Recently, CMS ramped up incentives for remote patient monitoring (RPM) initiatives with the goal of lowering costs of chronic conditions, which currently account for 75% of healthcare costs.
Remote patient monitoring is the use of digital technology, such as connected health devices, to collect patient data and securely send it to healthcare professionals. Examples include activity, blood pressure, and continuous glucose monitors. The goal is to help patients manage their diseases, such as type 2 diabetes or heart disease, remotely, which can have a profound impact on the quality of care and outcomes of their condition.
New CPT Codes
Although Medicare was already offering reimbursement for RPM services, the billing code was more complicated and time consuming and only qualified providers could provide services. The new codes were created because of the reality of technology and staffing, and how they affected RPM services. New CPT codes for RPM include:
99453 – Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, etc) and initial set-up and patient education of the monitoring equipment.
99454 – Device(s) supply with daily recording( s) or programmed alert(s) transmission, each 30 days. (Initial collection, transmission, and report/summary services to the clinician managing the patient).
99457 – Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.
If implemented appropriately by healthcare systems, these codes could generate millions of dollars in revenue and also address the confusion around eligibility that has caused pause of RPM implementation by healthcare professionals.
Moreover, as of 2020, RPM can occur under general rather than direct supervision, which means practices can work with a vendor to supply devices, monitoring platforms, and billing duties. This frees up clinicians’ valuable time when caring for their patients.