CCP RPM & Telehealth Delivery 2

Question 1

Under Medicare's RPM benefit, what is the minimum number of days per 30-day period that physiologic data must be transmitted for the monitoring service code to be billed?

Accepted Answer

16 days

Answer

Medicare requires that physiologic data be transmitted at least 16 days out of any 30-day period to bill RPM monitoring codes (e.g., CPT 99457).

Question 2

A patient enrolled in an RPM program stops transmitting blood glucose readings for three consecutive weeks. What is the most appropriate care team action?

Accepted Answer

Attempt outreach via phone or portal to assess barriers

Answer

Proactive outreach to identify and address barriers (technology issues, health status changes, low engagement) is the recommended step before considering disenrollment.

Question 3

Which telehealth modality is considered most appropriate for an initial RPM setup and patient education session?

Accepted Answer

Synchronous audio-video visit

Answer

A synchronous audio-video visit allows real-time demonstration of device use, patient Q&A, and assessment of readiness, which is ideal for onboarding.

Question 4

Which of the following is NOT a required element for billing CPT 99453 (RPM device setup and patient education)?

Accepted Answer

At least one interactive communication during the month

Answer

CPT 99453 covers device setup and education only; interactive communication is a requirement for the ongoing management codes (99457/99458), not 99453.

Question 5

A 68-year-old Medicare patient with COPD is enrolled in remote pulmonary monitoring. The care team spends 22 minutes in a month reviewing data and communicating with the patient. Which CPT code combination is most appropriate?

Accepted Answer

99457 + 99458

Answer

99457 covers the first 20 minutes of RPM management, and 99458 is an add-on for each additional 20 minutes; 22 minutes triggers both codes.

(CCP) Chronic Care Professional Certification Practice Test

(CCP) Chronic Care Professional Certification Practice Test

CCP RPM & Telehealth Delivery 2