HCCIntelligence Recording: 2022 Coding & Policy Impacts-December 2021-Remote Patient Monitoring Resource

Remote Patient Monitoring Resource

Pdf Summary

The guidance document aims to assist house call programs in implementing Remote Patient Monitoring (RPM) services for patient care, spotlighting its importance especially post COVID-19 pandemic. RPM involves using medical devices to gather and analyze patient data to tailor treatment plans, treating chronic or acute conditions. The Centers for Medicare and Medicaid Services (CMS) distinguishes RPM from telehealth, ensuring its continuation beyond the Public Health Emergency (PHE). RPM services can be billed by qualified providers, with care management collaboratively done by clinical staff.<br /><br />Key requirements for billing RPM include medical necessity, initiation during face-to-face visits, patient consent, and usage of FDA-defined medical devices. RPM billing codes include:<br /><br />1. **CPT 99453:** For initial setup and patient education on device use, billable once per care episode.<br />2. **CPT 99454:** For device supply and data transmission, billed monthly with at least 16 days of data.<br />3. **CPT 99091:** For the collection and interpretation of data over a 30-day period, requiring 30 minutes of provider time.<br />4. **CPT 99457:** Care management service requiring interactive communication and at least 20 minutes of clinical staff/provider time monthly.<br />5. **CPT 99458:** Additional 20 minutes service code, reportable with CPT 99457.<br /><br />RPM services can be conducted for new and established patients during the PHE, but post-PHE, an established patient-provider relationship is necessary. The document outlines that RPM can be billed alongside Chronic Care Management (CCM) and other services, as long as time is not double-counted.<br /><br />The sequence for billing is:<br />1. **CPT 99453** for the initial setup.<br />2. **CPT 99454** after collecting 16 days of data.<br />3. **CPT 99091**, following 30 days of data analysis by the provider.<br />4. **CPT 99457**, and possibly **CPT 99458**, after ensuring the care plan and ongoing management.<br /><br />The resource center offers additional tools, tips, and webinars to support home-based primary care providers.

Keywords

Remote Patient Monitoring

RPM services

COVID-19

Centers for Medicare and Medicaid Services

CMS

billing codes

CPT codes

medical devices

care management

home-based primary care