How much does Medicare pay for CPT 99453?

Medicare allowed an average of $20.35 per service and paid $15.75 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $54.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 99453?

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment. It was billed 184,783 times to 172,589 Medicare beneficiaries by 3,258 providers in 2024.

Does 99453 pay differently in an office than a hospital?

Yes. The allowed amount averaged $20.34 in an office setting and $21.16 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 99453 most?

Internal Medicine, with 41,278 services from 791 clinicians. Next are Cardiology, Geriatric Medicine, Family Practice.

CPT 99453

Remote monitoring of physiologic parameters, initial set-up and patient education on use of equipment

$20.35Medicare-allowed amount per service, averaged across 184,783 services

Providers submitted

$54.83

Asking price, not received

Medicare allowed

$20.35

The fee schedule figure

Medicare paid

$15.75

Balance is patient coinsurance

Providers submitted an average of $54.83 for this code and Medicare allowed $20.35 — 2.7× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $15.75 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $20.34
Hospital / facility: $21.16

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 181,847 services were billed in an office setting and 2,936 in a facility.

Services: 184,783
Beneficiaries: 172,589
Providers billing it: 3,258
Total allowed: $3,760,334

What Medicare pays for CPT 99453

Across 184,783 services billed by 3,258 providers to 172,589 beneficiaries, Medicare allowed an average of $20.35 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99453

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	41,278	37,388	$21.06	791
Cardiology	34,668	33,547	$20.36	564
Geriatric Medicine	26,637	23,210	$20.79	11
Family Practice	22,786	22,149	$20.48	610
Nephrology	11,663	11,458	$19.67	324
Nurse Practitioner	11,473	10,856	$17.33	351
Interventional Cardiology	6,466	6,355	$20.07	138
Radiation Oncology	5,107	5,060	$20.88	1
Emergency Medicine	3,967	2,639	$21.55	31
Pulmonary Disease	2,996	2,859	$19.67	60
Physician Assistant	2,440	2,296	$18.00	72
Sleep Medicine	2,127	2,097	$19.88	12
Endocrinology	2,026	1,831	$21.15	36
General Practice	1,528	1,504	$21.82	33
Orthopedic Surgery	1,487	1,424	$19.37	30

99453 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Connecticut	30,205	$21.17	$15.53	14
California	29,898	$22.74	$14.94	529
Florida	15,005	$19.43	$15.05	262
Texas	14,440	$19.25	$15.02	311
New York	12,155	$21.79	$14.90	243
Arizona	10,113	$18.73	$14.69	197
Michigan	7,491	$20.36	$15.41	77
Missouri	6,841	$19.34	$15.37	33
Illinois	6,449	$20.21	$14.92	147
Georgia	5,122	$18.39	$14.78	120
Virginia	4,981	$19.37	$14.93	119
New Jersey	3,871	$21.94	$14.88	126
Maryland	3,294	$27.79	$14.48	101
Tennessee	3,030	$17.29	$14.37	81
Louisiana	1,915	$16.95	$14.40	44
Arkansas	1,895	$16.43	$14.95	49
Oklahoma	1,819	$17.34	$14.74	45
Alabama	1,735	$16.76	$14.40	63
Massachusetts	1,594	$20.28	$14.88	27
South Carolina	1,592	$17.90	$14.72	52
North Carolina	1,472	$17.72	$14.86	59
Indiana	1,438	$17.56	$13.96	53
Nevada	1,406	$19.29	$14.58	49
Kentucky	1,385	$18.06	$14.31	22
Pennsylvania	1,381	$18.96	$14.78	43
Utah	1,367	$18.19	$14.30	30
Ohio	1,312	$18.47	$14.68	29
Kansas	1,186	$18.00	$15.27	25
Colorado	1,162	$20.27	$15.19	41
Washington	1,114	$19.86	$14.13	42
Mississippi	1,081	$16.18	$14.09	37
Delaware	790	$19.54	$14.72	13
District of Columbia	754	$23.10	$15.49	7
New Mexico	734	$17.87	$14.37	25
Oregon	615	$19.02	$14.57	18
New Hampshire	589	$18.45	$13.52	18
Hawaii	466	$21.14	$14.54	9
Nebraska	447	$17.31	$14.17	21
Idaho	411	$16.88	$14.69	7
Maine	409	$19.98	$15.40	4
Iowa	399	$17.13	$14.00	21
South Dakota	338	$18.53	$15.50	3
Alaska	296	$20.76	$12.05	11
Wisconsin	218	$17.25	$13.74	8
West Virginia	166	$18.34	$14.98	5
Minnesota	144	$18.77	$13.59	10
Montana	107	$19.78	$15.64	3
Wyoming	96	$19.50	$14.69	1
North Dakota	30	$18.20	$14.79	2
Vermont	25	$17.94	$14.63	2

Related codes

99490Chronic care management services$59.70
99439Chronic care management services for two or more chronic conditions$46.13
99497Advance care planning$73.95
99457Management using the results of remote vital sign monitoring per calen$48.61
99458Management using the results of remote vital sign monitoring per calen$39.11
99454Remote monitoring of physiologic parameters$47.97
99489Complex chronic care management services for two or more chronic condi$67.00
99442Telephone medical discussion$83.84
99443Telephone medical discussion$120.39
99487Complex chronic care management services for two or more chronic condi$124.70
99496Transitional care management services for problem of high complexity$252.87
99426Principal care management services for a single high-risk disease$60.08

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.