RPM CPT Framework

Remote Patient Monitoring (RPM) programs rely on specific CPT codes that define eligible services for reimbursement. Chorus supports RPM workflows aligned with commonly used CPT codes to help healthcare organizations structure their monitoring programs appropriately.

Clinical Traceability

Chorus does not replace existing billing systems; instead, it provides structured documentation seamlessly linked to FHIR resources. This creates claim-ready data backed by defensible, auditable physiological and encounter histories.

Common RPM CPT Codes

The following table summarizes the primary CPT codes supported by Chorus event-driven billing logic:

CPT Code	Description	Requirement Summary	Chorus Automation
99453	Enrollment	Initial device setup & training	Captures onboarding date, device assignment, and initial education logs.
99454	Data Transmission	16 days of data within 30 days	Tracks daily transmission counts and automatically flags when the 16-day criteria is met.
99457	Care Management	First 20 minutes of engagement	Aggregates time spent on clinician review, secure messaging, and video calls per month.
99458	Additional Time	Additional 20-minute increments	Computes subsequent engagement thresholds beyond the initial 99457 block.
99091	Physician Review	30 minutes of clinical review	Tracks dedicated physician time spent interpreting structured data and reports.

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Detailed CPT Workflow Support

CPT 99453 – Enrollment

Covers the initial setup and patient onboarding for remote monitoring programs. Chorus supports enrollment documentation by recording:

• Patient program enrollment date (EpisodeOfCare)
• Device setup and activation (DeviceRequest)
• Initial patient education and training
• Monitoring program initiation

CPT 99454 – Data Transmission

Applies to the supply of devices and the collection of physiological data transmitted from the patient. Chorus tracks:

• Device assignment to the patient
• Incoming biosignal transmissions (blood pressure, glucose, ECG, etc.)
• Device connectivity status
• Monitoring activity over defined 30-day reporting periods

All physiological readings are stored natively as FHIR Observation resources, providing verifiable evidence of data transmission.

CPT 99457 – Care Management

Covers remote monitoring treatment management services that involve interactive communication with the patient. Chorus records patient engagement activities, including:

• Provider-patient communication
• Care management sessions and clinical follow-ups
• Time spent during interventions

These interactions are documented as structured events (Encounter, Communication) linked to the patient record.

CPT 99458 – Additional Time

Applies when additional monitoring time is required beyond the standard care management duration. Chorus tracks incremental time spent in care management activities through structured interaction records, accurately accumulating minutes to trigger this add-on code.

CPT 99091 – Physician Review

Covers the collection and interpretation of physiologic data by a physician or qualified healthcare professional. Chorus supports this documentation through:

• Review of physiological monitoring data
• Interpretation of trends or anomalies
• Documentation of clinical DiagnosticReport findings
• Structured reporting of review outcomes