2025 CPT code 99474
(Active) Effective Date: N/A Revision Date: N/A Evaluation and Management - Remote Physiologic Monitoring Evaluation and Management > Non-Face-to-Face Services Feed
Remote physiologic monitoring; initial set-up and patient education on the use of equipment.
Modifier 25 may be appended if a separately identifiable E/M service is provided on the same day.
Medical necessity is established by the presence of a condition that necessitates remote monitoring to improve patient outcomes. Examples include conditions that require frequent monitoring for timely interventions or those managed through close clinical surveillance.The physician’s clinical judgment should justify the use of remote physiologic monitoring.
The clinician is responsible for setting up the remote monitoring equipment, providing thorough education to the patient on its use, and ensuring the patient understands how to accurately record and transmit the data. The clinician is also responsible forsubsequent review and interpretation of the transmitted data, adjusting the treatment plan as needed, and communicating with the patient.
- Evaluation and Management > Non-Face-to-Face Services
- Evaluation and Management, Non-Face-to-Face Services, Remote Physiologic Monitoring
In simple words: This code covers the initial training and setup for using a special device to remotely monitor your health (like blood pressure or weight).A healthcare professional will teach you how to use the device and how to send your readings to them.
This CPT code, 99474, encompasses the initial setup and patient education related to remote physiologic monitoring.This includes the explanation of the equipment, the monitoring process itself, and how to accurately record and transmit the data. It is specifically for the initial setup; subsequent monitoring is billed under different codes. The monitoring must involve a medical device validated by the FDA, and parameters like weight, blood pressure, pulse oximetry, or respiratory flow rate can be included.
Example 1: A patient with newly diagnosed hypertension is provided with a validated home blood pressure monitor.Code 99474 is used to bill for the initial setup and training of the patient on the device’s use, including how to take and record readings and communicate the data to the practice., A patient with congestive heart failure is given a device to remotely monitor their weight. Code 99474 is used to bill for the initial set-up and training on using the device, including accurate recording of the weight and instructions on when and how to contact the healthcare provider., A patient with chronic obstructive pulmonary disease (COPD) is given a device to monitor their respiratory flow rate. Code 99474 is used to bill for the education and training session in which the clinician explains how to operate the device and understand the data it produces. Instructions for reporting the findings are also included.
Detailed documentation should include the type of remote physiologic monitoring device used, the specific parameters monitored, the date and time of the initial set-up and patient education, and evidence that the patient understands the process of recording and transmitting the data.The device must be FDA-approved. A copy of patient education materials provided would also be beneficial.
** The patient must be actively engaged in the monitoring process.This code does not include the review and interpretation of the data, which is billed separately under other codes such as 99091.Only report this code for the initial setup and education.
- Revenue Code: M5D (SPECIALIST - OTHER)
- RVU: Information not available in provided text.
- Global Days: Not applicable.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Information not available in provided text.
- Specialties:Cardiology, Internal Medicine, Family Medicine, Endocrinology, Nephrology
- Place of Service:Office, Home, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home