New Hampshire Medicaid Program
Medicaid Coverage of Remote Patient Monitoring and
Store & Forward Telehealth Services
New Hampshire Medicaid now covers remote patient monitoring and store & forward telehealth services as required with the passage of NH SB258 to amend RSA 167:4-d. The following new procedure codes have been added to MMIS with an effective date of 10/1/2023.
CPT code 99453: “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.” This service may be billed once per year.
CPT code 99454: “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.” This service may be billed once per month.
CPT code 99457: “Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.” Max unit of one per month
CPT code 99458: CPT code 99458 (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; additional 20 minutes) This service may be billed once per month.
CPT code 99091: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional. This service may be billed once per month.
CPT code G2010 covers “remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment).” This service may be billed twice per month.
These procedure codes do not require a service authorization.
If there are questions on how one of the NH Medicaid Managed Care Organizations (MCO) or Dental Organization (DO) handles the above information, please reach out to your DO or MCO provider representative.
If you have any questions or concerns regarding this notice, New Hampshire Provider Relations is available between the hours of 8:00 AM and 5:00 PM, Monday through Friday at (603) 223-4774 or (866) 291-1674 Toll-Free.