CMS Releases New RPM and CCM Data: 5 Key Takeaways

The Centers for Medicare & Medicaid Services (CMS) recently released its latest data on the frequency of Medicare providers delivering remote patient monitoring (RPM) and chronic care management (CCM) services. More specifically, the CMS data set shared statistics on the usage of two key CPT codes: (1) for RPM, CPT 99454, used for remote monitoring and management of device readings, and (2) for CCM, CPT 99490, used for the initial 20 minutes of clinical staff time providing care management services.

The CMS data covered submission of these two codes by Medicare providers for all of 2022. Using data compiled from similar CMS data for 2021 both years can be compared roughly 1:1. By looking at the usage of CPT codes 99454 and 99490 in 2022 compared to 2021, we can get a good sense of how the adoption of RPM and CCM is rapidly changing and growing.

Remote Patient Monitoring and Chronic Care Management Data: What We Learned

Here are five of the top takeaways from our analysis of the new data set that help showcase the evolution of RPM and CCM adoption.

1. RPM and CCM code volume increased substantially

According to the 2022 CMS data, RPM CPT 99454 was billed nearly 1,275,000 times, split amongst about 4,300 individual practitioners providing services to about 258,000 patients. This represents a massive increase of 41% in code volume over the 2021 data, which listed about 903,000 uses of 99454 by 3,100 providers with 178,000 patients. The data also shows an increase in providers who used RPM and the number of patients enrolled, with over 80,000 more patients receiving RPM services in 2022.

A less sizable but still significant increase in the use of CCM CPT 99490 also occurred. 99490 was billed about 4,590,000 times in 2022, an over 5% increase compared to the 2021 CMS data, which identified about 4,344,000 uses of 99490. In 2022, these uses were split amongst about 13,600 individual practitioners and 1,033,000 patients, compared to about 12,000 providers supporting 927,000 patients the year prior.

There is every reason to believe that the increased usage of the RPM and CCM CPT codes from 2021 to 2022 has continued through 2023 and into 2024, with more providers taking the time to launch remote patient monitoring and chronic care management programs and enroll more participants in existing programs. The increased use may also point to a growth in the development of comprehensive care management programs, which Prevounce Co-founder Daniel Tashnek, JD, discusses in this Medical Economics report.

2. Top RPM specialties experience a few changes

In 2022, the medical specialties most frequently using RPM CPT 99454 fell largely in line with the 2021 data, although there were a few noteworthy changes in volume for some of the higher utilizers. Looking at the top specialties billing 99454 in 2022 compared to 2021, cardiology, both general and interventional, showed increases in their use of RPM, which elevated general cardiology from third to second and interventional cardiology from ninth to sixth. Geriatric medicine rose a noticeable amount, jumping from the twelfth highest to ninth highest by volume between 2021 and 2022. 

The variance between specialties also changed significantly year over year. While the top three specialties billing 99454 still strongly outpaced other specialties, the middle of the top steadily increased and the gap between the top three and the remaining top 10 specialties decreased substantially.

3. Top CCM provider specialties show strong continuity

The 2022 CCM CPT 99490 data showed almost no change in the order of specialties by volume. The most notable change is with geriatric medicine, echoing a similar change also seen in RPM usage within this specialty. For the use of 99490, geriatric medicine rose from 14th by volume in 2021 to 7th in 2022, with an almost four times increase in code volume from about 32,000 to 128,000.

4. Highest-volume RPM and CCM states share similarity in geography

In general, there is much less variance in code usage volumes between states compared to specialties. California is the clear leader in RPM volume over other states, but the remainder of the top 10 — from Texas at #2 through Connecticut at #10 — are close in volume. For CCM, the numbers are more uniform throughout the top 10. While the states that have been faster to adopt RPM or CCM are slightly different, the top states stay generally the same. Maryland and Virginia earned spots in the top 10 for RPM but not CCM, while Illinois and North Carolina appear in the top 10 CCM list but not in the RPM top 10.

5. Lowest-volume states see uptick in RPM and CCM adoption

The states with the lowest volume of Medicare RPM and CCM services did not change significantly from 2021 to 2022. What is noteworthy is that the average CCM code usage in the bottom 10 states saw a roughly 65% increase from 2021 to 2022. Average RPM code usage by the lowest states also experienced big growth of about 54% year over year.

RPM and CCM CPT Code Data Shows Remote Care Is Being Embraced

The nationwide growth in the billing of RPM CPT code 99454 and CCM CPT code 99490, as supported in this release of 2022 CMS data, suggests that remote patient monitoring and chronic care management are becoming more broadly accepted and valued as a preventive services and beneficial extension of patient care. Increases in the number of providers using these codes and patients receiving the services covered by these codes further supports this sentiment. 

Furthermore, data like the increase in average code usage amongst the lowest-volume states or the decrease in variation between the top 10 specialties for RPM and CCM shows that adoption of RPM and CCM has expanded both geographically and amongst medical specialties. 

And there’s even more good news for the future of remote care management: Data and anecdotal evidence demonstrate the strong return on investment for remote care programs in both patient outcomes and the financial bottom line and also point to the likelihood of the year-over-year trends seen in the CMS data continuing forward. More providers are starting RPM and CCM programs, existing programs are enrolling more patients while increasing their care offerings, and access to remote care across the U.S. is increasing significantly. 

Providers interested in capitalizing on the growing interest in and adoption of remote care management can turn to Prevounce for assistance. Schedule a consultation with us to discuss how we can improve your ability to care for your patients at a distance, help you better understand the benefits of creating a remote care program, or help strengthen and further streamline your existing RPM or CCM programs.

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