More Income for You, as New Codes Cover Video Patient Visits, Virtual Check-in, Remote Monitoring

Betsy Nicoletti, MS

Disclosures

February 18, 2019

In This Article

How to Use CPT Code 99091 for Reimbursement

Code 99091 is defined as "collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days."

According to CPT, if the data interpretation occurs on the day of an E/M service, it is not separately payable. CPT puts further restrictions on the use of this service with CPT care plan oversight (CPO) codes, stating not to report 99091 within 30 calendar days of the CPO codes. However, there is no prohibition against reporting them in the same period as transitional care management or chronic care management.

Keep in mind that it is an important CPT principle that time may not be double-counted. Also ensure:

  • The data were collected by the patient, digitally stored, and transmitted to the physician/NP/PA for interpretation;

  • The interpretation by the practitioner requires a minimum of 30 minutes;

  • Following CPT time rules, that would be 16 minutes of time, although CPT does not specifically say that in this section;

  • It may only be billed once in a 30-day period;

  • 99091 may not be reported with 99457; and

  • If the collection of data and interpretation is done on the day of an E/M service, it is considered part of the visit, and may not be separately reported.

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