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Remote Patient Monitoring
Remote Patient Monitoring
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Pdf Summary
The document serves as a guide for house call programs on using Remote Patient Monitoring (RPM) services, especially pertinent during and post the COVID-19 pandemic. RPM involves using technology to collect and analyze patient physiological data like blood glucose and blood pressure, which are transmitted digitally to healthcare providers. Although RPM is not classified as telehealth by the Centers for Medicare and Medicaid Services (CMS), it presents continued technological and reimbursement opportunities beyond the Public Health Emergency (PHE).<br /><br />**Key Points:**<br /><br />1. **Definition and Purpose:** RPM uses medical devices to gather physiological data to inform treatment plans for chronic or acute conditions. The data must be transmitted automatically, not manually reported by patients or caregivers.<br /><br />2. **Provider and Billing Requirements:** RPM can be billed by qualified providers such as physicians, nurse practitioners, and physician assistants. CMS requires an established patient-provider relationship for RPM services to be billed after the PHE.<br /><br />3. **Billing Codes and Data Requirements:** <br /> - **CPT 99453:** For initial setup and patient education, billed once per care episode.<br /> - **CPT 99454:** Device supply with daily recordings or alerts, billed once every 30 days with at least 16 days’ worth of data.<br /> - **CPT 99091:** For 30 minutes of data interpretation by the billing provider, not on the same day as other services.<br /> - **CPT 99457 and 99458:** Time-based codes for interactive communication and care management, requiring a minimum of 20 minutes (CPT 99457) and additional 20 minutes (CPT 99458).<br /><br />4. **Regulatory Compliance and Documentation:** Providers must ensure medical necessity, obtain patient consent, and adhere to CMS guidelines for RPM devices and data transmission.<br /><br />5. **Interoperability with Other Services:** RPM can be integrated with Chronic Care Management, Transitional Care Management, and Behavioral Health Integration services, ensuring proper time documentation to avoid double-counting.<br /><br />6. **Guideline Resources:** The document highlights resources developed by HCCI for further assistance, including webinars, virtual office hours, and downloadable tools.<br /><br />This structured guidance aims to assist healthcare providers in effectively implementing RPM services while ensuring compliance with CMS requirements to optimize patient care and reimbursement opportunities.
Keywords
Remote Patient Monitoring
RPM
COVID-19
CMS
billing codes
physiological data
CPT 99453
CPT 99454
CPT 99457
CPT 99458
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