{"id":40341,"date":"2022-03-26T12:15:00","date_gmt":"2022-03-26T16:15:00","guid":{"rendered":"https:\/\/mtelehealth.com\/?p=40341"},"modified":"2022-03-26T12:15:00","modified_gmt":"2022-03-26T16:15:00","slug":"4-remote-patient-monitoring-reimbursement-tips-for-your-practice","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/4-remote-patient-monitoring-reimbursement-tips-for-your-practice\/","title":{"rendered":"4 Remote Patient Monitoring Reimbursement Tips for Your Practice"},"content":{"rendered":"\n\n\n

By: Collin Couey<\/a> on March 25, 2022<\/p>\n\n\n\n

Imagine spending precious time and money setting up a remote patient monitoring<\/a> program at your practice only to realize it\u2019s too costly to maintain. If you\u2019re on the fence about setting up such a program, you can avoid that worst-case scenario. We\u2019ll break down the ins and outs of remote patient monitoring reimbursement so you can feel confident that it makes financial sense for you.<\/p>\n\n\n\n

 What is remote patient monitoring?<\/strong><\/p>\n\n\n\n

Remote patient monitoring is a healthcare delivery model that uses tech to monitor patients\u2019 health outside of your clinic or practice. Put simply, remote patient monitoring uses electronically transmitted patient health data to assess and monitor patient vitals remotely.<\/p>\n\n\n\n

Practices that can master the reimbursement component shouldn\u2019t hesitate to reap the many benefits of a remote patient monitoring program<\/a>. For you, it\u2019s a chance to get a more complete look at your patient\u2019s overall condition while boosting your marketing and patient retention efforts. For patients, remote monitoring helps them establish a chronic care management routine and gives them more control over their health.<\/p>\n\n\n\n

Understand how remote patient monitoring coverage works<\/h2>\n\n\n\n

Remote patient monitoring reimbursement is pretty simple from a coverage perspective because it\u2019s covered by Medicare as well 27 state Medicaid<\/a> services. Additionally, many commercial insurance providers cover remote monitoring using their telehealth coverage policies. In fact, the number of commercial insurance providers who offer remote patient monitoring coverage has increased due to the COVID-19 pandemic.<\/p>\n\n\n\n

When planning a remote patient monitoring program, it\u2019s important to take stock of your practice\u2019s patient population to determine whether your practice is a good candidate to make a continual profit. For instance, if you have a lot of Medicaid and Medicare patients with chronic conditions (heart disease, high blood pressure, diabetes, etc.), you probably have enough patients to set up a remote patient monitoring program right away.<\/p>\n\n\n\n

On the other hand, if you\u2019re a smaller independent physician who mostly sees privately insured patients who don\u2019t experience chronic conditions, you might not be well set-up to start a remote patient monitoring program today.<\/p>\n\n\n\n

Additionally, <\/strong>remote patient monitoring should be one of your first thoughts for patients with chronic conditions who prefer telehealth, telemedicine, or at-home treatment who are insured or qualify for Medicare or (in some cases) Medicaid services because they are covered and your reimbursement process will be simple.<\/p>\n\n\n\n

 Key considerations: <\/strong>If you want to start a remote patient monitoring program, it\u2019s important to have a firm grasp on your patient population. Running patient surveys to gauge interest is a great place to start once you know if your patient population can support a robust and profitable remote patient monitoring program.<\/p>\n\n\n\n

Know which CPT codes are crucial for remote patient monitoring reimbursement<\/h2>\n\n\n\n

If you want to be reimbursed, you need to know which Current Procedural Terminology (CPT) codes are important for remote patient monitoring services.<\/p>\n\n\n\n

The five primary Medicare RPM codes are CPT codes: 99453, 99454, 99457, 99458, and 99091. Remote patient monitoring codes are considered evaluation and management (E\/M) services and can be ordered and billed only by a healthcare provider or non-physician provider who are eligible to bill Medicare E\/M services.<\/p>\n\n\n\n

Most remote patient monitoring services will be billed under four codes that are split into two categories: service codes and timed remote patient monitoring management codes.<\/p>\n\n\n\n

Remote patient monitoring service codes<\/h3>\n\n\n\n

CPT code 99453<\/strong> and 99454<\/strong> are practice expense only codes specifically related to device set-up and education and are valued to cover clinical staff time, supplies, and equipment, including the medical device<\/a> for remote monitoring.<\/p>\n\n\n\n

Remote patient monitoring management codes<\/h3>\n\n\n\n