E&M 99213 + RPM treatment management (0780T equivalent)
Remote physiologic monitoring services and same-day E&M generally do NOT bundle when distinct services performed.
Why this pair bundles
Remote monitoring is asynchronous from in-person E&M. Separate documentation supports both.
Modifier-bypass policy
Modifier indicator: 1 — modifier 59 / XE / XP / XS / XU permitted when supporting documentation is on file.
Generally separately reportable. Document time and content of each.
Documentation requirements
- RPM monitoring criteria met (16+ days/30, 20+ min interactive time)
- Separate in-person E&M with distinct evaluation
Common clinical scenarios
- Monthly RPM check + in-person visit for unrelated issue
Frequently asked questions
Why does CMS bundle 0780T and 99213?
Remote monitoring is asynchronous from in-person E&M. Separate documentation supports both.
When can I use modifier 59 (or X{EPSU}) to bypass?
Generally separately reportable. Document time and content of each.
What documentation supports separate billing?
RPM monitoring criteria met (16+ days/30, 20+ min interactive time); Separate in-person E&M with distinct evaluation.
When does this conflict typically arise?
Monthly RPM check + in-person visit for unrelated issue.
Related NCCI edits
- E&M 99213 + Joint injection 20610E&M and major joint injection (knee, shoulder, hip) bundle without modifier 25 o
- E&M 99213 + Venipuncture 36415Office E&M and routine venipuncture can be reported together — 36415 is separate
- E&M 99213 + Urine pregnancy test 81025Urine pregnancy test (POC) and office E&M can be reported together — 81025 is se
- E&M 99213 + Vaccine admin 90471E&M 99213 and vaccine administration 90471 bundle without modifier 25 on the E&M
- E&M 99213 + ECG 93000Office E&M and complete ECG can be reported together but require modifier 25 on
- E&M 99213 + Pressurized inhalation (94640)E&M and nebulizer treatment bundle without modifier 25 on the E&M.
Sources
Catch NCCI 0780T/99213 conflicts before submission
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