Medicare Expands Remote Patient Monitoring Reimbursement

Great news for Medicare patients and their doctors: the Center for Medicare & Medicaid Services (CMS) has expanded its reimbursement options for healthcare providers who use remote patient monitoring technology to manage and coordinate care.

This means providers will have more incentive than ever to adopt remote patient monitoring (RPM) workflows and technology. Even better, patients will have new opportunities to connect with providers from home.

It’s a win for everyone involved.

Doctor with clipboard and medical supplies for remote patient monitoring

 

CMS Adds Three New Remote Patient Monitoring Codes

Let’s get into the details. Earlier this month, CMS issued its final rule on “Chronic Care Remote Physiologic Monitoring,” detailed in its 2019 Physician Fee Schedule and Quality Payment Program. Important changes include the creation of 3 new RPM codes that expand on CPT code 99091. These new codes clarify how care providers use technology and staff to implement RPM.

The RPM codes that will take effect on January 1, 2019 are:

  • CPT code 99453, which concerns remote monitoring of physiologic parameters like weight, blood pressure, and pulse oximetry, and which covers time spent on the initial set-up of remote monitoring equipment and related patient training
  • CPT code 99454, which concerns the same physiologic parameters as 99453 and offers reimbursement for monitoring devices that supply providers with daily recordings or programmed alert transmissions
  • CPT code 99457, which concerns “remote physiologic monitoring treatment management services” and covers time spent by providers on interactive communication with a patient or caregiver (with a minimum of 20 minutes per calendar month required for billing)

 

What This Means for Medicare Patients & Doctors

In short, doctors will be reimbursed for RPM set-up costs, virtual check-ins, and remote evaluation of patient-submitted videos and images. Such developments encourage providers to adopt new technology to monitor patients and provide ongoing care remotely.

Crucially, CPT 99457 specifies that “clinical staff” such as nurses and medical assistants can provide RPM services along with doctors. This caveat will make RPM implementation even more attractive to clinics already stretched thin.

This is great news for doctors, for whom RPM now makes even more practical, professional, and financial sense. And for patients with chronic conditions like hypertension and diabetes, tailored care plans and extra attention between visits can only help.

Previous RPM benefits focused mostly on rural providers, but access issues are not limited to such populations. These CMS updates will undoubtedly help bridge gaps between patients and their doctors.

To learn more about how Salusive helps clinics support these new Medicare programs, click here to schedule a meeting with our product specialists and our team will reach out to you.

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