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Remote Patient Monitoring Resource
Remote Patient Monitoring Resource
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Pdf Summary
This document serves as a comprehensive guide for house call programs on the utilization of Remote Patient Monitoring (RPM) services in the context of patient care, particularly following the increased need for such technologies during the COVID-19 pandemic. Although RPM is not classified as telehealth by the Centers for Medicare and Medicaid Services (CMS), reimbursable opportunities for RPM will persist beyond the Public Health Emergency (PHE).<br /><br />**Definitions and Protocols:**<br />- **RPM Definition:** It involves using medical devices to collect patient data (e.g., blood glucose, blood pressure), which is then transmitted automatically to healthcare providers. These data assist in developing and managing treatment plans for chronic or acute health conditions.<br />- **Billing Requirements:** RPM services can be billed by qualified providers (physicians, nurse practitioners, physician assistants). Clinical staff can assist in care management under the provider's supervision. Patient consent is required, which can be obtained at service initiation.<br /><br />**Service Requirements:**<br />- **Medical Necessity:** RPM must justify the necessity for diagnosis or treatment.<br />- **Initiation:** RPM must begin during a face-to-face visit or a telehealth visit during PHE for patients not seen in the past year.<br />- **Device Compliance:** The RPM device must meet the FDA’s definition of a "medical device" and must reliably collect and transmit accurate data.<br />- RPM billing codes include CPT 99453 (setup and education), 99454 (device supply with daily recordings), 99457 (treatment management requiring interactive communication for the first 20 minutes), and 99458 (additional 20 minutes).<br /><br />**Billing Guidelines:**<br />- **Duration Requirements:** CMS mandates 16 days of data collection for RPM codes 99453 and 99454. During PHE, a minimum of 2 days suffices for COVID-19 cases.<br />- **Interactive Communication:** Essential for CPT 99457 and 99458, requiring real-time, two-way communication with patients or caregivers.<br /><br />Providers are encouraged to maintain a separate treatment plan specific to RPM services. The sequence for billing RPM services involves setting up the device and collecting the data before progressing to data interpretation and active management.<br /><br />**Additional Resources:**<br />- Home Centered Care Institute (HCCI) offers various tools, webinars, and support for home-based primary care providers via the HCCIntelligence Resource Center.
Keywords
Remote Patient Monitoring
RPM services
house call programs
COVID-19 pandemic
Centers for Medicare and Medicaid Services
billing requirements
medical necessity
FDA compliance
CPT codes
Home Centered Care Institute
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