CMS recently released new CPT Codes meant for use in the reimbursement of Remote Patient Monitoring (RPM) services. In doing so, the agency proclaimed, “We now recognize that advances in communication technology have changed patients’ and practitioners’ expectations regarding the quantity and quality of information that can be conveyed via communication technology. From the ubiquity of synchronous, audio/video applications to the increased use of patient-facing health portals, a broader range of services can be furnished by health care professionals via communication technology as compared to 20 years ago.”
And though they specifically mention audio/video applications, these new codes differ greatly from the previous iterations that were meant to reimburse tele-health Services that connect providers to patients using these A/V plat
The new Remote Patient Monitoring codes are specifically designed to address reimbursement for establishing RPM services, remotely collecting and transmitting health related data from patients to clinicians, reviewing the data collected and interacting remotely with the patient. More information on the specific codes can be found here, in one of my earlier blog posts.
Some of the most notable differences between what qualifies as tele-health and what qualifies as Remote Patient Monitoring are within the requirements for the visual side of contact, rural geographies and originating sites.
Unlike Tele-health, RPM does not specifically require audio/visual interaction between patients and providers and there is no requirement for patients to access or receive services in a rural area. There are also no requirements for originating sites in order to bill for RPM services. However, for RPM services to be reimbursable, patients must have a qualifying face-to-face visit with the provider within one-year prior to the beginning of services. RPM simplifies the contact aspect, noting only that providers are required to deliver 20 minutes of professional time each month which includes interactive communication with the patient or caregiver.
The new regulations also make it easier for healthcare providers to partner with health technology companies to provide Remote Patient Monitoring services. This is because most RPM services can be provided by “clinical staff” under “general supervision” to help fulfill the 20-minute-per-month requirement for providing RPM services. With that provision in place, providers are not required to be in the same place as the staff charged with providing RPM services.
Given this autonomy, choosing the right Remote Patient Monitoring partner gives providers peace-of-mind that the staff they choose to manage RPM will have all of the training and tools necessary to provide high quality services and outstanding patient satisfaction. It also means they’ll be positioned correctly to capture the increased reimbursement possible when all of the requirements are met.
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