CPT 99454 is a cornerstone of remote patient monitoring (RPM) reimbursement, covering the monthly supply of an FDA-approved device and automated transmission of patient-generated health data. In the context of maternity care, this code becomes especially powerful, enabling clinics to monitor high-risk pregnancies more closely while reducing unnecessary in-person visits for low-risk patients. That means better outcomes, fewer disruptions for patients, and improved financial performance for your practice.

Unlike CPT 99453, which is billed once for device setup and education, 99454 can be reimbursed every 30 days as long as the patient transmits health data for at least 16 days within that period.

Beyond reimbursement, CPT 99454-based care directly aligns with national quality standards and guidelines, including:

  • American College of Obstetricians and Gynecologists (ACOG): Endorses the use of remote monitoring to extend prenatal care and reduce disparities in access.
  • USPSTF: Recommends regular monitoring of maternal blood pressure, glucose, and weight to prevent perinatal complications.
  • NCQA/HEDIS: Supports remote management as a method to meet timeliness of prenatal care, postpartum follow-up, and blood pressure control measures.
  • AMA: Advocates for digital tools like RPM to support maternity care management, shared decision-making, and equity in care access.
  • AIM Patient Safety Bundles: by enabling continuous remote monitoring of vital signs and symptoms for early identification and timely response to conditions like hypertension
  • MiPATH recommendations by facilitating personalized, data-driven prenatal care through remote monitoring

How CPT 99454 Supports Maternity Care

Remote monitoring is a game changer for maternity patients. By leveraging CPT 99454:

  • High-risk pregnancies (e.g., patients with hypertension, gestational diabetes, or preeclampsia risk) can be monitored proactively at home, enabling early intervention without the need for frequent clinic visits.
  • Low-risk patients benefit by avoiding unnecessary travel and time away from work or childcare while still staying connected to their care team.
  • Clinics can optimize appointment schedules, prioritize in-person care for those who need it most, and generate consistent reimbursement for ongoing monitoring.

This code helps bridge gaps in access while providing a scalable model for hybrid prenatal care.

99454 at a Glance: Key Facts for Providers

  • Reimburses monthly for RPM devices transmitting health data for at least 16 days within a 30-day period.
  • Does not require time-based provider interaction only data transmission is needed.

Who Can Bill CPT 99454?

This code can be billed by:

  • Physicians
  • Advanced Practice Registered Nurses (APRNs)
  • Clinical staff under general supervision of a qualified healthcare provider

Only one provider may bill 99454 per patient per 30 days, even if multiple devices are used.

Requirements to Bill CPT 99454

To qualify:

  1. The device must be FDA-cleared.
  2. It must automatically transmit data – manual uploads don’t count.
  3. There must be at least 16 days of transmitted data during the billing period.
  4. Only one claim per patient per month is allowed.

Devices That Qualify and Their Role in Maternity Care

RPM devices used for maternity care that may qualify under CPT 99454 include:

  • Blood pressure monitors – vital for tracking signs of gestational hypertension or preeclampsia.
  • Weight scales – useful for monitoring excessive or insufficient weight gain.
  • Pulse oximeters – to ensure proper oxygen saturation, particularly in patients with respiratory complications.
  • Blood glucose monitors – essential for managing gestational diabetes.

The device must automatically transmit data to qualify for reimbursement.

Pairing CPT 99454 with Other RPM Codes

Combining 99454 with codes like 99457 and 99458 can supercharge care delivery and revenue. For example:

  • CPT 99454 covers the device and transmission of physiological data.
  • CPT 99457 and 99458 or CCM codes reimburse for care team time spent reviewing that data, making treatment changes, and communicating with the patient.

This combination supports continuous engagement, better management of complications, and stronger clinic finances.

Tips for Success: Best Practices and Pitfalls

  • Best Practices:
  • Confirm 16 days of device-transmitted data each month.
  • Ensure device connectivity and troubleshoot transmission failures early.
  • Maintain detailed documentation to support audit readiness.
  • Consider bundling with other RPM codes for broader care and higher reimbursement.
  • Common Errors to Avoid:
  • Billing with fewer than 16 days of data.
  • Submitting multiple 99454 claims for one patient in a month.
  • Using devices that are not FDA-cleared or require manual data upload.

Final Thoughts: Why CPT 99454 Matters in Prenatal and Postpartum Care

CPT 99454 is more than a billing code. It’s a tool to:

  • Enhance safety and outcomes for high-risk maternity patients.
  • Reduce patient burden for those with healthy pregnancies.
  • Sustain your RPM program financially without requiring extra time-based interaction.

As maternity care continues to evolve toward a hybrid model, CPT 99454 ensures that providers can offer continuous, connected care that is both high-quality and financially viable.

How Marani Helps You Get the Most Out of CPT 99454

At Marani, we specialize in helping maternity clinics turn CPT 99454 into a powerful tool for increasing reimbursement, boosting patient engagement, and improving maternal outcomes.

Our end-to-end platform is built specifically for pregnancy care and takes the complexity out of remote patient monitoring. With Marani, your clinic can confidently scale its RPM program without adding administrative burden.

What We Offer:

  • Automated device delivery – Seamless logistics get FDA-approved devices into patients’ hands fast.
  • Real-time data transmission – Continuous, automatic uploads ensure you meet the 16-day billing threshold.
  • Escalation logic & clinical alerts – Smart rules flag abnormal readings and notify your care team instantly.
  • Workflow integration – We fit into your existing systems and processes, minimizing disruption and improving staff efficiency.
  • Configurable & customizable platform – Tailor our tools to fit your clinic’s protocols, staffing, and goals.
  • Affordable, value-based pricing – Whether you’re a solo OB practice or a large health system, our pricing structure is designed to deliver ROI under any operational model.

Proven Results for Maternity Clinics:

Marani’s technology is already driving better care for high-risk patients, reducing unnecessary in-person visits, and generating sustained reimbursement through CPT 99454 and other RPM codes. Clinics using our platform have seen measurable improvements in both care quality and financial performance.

Let Marani power your RPM strategy so you can focus on what matters most: supporting healthy pregnancies.