Can RPM And CCM Be Billed Together? What Healthcare Providers Should Know

The Short Answer Is Yes, But There Are Rules

If you're running both Remote Patient Monitoring and Chronic Care Management programs, you've probably wondered whether you can bill for both services in the same month. The good news is that CMS explicitly allows concurrent billing for RPM and CCM, as long as each program independently meets all its requirements.

The challenge is that many providers don't realize how strict those requirements actually are. According to CCMRPM Help, a consulting service for care management programs, the most common mistake is assuming that time spent on one program can count toward the other. It can't, and trying to do so creates serious compliance problems.

Understanding The No Double-Counting Rule

Both programs require minimum time commitments each month. CCM needs at least 20 minutes of care coordination, while RPM requires 20 minutes of treatment management time. Those minutes must be tracked separately and cannot overlap, even if you're discussing the same patient during the same call.

For example, time spent reviewing blood pressure data from an RPM device counts toward RPM codes. Time spent coordinating appointments, medication refills, or community resources counts toward CCM. You need clear documentation showing which activities fall under which program, because auditors will check.

What The Research Shows

A 2024 Office of Inspector General report revealed that 43% of Medicare beneficiaries enrolled in RPM didn't receive all three required components of the service. That's a massive compliance gap, and it's exactly why federal audits of these programs have intensified recently.

Meeting Both Sets Of Requirements

Beyond time tracking, each program has its own eligibility criteria and documentation needs. CCM requires patients to have two or more chronic conditions expected to last at least 12 months. RPM can be used for patients with just one condition, but they must have 16 days of device readings each month.

Both programs need separate patient consent forms. You can discuss both during the same initiating visit, but the consent documentation must clearly show the patient agreed to each program individually, including understanding any cost-sharing responsibilities they might have.

The Billing Mechanics

When billing concurrently, you'll submit different CPT codes for each program. CCM uses codes like 99490 for the first 20 minutes, while RPM uses 99457 for its initial 20-minute threshold. Only one provider can bill device codes per patient per month, so coordination is essential if multiple practitioners are involved.

Why Bother With Both Programs?

Running CCM and RPM together creates a powerful combination for patient care and practice revenue. The programs complement each other perfectly since RPM provides the clinical data while CCM offers the care coordination framework. When implemented correctly, practices see better patient outcomes and stronger recurring revenue streams.

Getting these programs right requires attention to workflow design, staff training, and accurate documentation. Many practices find that working with specialists who understand both the clinical and billing sides helps them avoid expensive mistakes and build sustainable care management programs from the start.

CCM RPM Help
City: Herriman
Address: 12953 Penywain Lane
Website: https://ccmrpmhelp.com/
Phone: +1 866 574 7075
Email: brad@ccmrpmhelp.com