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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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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 ) [1] => WP_Post Object ( [ID] => 2012 [post_author] => 11 [post_date] => 2025-06-03 19:17:23 [post_date_gmt] => 2025-06-03 19:17:23 [post_content] =>

Introduction

 

Diabetic foot ulcers (DFUs) are a major and often debilitating complication of diabetes, contributing significantly to patient morbidity, mortality, and healthcare costs. Despite advancements in diabetes care, the incidence of DFUs remains high, with a substantial impact on quality of life and healthcare resources. A recent study published in the journal Frontiers in Endocrinology compared the use of electrochemical skin conductance (ESC) to the current standards in DFU detection. The current method for assessing DFU risk primarily involves clinical examination, including the monofilament test, which is subjective and dependent on the examiner’s skills. Therefore, there is a need for objective, reproducible, and reliable methods for early detection of at-risk patients.

 

One of the many complications of diabetes is peripheral neuropathy, which, if left untreated, can lead to DFUs. Electrochemical Skin Conductance (ESC) is a promising non-invasive diagnostic tool that can be used to assess autonomic nerve activity. ESC is measured in-clinic using Sudoscan, which assesses small fiber peripheral neuropathies, specifically the innervation around the sweat glands, by stimulating the glands and measuring the conductance (in µS) of chloride ions contained in the sweat. Lower ESC values indicate more severe neuropathy. This study investigates the association between ESC and DFU risk stratification, offering a potential new approach to managing and preventing diabetic foot complications.

Methods

 

This study was a retrospective analysis involving 2,149 diabetic patients from four clinics in Greater Paris University Hospitals, the largest hospital system in Europe and one of the largest in the world. The primary aim was to evaluate the relationship between ESC measurements and DFU risk, as classified using the 2016 International Working Group on Diabetic Foot (IWGDF) grading system. This grading system assigns DFU risk based on clinical evaluation, including the presence of neuropathy, ulceration, and other factors.

To assess the predictive performance of ESC in DFU risk stratification, the study incorporated a range of factors: age, sex, type of diabetes, and results from the monofilament test, which is a standard assessment of peripheral neuropathy. The study employed regression and Receiver Operating Characteristic (ROC) analyses to explore the predictive value of ESC measurements for different DFU risk categories.

 

Results

 

The study revealed a significant correlation between ESC values and DFU risk grades (p<0.001). Specifically, lower FESC values were associated with higher grades of DFU risk, suggesting that reduced sweat gland function, indicative of small fiber neuropathy, plays a role in the progression of foot ulcers in diabetic patients.

 

One of the most noteworthy findings of this study was that ESC measurements were able to identify patients at risk for DFUs who would not have been classified as high risk using the standard IWGDF grading system. Specifically, ESC detected autonomic dysfunction and small fiber nerve involvement in 43% patients classified as grade 0 (13% with severe cases of neuropathy), who otherwise showed no obvious signs of risk through traditional assessments, showing better granularity in the lower grades for better risk stratification.

 

The findings of this study suggest that Electrochemical Skin Conductance (ESC) provides a valuable, reproducible, and operator-independent tool for assessing DFU risk. ESC measurements offer an objective method for identifying early signs of small fiber neuropathy, a critical factor in the development of DFUs. Unlike traditional risk stratification, which relies heavily on clinical judgment and may overlook early-stage neuropathy, ESC can detect subtle changes in nerve function that precede visible foot ulcers.

 

The ability of ESC to detect at-risk patients in the grade 0 category, who would otherwise be overlooked by conventional classification methods, highlights its potential role in preventing DFUs. By identifying patients with early-stage nerve dysfunction, ESC could facilitate earlier intervention, potentially reducing the incidence of foot ulcers, amputations, and associated healthcare costs.

 

The ability to detect DFU risk early using ESC shows promise for the prevention of amputation.Therefore, we conclude that feet skin conductance is a relevant parameter for detecting diabetic foot syndrome, specifically at an early stage when there is still no presence of feet ulceration or wounds. A recent meta-analysis on ESC supports this conclusion, indicating that ESC, when combined with temperature measurements, serves as a valuable tool for the early detection of diabetic foot syndrome. ESC can be measured in-clinic, using Sudoscan, and at home using Withings Body Pro 2. Measuring ESC through home use of the Body Pro 2 scale allows for additional data collection and better assessment of trends and progression between appointments. Through this enhanced monitoring of DFU risk, care teams can better risk-stratify and provide targeted care that could prevent amputations and complications.

Interested in partnering with us?

Contact Us [post_title] => Electrochemical Skin Conductance as a Novel Tool for Diabetic Foot Ulcer Risk Stratification and Prevention [post_excerpt] => Diabetic foot ulcers (DFUs) are a major and often debilitating complication of diabetes, contributing significantly to patient morbidity, mortality, and healthcare costs.Electrochemical Skin Conductance (ESC) is a promising non-invasive diagnostic tool that can be used to assess autonomic nerve activity. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => electrochemical-skin-conductance-as-a-novel-tool-for-diabetic-foot-ulcer-risk-stratification-and-prevention [to_ping] => [pinged] => [post_modified] => 2025-06-16 13:31:21 [post_modified_gmt] => 2025-06-16 13:31:21 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2012 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 2005 [post_author] => 11 [post_date] => 2025-05-29 18:17:36 [post_date_gmt] => 2025-05-29 18:17:36 [post_content] =>

Menopause can significantly impact sleep, blood pressure, and body composition—and it goes far beyond hot flashes.

As estrogen and progesterone levels decline, the risk of obstructive sleep apnea (OSA) increases. These hormones help keep airway muscles strong and support stable breathing during sleep. When they drop, the airway is more likely to collapse during the night. Combined with menopause-related weight gain, this can significantly heighten the risk. According to the Sleep Foundation and Mayo Clinic, postmenopausal women are more prone to sleep apnea, even if they hadn’t previously experienced symptoms.

 

Menopause also increases the risk of hypertension. Lower estrogen levels reduce blood vessel flexibility, making it harder for blood to flow efficiently. Coupled with changes in weight, cholesterol, and insulin sensitivity, blood pressure tends to rise. The American Heart Association highlights that the risk of heart disease, including high blood pressure, climbs sharply in postmenopausal women—making routine monitoring all the more important.

 

Body composition also shifts during menopause. Fat tends to accumulate around the abdomen—even if overall weight remains stable—due to hormonal changes. This increase in visceral fat, which surrounds internal organs, is linked to elevated risks of cardiovascular disease, type 2 diabetes, and certain cancers. A University of Pittsburgh study found that for every 20% increase in abdominal fat, artery thickness, a key marker of heart disease risk, also increased. The Mayo Clinic reinforces the importance of addressing these changes through exercise, strength training, and healthy eating.

 

Monitoring these health changes is crucial for comprehensive menopause care. Withings Health Solutions can help. Withings offers clinically validated devices that make it easy to track vital health metrics from home. Body Pro 2 measures not just weight, but also body fat, visceral fat and muscle mass—providing a deeper understanding of your cardiovascular health. Sleep Rx aids in the detection of sleep apnea without requiring a wearable, while the BPM Pro 2 enables simple, accurate blood pressure monitoring.

 

Connected health devices offer a powerful way to enhance care and demonstrate measurable outcomes. As menopause impacts everything from sleep and blood pressure to weight and long-term cardiovascular health, cellular-connected devices—like Body Pro 2, BPM Pro 2, and Sleep Rx—enable real-time tracking of key metrics. These insights help patients and users better manage symptoms and allow care teams to personalize support. Just as importantly, aggregated health data can validate the impact of your solution, making it easier to show ROI to employers and insurers and improve engagement across populations.

Interested in partnering with us?

Contact Us [post_title] => The Need for Remote Patient Monitoring in Menopause Care [post_excerpt] => Menopause can significantly impact sleep, blood pressure, and body composition—and it goes far beyond hot flashes. Connected devices can enable comprehensive care and proof of ROI for menopause benefits. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => the-need-for-remote-patient-monitoring-in-menopause-care [to_ping] => [pinged] => [post_modified] => 2025-05-29 18:19:03 [post_modified_gmt] => 2025-05-29 18:19:03 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=2005 [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] => 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 ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 48 [max_num_pages] => 16 [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:0.02429900 17524761500.02418900 1752476150 )
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Revolutionizing Chronic Kidney Disease Management with Digital Health Tools: The Withings Case Study

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Electrochemical Skin Conductance as a Novel Tool for Diabetic Foot Ulcer Risk Stratification and Prevention

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The Need for Remote Patient Monitoring in Menopause Care

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References

References

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