2024 Payment Rates for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Principal Care Management (PCM), Remote Therapeutic Monitoring (RTM), and other Virtual Care Programs

Code

CMS Description

2024 Rate

Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment)

Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days) [minimum 16 readings each 30 days]

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (list separately in addition to code for primary procedure)

Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) provided personally by a physician or other QHP, a minimum of 30 minutes of time during the month.

Chronic Care Management (CCM) services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements: Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; Chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; Comprehensive care plan established, implemented, revised, or monitored

Chronic Care Management (CCM) services, each additional 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar month

Rural health clinic or federally qualified health center (RHC or FQHC) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an RHC or FQHC practitioner (physician, NP, PA, or CNM), per calendar month

Chronic Care Management (CCM), provided personally by a physician or other qualified health care professional, at least 30 minutes of physician or other qualified health care professional time, per calendar month, with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient; chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline; comprehensive care plan established, implemented, revised, or monitored

Chronic Care Management (CCM) services each additional 30 minutes by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Principal Care Management (PCM), for a single high-risk disease first 30 minutes of clinical staff time directed by physician or other qualified health care professional, per calendar month (replaces G2065)

Principal Care Management (PCM) services, for a single high-risk disease each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Principal Care Management (PCM) services for a single high-risk disease first 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (replaces G2064)

Principal Care Management (PCM) services for a single high-risk disease each additional 30 minutes provided personally by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Complex chronic care management (CCCM) services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months,
or until the death of the patient, chronic conditions place the patient at significant risk of death,
acute exacerbation/decompensation, or functional decline, comprehensive care plan established,
implemented, revised, or monitored, moderate or high complexity medical decision making; first
60 minutes of clinical staff time directed by a physician or other qualified health care
professional, per calendar month

Complex chronic care management (CCCM) services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored, moderate or high complexity medical decision making; each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment

Remote therapeutic monitoring (e.g., respiratory system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s), manual reporting by patient, and/or programmed alert(s) transmission to monitor respiratory system, each 30 days [16 readings minimum each 30 days]

Remote therapeutic monitoring (e.g., musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s), manual reporting by patient, and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days [16 readings minimum each 30 days]

Remote therapeutic monitoring treatment management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, requiring at least one interactive communication with the patient/caregiver during the calendar month

Remote therapeutic monitoring treatment management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure)

Behavioral Health Integration (BHI)

99484

BHI services, at least 20 minutes of clinical staff time (does not require specialized Behavioral Health Care Manager) per calendar month, may be delivered under general supervision of a physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow-up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella. 

Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatric consultant, under general supervision of the treating physician or other qualified health care professional. Includes time-tracking and documentation in registry, initial assessment including rating scales (e.g. PHQ-9), assignment of treatment plan.

99493

Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of Behavioral Health Care Manager activities, in consultation with a psychiatric consultant, and under general supervision of the treating physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella. 

Subsequent psychiatric collaborative care management, each additional 30 minutes in a subsequent month of Behavioral Health Care Manager activities (beyond the 99493 60 minutes), in consultation with a psychiatric consultant, under the general supervision of the treating physician or other qualified health care professional, with the following required elements: registry for time and documentation recording and documentation, initial assessment and follow up utilizing rating scales (e.g. PHQ-9), coordinating care as needed under the mental health umbrella.