Digitally Stored Data Services/Remote Physiologic Monitoring
The two new codes—99473 and 99474—support home blood-pressure monitoring, which provides useful information physicians can use to better diagnose and manage hypertension. Home BP monitoring also helps patients to take an active role in the process.
- 99473: Self-measured blood pressure using a device validated for clinical accuracy; patient education/training and device calibration;
- 99474: separate self-measurements of two readings one minute apart, twice daily over a 30-day period (minimum of 12 readings), collection of data reported by the patient and/or caregiver to the physician or other qualified health care professional, with the report of average systolic and diastolic pressures and subsequent communication of a treatment plan to the patient.
Remote Physiologic Monitoring Treatment Management Services
- 99457: 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;
- 99458: each additional 20 minutes (List separately in addition to code for primary procedure).
Chronic Care Management and Complex Chronic Care Management
- G2064: Comprehensive care management services for a single high-risk disease, e.g., Principal Care Management, at least 30 minutes of physician or other qualified health care professional time per calendar month with the following elements: One complex chronic condition lasting at least 3 months;
- G2065: Comprehensive care management for a single high-risk disease service, e.g. Principal Care Management, at least 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month with the following elements: one complex chronic condition lasting at least 3 months;
- 99490: Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month;
- G2058: Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month;
- 99487: Complex chronic care management 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, establishment or substantial revision of a comprehensive care plan, moderate or high complexity medical decision making; 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month;
- 99489: Complex chronic care management services, each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.
- 99497: Advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or surrogate;
- 99498: Advance care planning; each additional 30 minutes.
Behavioral Health Management
- 99484: Care management services for behavioral health conditions, at least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional time, per calendar month.
