{"id":7214,"date":"2019-06-22T18:50:01","date_gmt":"2019-06-22T18:50:01","guid":{"rendered":"http:\/\/tele.healthcare\/?p=7214"},"modified":"2019-06-22T18:50:01","modified_gmt":"2019-06-22T18:50:01","slug":"why-is-almost-no-one-billing-for-remote-patient-monitoring","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/why-is-almost-no-one-billing-for-remote-patient-monitoring\/","title":{"rendered":"Why is (almost) no one billing for remote patient monitoring?"},"content":{"rendered":"\n<figure class=\"wp-block-image\"><a href=\"mailto:demorequest@mtelehealth.com?subject= mTelehealth%20Remote%20Patient%20Monitoring%20and%20Virtual%20Exam%20Solutions%20- Information%20and%20Demo%20Request%20-%20Why%20is%20(almost)%20no%20one%20billing%20for%20remote%20patient%20monitoring?&amp;body=Please%20enter%20the%20following%20information%20and%20click%20\u201cSEND\u201d%20to%20forward%20your%20email%20to%20our%20attention.%20%20Upon%20receipt,%20a%20representative%20from%20mTelehealth%20will%20contact%20you%20in%20order%20to%20provide%20the%20information%20requested,%20answer%20any%20questions,%20and\/or%20to%20set%20up%20a%20demonstration%20of%20our%20mTelehealth%20Remote%20Patient%20Monitoring%20and%20Virtual%20Exam%20Solutions.%0A%0AFull%20Contact%20Name:%0A%0AOrganization:%0A%0ATitle:%0A%0AEmail%20Address:%0A%0APhone:%0A%0AWould%20You%20Like%20a%20Demo%20of%20Our%20Remote%20Patient%20Monitoring%20(RPM)%20Solution?:%0A%0AWould%20You%20Like%20a%20Demo%20of%20Our%20Virtual%20Exam%20Solution?:%0A%0AAdditional%20Questions%20and%20Information%20Requested:%0A%0A\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"148\" src=\"https:\/\/mtelehealth.com\/wp-content\/uploads\/2019\/10\/Request-A-Demo-Heart.jpg\" alt=\"Request A Demo from mTelehealth\" class=\"wp-image-25972\"\/><\/a><\/figure>\n\n\n\n<p><strong>Did\nyou know that there are eight CPT codes that could generate potentially\nmillions of dollars of annual revenue for your organization without\nsignificantly changing provider workflows \u2014 and that would also help you\ndeliver better care?<\/strong> <\/p>\n\n\n\n<p>The Centers for Medicare and Medicaid Services\u2019 (CMS) remote patient monitoring (RPM) codes are here: however, very few organizations seem to know about them, and even fewer are taking advantage of them. <br \/> <br \/>RPM codes appear to be the best-kept revenue-generation secret in healthcare today. Perhaps the main reason the codes have not been more fully embraced is the misconception that phone calls to patients are required. Trying to get a patient on the phone is difficult and the calls can be time-consuming, but the fact is that RPM codes do not require phone calls. Rather, RPM can be delivered through electronic means, such as patients\u2019 mobile devices, to communicate and share data, which significantly reduces providers\u2019 time commitment and workflow disruption.<\/p>\n\n\n\n<p>Perhaps another RPM concern among providers is being flooded with irrelevant information from patients they are monitoring. However, with the right type of mobile-enabled RPM (mRPM) platform, providers can tightly control the amount and frequency of information collected, so it\u2019s concise and clinically meaningful, while also not a reporting burden on patients. <br \/> <br \/>By launching an mRPM program, healthcare organizations can grow a significant new revenue stream. Moreover, they can improve care quality by capturing and analyzing timely and relevant data that they can use to improve chronic condition management, avoid emergency department visits, ensure safe recoveries, and bring about overall better outcomes. <br \/> <br \/> <strong>The lesser-known RPM codes<\/strong> <\/p>\n\n\n\n<p>Less\nthan a year later, CMS unveiled three new RPM codes, 99457, -453, -454, with\nthe official collective title: \u201cChronic Care Remote Physiologic Monitoring.\u201d\nAgain, the codes do not require telephonic communication with the patient, but\nrather, as stated in the -454 description, only \u201cinteractive communication with\nthe patient\/caregiver during the month.\u201d What also needs to be more widely\nknown is that with -453 code, CMS will reimburse providers simply for helping\nthe patient set up and learn how to use any home health device, such as a blood\npressure cuff or a pulse oximetry device. <br \/>\n<br \/>\n<strong>Seizing\nthe opportunity<\/strong><\/p>\n\n\n\n<p>To get an idea of how much more organizations could be earning with RPM, let\u2019s take a hypothetical example of the 99091 code, which requires 30 minutes a month to collect and interpret physiologic data, such as blood pressure. Thirty minutes a month is not a stretch if the patient is checking their blood pressure once a week and then sending the reading to the physician\u2019s office through their mobile device. <br \/> <br \/>The average reimbursement for 99091 code in 2018 was $58.68, according to the American College of Physicians. So even if a solo practice only wants to monitor a group of 100 patients with hypertension on Medicare, they could still earn an extra $70,416 a year. That\u2019s only 100 patients and doesn\u2019t include other RPM codes that can be billed concurrently, such as the CCM codes if the patient has two or more chronic conditions. <br \/> <br \/>Maximizing this opportunity requires mobile and automation. Data collection and communication should be through the patient\u2019s mobile device using an app that can efficiently collect biometric, objective and subjective data, along with social determinants of health information through short, easy-to-answer surveys that are automatically sent from and then returned to the provider. <br \/> <br \/>To prevent providers from becoming overburdened, the mRPM program needs to be highly structured to a specific condition(s) or clinical event(s) and carefully scheduled so the provider is the information gatekeeper, preventing a data deluge. To ensure safety, patients should always have the opportunity to call the physician directly if they have health concerns. <br \/> <br \/>Further maximizing this opportunity, the non-chronic-care RPM codes could be used for monitoring a wide range of other conditions and health events, such as post-emergency department discharge monitoring, new medication adjustment, high-risk pregnancies and new mother support (for Medicaid beneficiaries), surgical recovery, and many others.<\/p>\n\n\n\n<p><strong>New\nworld of effective, efficient care<\/strong> <\/p>\n\n\n\n<p>The goal of launching an mRPM program, however, is not simply to generate additional revenue. Rather, collecting data and communicating with patients can help them stay adherent with their care plans. That is because the act of reporting on a consistent, but unobtrusive, schedule requires the patient to regularly consider their condition(s) and their health-related choices, which can influence their behaviors. <br \/> <br \/>Through the reporting, patients are also reminded that their physician is monitoring their behavior and desires their success year-round. This \u201csentinel effect\u201d could be better characterized as a \u201ccared about\u201d effect, developing a patient\u2019s sense of responsibility in their own care plan. Consistent data-sharing opens the door for enhanced communication with the provider, which deepens the trust that is essential for engagement. <br \/> <br \/>By improving engagement and adherence through mRPM, providers can potentially reduce ED utilization and prevent hospitalizations, both of which reduce costs, which would positively affect financial performance under value-based care programs. This means regardless of the payment model, mRPM can improve a healthcare organization\u2019s bottom line without significantly adding to providers\u2019 already enormous workloads. In fact, with the additional revenue generated through an mRPM program, it can become highly cost-effective to add a full-time clinician who enters, analyzes and monitors the patient-reported data, intervenes when necessary, and helps expand the program to more patients and conditions. <br \/> <br \/>The best-kept secret in healthcare no longer needs to be a secret. Billing for these RPM codes is well worth providers\u2019 time, and offering RPM improves outcomes and engages patients. When coupled with a mobile-focused program, RPM will deliver financial and patient care dividends for years to come. <br \/> <br \/> <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Did you know that there are eight CPT codes that could generate potentially millions of [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":5115,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_uag_custom_page_level_css":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[14,186,239,141,143,159],"tags":[],"class_list":["post-7214","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-medicare","category-physician-fee-schedule","category-reimbursement","category-remote-patient-monitoring","category-telehealth"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v23.3 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Why is (almost) no one billing for remote patient monitoring? &#183; Dr. Miltie, LLC - At-Home Testing<\/title>\n<meta name=\"description\" content=\"Did you know that there are eight CPT codes that could generate potentially millions of dollars of annual revenue for your organization without\" 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