that these requirements were followed.

Patient copay amount

CMS requires that patients covered under Medicare Part B be charged a 20% copayment. Choosing to waive these copayments may result in federal fines for providers.

Patient consent

Providers must gain consent from patients to provide remote patient monitoring services. This consent can be provided prior to delivering the service, either verbally or in writing.

Required monthly monitoring duration

In order to bill CMS for remote patient monitoring services, patients must be monitored for at least 16 days per billing period. Health data collected by remote patient monitoring devices can be wirelessly synced for evaluation by the patient’s provider.

RPM service must be ordered by a physician or other healthcare provider

In order to initiate patient participation in a remote patient monitoring program, RPM must be ordered by the patient’s doctor or other qualified health professional. These individuals could include a nurse practitioner, certified nurse specialist, or a physician assistant.

State Medicaid Coverage for RPM Services

Patients covered by state Medicaid programs are often eligible for remote patient monitoring programs. In fact, according to the Center for Connected Health Policy (CCHP), over half of state Medicaid programs will provide reimbursement for RPM. Since every state administers its own Medicaid program, guidelines and coverage restrictions vary. This comprehensive resource from CCHP lists the remote patient monitoring policies for each state Medicaid program.

Commercial Insurance Coverage for RPM Services

Commercial insurance providers have embraced remote patient monitoring technology. This trend toward greater coverage was accelerated during the height of the COVID-19 pandemic and hasn’t shown signs of slowing. As a result, the vast majority of private health insurers now reimburse for remote patient monitoring services for eligible patients covered under one of their policies.

Grow Your RPM Program with Withings Health Solutions

Withings Health Solutions is an industry leader in remote patient monitoring. Our FDA-approved medical-grade devices feature intuitive, patient-friendly designs that create higher levels of user engagement. Withings RPM, an all-in-one remote patient monitoring solution, comes with an AI-powered digital assistant that lets participants engage more fully.

Additionally, practices can automatically record time spent on patients for streamlined claim creation. With Withings RPM, you can grow your practice by easily tracking time spent on the platform by your practice to bill CPT codes and get reimbursed for remote patient monitoring. You can also automatically track the time spent monitoring patient measurements to build comprehensive, CMS-compliant billing reports. The solution also builds audit reports to ensure that your RPM records are audit-proof. You can have all RPM services charges automatically uploaded directly into your EHR, ready for submission.

Our experienced support team makes starting a new remote patient monitoring program easy. Withings Health Solutions handles all of the onboarding and managing support, so your care teams can focus on what matters most, providing high-quality care to patients.

Learn more about Withings Health Solutions for remote patient monitoring.

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Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. At Withings, he serves as Vice President of Value-Based Care, partnering with risk-bearing organizations to design and scale programs that improve affordability, outcomes, and the care experience.

 

The Centers for Medicare & Medicaid Services (CMS) proposed a fee schedule that would drastically expand funding for remote patient management  — a move that could mark a turning point in how we think about healthcare delivery in America. If finalized, it would be more than a policy update; it would be a recognition that the future of healthcare lies in providing patients with a concierge-like experience focused on delivering care that is coordinated, comprehensive, and personalized. At Withings, we believe this shift is coming at exactly the right time. Digital health has proven it can improve access, but to truly improve outcomes and drive savings, it must go beyond the occasional video visit, the siloed widget, and the noisy data. It requires impactful patient engagement, integrated data communication, and the accessibility of evidence-based preventive care. That’s where our technology can make a measurable difference.

 

Our connected ecosystem for virtual heart health, anchored around award-winning medical devices, captures a breadth of biomarkers and patient-reported outcomes; everything from ECGs to body composition to symptom assessments—giving care teams an ongoing, comprehensive view of a patient’s cardiovascular function along with key metabolic and respiratory drivers. Paired with personalized care pathways, this actionable insight empowers patients to play an active role in their own care while enabling clinicians to deliver timely interventions. This means more healthy days at home and fewer costly, preventable acute care events.

 

The opportunity is only accelerating. Withings recently secured a large grant to develop advanced artificial intelligence that precisely detects risk based on multi-marker analysis of device-captured patient data. When applied to a Heart Failure population for example, this would enable intervention weeks prior to weight gain, and increase the likelihood of avoiding decompensation and an acute care event. It’s a leap from reactive to proactive care—one the healthcare system urgently needs.

 

CMS’s proposal creates the framework for digital health to play a cornerstone role in a future of healthcare that  places the patient at the center. This future of healthcare will be defined by its ability to predict and prevent, not just treat. With the right policies, technologies, and partnerships, we can make that future a reality now by giving patients more healthy days at home and delivering on the promise of a stronger, more sustainable healthcare system.

Interested in partnering with us?

Contact Us [post_title] => The Perfect Moment for Digital Health to Go Further by Patrick Sheehan [post_excerpt] => Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-perfect-moment-for-digital-health-to-go-further-by-patrick-sheehan [to_ping] => [pinged] => [post_modified] => 2025-10-07 19:59:23 [post_modified_gmt] => 2025-10-07 19:59:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2047 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [1] => WP_Post Object ( [ID] => 2034 [post_author] => 11 [post_date] => 2025-09-02 16:47:55 [post_date_gmt] => 2025-09-02 16:47:55 [post_content] =>

Introduction

Sleep is an essential pillar of health and well-being. The clinical gold standard for sleep assessment, polysomnography or PSG, provides a detailed analysis of sleep architecture but is impractical for routine or long-term monitoring. Its reliance on complex equipment, high cost, and typically in-lab application make it an intrusive process. The proliferation of consumer wearable and nearable devices offers more accessible alternatives, yet their accuracy often lacks rigorous scientific validation, particularly in home environments.

 

A recent study sought to address this gap by evaluating the accuracy and reliability of the Withings Sleep Analyzer (WSA). This contactless sleep mat, placed under the mattress, was compared directly against simultaneous PSG recordings in a large and diverse group of individuals in their own homes. This research investigates the sensor's performance in real-world conditions, offering critical insights into the current state of consumer sleep-tracking technology.

 

Methods

The study involved 117 healthy participants, with 69 women, and a mean age of approximately 40 years. Each participant slept in their own bed for one night with both the PSG equipment and the under-mattress device active. This setup allowed for a direct, epoch-by-epoch comparison of the data recorded by the consumer device against the clinical reference standard. The analysis focused on two primary objectives: the accuracy of distinguishing sleep from wakefulness and the precision of classifying distinct sleep stages, including light, deep, and REM sleep. Performance was assessed using standard classification metrics to ensure a robust evaluation.

 

Results

The investigation found that the contactless device performs effectively in identifying sleep and wake states. It achieved an overall accuracy of 87% in this core task, demonstrating a high sensitivity of 93% for detecting sleep and a moderate sensitivity of 73% for detecting wakefulness. A key strength observed was the sleep mat's consistent performance across various subgroups. The accuracy of sleep-wake detection remained stable regardless of participant age, BMI, sex, mattress type, mattress thickness, sleep quality or the presence of a bed partner.

 

Challenges emerged in the classification of specific sleep stages. The sensor's mean accuracy for staging sleep was 63%, with a Cohen’s Kappa of 0.49. The primary difficulty was in distinguishing between light and deep sleep. This led to systematic biases in sleep duration estimates; the device tended to slightly overestimate total sleep time by an average of 20 minutes but substantially overestimated light sleep by 1 hour and 21 minutes. Conversely, it moderately underestimated REM sleep by 15 minutes and deep sleep by a more significant 46 minutes.

 

Notably, a notable proportion of misclassifications made by the sensor mirrored disagreements found between the expert human reviewers who scored the PSG data, especially concerning the boundary between light and deep sleep. Furthermore, participants reported that their perceived sleep quality was significantly altered for the worse on the night they used the PSG equipment, highlighting the intrusive nature of the gold standard itself.

In a comparative context, the Withings Sleep Analyzer exhibits highly competitive performance in sleep-wake discrimination relative to other devices on the market. For the more nuanced task of sleep stage classification, its accuracy is comparable to that of similar products. This level of performance is particularly noteworthy given the systemic challenges in sleep staging.

 

Conclusion

For individuals seeking to understand their sleep over weeks and months, the primary benefit of a device like the Withings Sleep Analyzer lies in its practicality. Its contactless, 'set-and-forget' nature eliminates the nightly burden of wearing a device and avoids the discomfort that can disrupt sleep, a notable issue even with the clinical gold standard. While the sensor's accuracy in distinguishing specific sleep stages requires further refinement, its strong performance in tracking overall sleep and wake times provides reliable insights into sleep duration and consistency. This capability for accessible, unobtrusive, and longitudinal monitoring is where at-home sensors currently provide the most value, empowering users with meaningful data on their long-term sleep trends.

 

Poster Session: Time and Location

“Evaluation of a Contactless Sleep Monitoring Device for Sleep Stage Detection against Home Polysomnography in a Healthy Population”

 

Session Title: Poster abstract group 2

 

Session Date: Monday, September 8, 2025

 

Presentation Time: 6:00pm to 7:00pm (Presenting authors will be present near their assigned poster board throughout the scheduled one-hour presentation window.)

 

Poster Board Number: 531

 

Location: Posters will be displayed in the exhibit hall on Level 4 and accessible during regular congress hours.

About Marie-Ange Stefanos

Marie-Ange Stefanos is a  Machine Learning Research Scientist and a PhD candidate pursuing a joint doctorate in Computer Science and Neuroscience from Université Paris Cité (France) and Reykjavik University (Iceland). Building on her background with an Engineering degree in Signal Processing from Grenoble INP - Phelma and an M.Sc. in Machine Learning from KTH Royal Institute of Technology, her path into health research was driven by a central question: how can my technical background be best applied to solve meaningful challenges in human health?

 

Her doctoral research focuses on insomnia, where she develops algorithms using data from wearables and self-reports to identify predictive biomarkers and differentiate subtypes of the disorder. This work depends entirely on data integrity, which is why she believes the rigorous validation of consumer devices, as discussed in this article, is the essential first step in translating complex signals into reliable, actionable insights for users.

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Contact Us [post_title] => The Promise and Pitfalls of At-Home Sleep Tracking: A Deep Dive into the Withings Sleep Analyzer [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-promise-and-pitfalls-of-at-home-sleep-tracking-a-deep-dive-into-the-withings-sleep-analyzer [to_ping] => [pinged] => [post_modified] => 2025-09-02 16:49:48 [post_modified_gmt] => 2025-09-02 16:49:48 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2034 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2015 [post_author] => 11 [post_date] => 2025-06-12 15:39:12 [post_date_gmt] => 2025-06-12 15:39:12 [post_content] =>

Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine. Among the many challenges faced by these patients, cardiovascular disease (CVD) stands out as the leading cause of mortality—a stark reminder of the systemic stress that accompanies kidney failure and dialysis.

 

But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? An article in Frontiers in Nephrology explores exactly that—highlighting the transformative potential of digital health technologies to monitor and manage CKD5D patients beyond the clinic.

 

The Hidden Risks Between Dialysis Sessions

For CKD5D patients, the risks of CVD are amplified by both traditional and disease-specific factors:

 

  • Traditional risks like hypertension, diabetes, and obesity.

  • CKD-specific risks such as inflammation, fluid overload, protein-energy wasting and vascular calcification.

  • The dialysis process itself, which induces rapid fluid shifts, blood pressure fluctuations, and metabolic imbalances.

Current clinical care models often focus on in-center dialysis data, leaving a crucial blind spot during the interdialytic period—a time when many adverse events begin to develop unnoticed.

 

A New Monitoring Paradigm: The Withings Toolkit

The article introduces a compelling case for home-based, connected health technologies—specifically, the Withings toolkit. This suite of medical-grade, consumer-friendly devices allows CKD patients to monitor key health indicators in the comfort of their homes:

 

  • Weight, body composition and ECG monitoring with the BodyScan smart scale.

  • Blood pressure, heart rate and survey responses for added context via BPM Pro 2.

  • Sleep quality and breathing event metrics using the Sleep Rx.

All data is seamlessly uploaded to the Withings Remote Patient Monitoring platform, providing healthcare providers and researchers with real-time, longitudinal insights into a patient’s well-being.

 

Why This Matters: Real-World Clinical Benefits

1. Early Detection of Complications

Weight gain could signal fluid retention, but muscle loss could indicate protein-energy wasting. A sudden spike in blood pressure or irregular heartbeat might indicate arrhythmias or volume overload. Poor sleep patterns could reflect apnea or restless leg syndrome—conditions with known ties to CKD.

2. Personalized, Data-Driven Care

These devices enable a dynamic view of health trends, allowing clinicians to tailor treatments proactively rather than reactively. Medication adjustments, fluid restrictions, or further diagnostics can be made with greater confidence.

3. Patient Empowerment

When patients can see and understand their own data, they become more engaged in their care. This promotes better self-management, increased treatment adherence, and a stronger sense of control over their condition.

4. Systemic Healthcare Advantages

Remote monitoring can reduce emergency visits and hospitalizations, easing the burden on overtaxed healthcare systems and offering a cost-effective alternative to frequent in-person evaluations.

 

The Future: Digital Tools as Standard of Care?

While still in its early stages, this integration of digital health into CKD care reflects a broader movement toward remote, preventative, and personalized medicine. The Withings case study serves as a promising example of how everyday technology can be adapted to serve complex clinical needs.

 

However, as the authors note, more clinical trials are needed to validate these tools in nephrology settings, establish protocols for data use, and ensure equitable access across diverse patient populations.

 

Final Thoughts

As we face growing rates of kidney disease and limited nephrology resources, connected health technologies offer a lifeline—not just to patients, but to an entire care infrastructure in need of modernization.

 

The Withings toolkit is more than a gadget suite; it's a glimpse into the future of chronic disease management, where data flows continuously, care is adaptive, and patients are active participants in their own health journey.

 

References
 Article: Frontiers in Nephrology, 2023 - DOI: 10.3389/fneph.2023.1148565

Interested in partnering with us?

Contact Us [post_title] => Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study [post_excerpt] => Chronic Kidney Disease stage 5 on dialysis (CKD5D) presents one of the most complex and high-risk scenarios in modern medicine.But what if technology could help bridge the gap between dialysis sessions, offering clinicians a window into the patient's health in real-time? [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => revolutionizing-chronic-kidney-disease-management-with-digital-health-tools-the-withings-case-study [to_ping] => [pinged] => [post_modified] => 2025-06-12 15:41:31 [post_modified_gmt] => 2025-06-12 15:41:31 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2015 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 2047 [post_author] => 11 [post_date] => 2025-10-06 19:26:35 [post_date_gmt] => 2025-10-06 19:26:35 [post_content] =>
Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. At Withings, he serves as Vice President of Value-Based Care, partnering with risk-bearing organizations to design and scale programs that improve affordability, outcomes, and the care experience.

 

The Centers for Medicare & Medicaid Services (CMS) proposed a fee schedule that would drastically expand funding for remote patient management  — a move that could mark a turning point in how we think about healthcare delivery in America. If finalized, it would be more than a policy update; it would be a recognition that the future of healthcare lies in providing patients with a concierge-like experience focused on delivering care that is coordinated, comprehensive, and personalized. At Withings, we believe this shift is coming at exactly the right time. Digital health has proven it can improve access, but to truly improve outcomes and drive savings, it must go beyond the occasional video visit, the siloed widget, and the noisy data. It requires impactful patient engagement, integrated data communication, and the accessibility of evidence-based preventive care. That’s where our technology can make a measurable difference.

 

Our connected ecosystem for virtual heart health, anchored around award-winning medical devices, captures a breadth of biomarkers and patient-reported outcomes; everything from ECGs to body composition to symptom assessments—giving care teams an ongoing, comprehensive view of a patient’s cardiovascular function along with key metabolic and respiratory drivers. Paired with personalized care pathways, this actionable insight empowers patients to play an active role in their own care while enabling clinicians to deliver timely interventions. This means more healthy days at home and fewer costly, preventable acute care events.

 

The opportunity is only accelerating. Withings recently secured a large grant to develop advanced artificial intelligence that precisely detects risk based on multi-marker analysis of device-captured patient data. When applied to a Heart Failure population for example, this would enable intervention weeks prior to weight gain, and increase the likelihood of avoiding decompensation and an acute care event. It’s a leap from reactive to proactive care—one the healthcare system urgently needs.

 

CMS’s proposal creates the framework for digital health to play a cornerstone role in a future of healthcare that  places the patient at the center. This future of healthcare will be defined by its ability to predict and prevent, not just treat. With the right policies, technologies, and partnerships, we can make that future a reality now by giving patients more healthy days at home and delivering on the promise of a stronger, more sustainable healthcare system.

Interested in partnering with us?

Contact Us [post_title] => The Perfect Moment for Digital Health to Go Further by Patrick Sheehan [post_excerpt] => Patrick Sheehan is a healthcare leader at the intersection of technology and care delivery, with a focus on virtual and at-home services for people with chronic conditions. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-perfect-moment-for-digital-health-to-go-further-by-patrick-sheehan [to_ping] => [pinged] => [post_modified] => 2025-10-07 19:59:23 [post_modified_gmt] => 2025-10-07 19:59:23 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2047 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 50 [max_num_pages] => 17 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => 1 [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => 1 [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => 6d1a776d6bc27eaafff54aaa4a4ce9c6 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) [query_cache_key:WP_Query:private] => wp_query:aa568ea4ce566a32de3aa3ea4e2f444a:0.82017300 17606306480.38078900 1760630557 )
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