An Ounce of Prevention
February 1, 2024 update: The AMA issued an unexpected and unusual notice that the application for the RPM code redesign had been withdrawn and would not be covered in its 2024 CPT Editorial Panel meeting. No rationale was offered, so we are working to uncover more information. Stay tuned! -------------------- The American Medical Association (AMA) has announced the agenda for its first quarter 2024 CPT Editorial Panel meeting in February, and it includes a surprising proposed full redesign of all remote patient monitoring (RPM) CPT codes.
Available on-demand webinar: Building Successful FQHC and RHC Remote Patient Monitoring Programs * * * The 2024 Medicare Physician Fee Schedule (PFS) final rule included news of great interest to federally qualified health centers (FQHCs) and rural health clinics (RHCs), with perhaps no developments bigger thanCMSfinalizing its policy to reimburse FQHCs and RHCs for remote patient monitoring and remote therapeutic monitoring services.
Arthritis is probably one of the most bothersome and frustrating health issues patients face. Classified as both degenerative and chronic, arthritis not only produces pain, but it can also increase symptoms of anxiety and depression, impact independence, contribute to sleep problems, and lead to a host of other chronic health issues due to neglectful self-management of the disorder. Fortunately, patients with the two most common types of arthritis — osteoarthritis and rheumatoid arthritis — are eligible for participation in both chronic care management (CCM) and remote patient monitoring (RPM) services.
The 2024 physician fee schedule (PFS) proposed rule from the Centers for Medicare & Medicaid Services (CMS) had a number of noteworthy proposals. Among them: three potential new care management services intended to help patients, including those with unmet social determinants of health (SDOH) needs and cancer, better navigate and overcome barriers to receiving services and support. These services, which CMS indicated it would pay for separately, are community health integration (CHI), principal illness navigation (PIN), and social determinants of health risk assessments.
In its 2024 physician fee schedule (PFS) proposed rule, the Centers for Medicare & Medicaid Services is proposing the development and reimbursement of a new service it's calling "principal illness navigation," or PIN.
The Centers for Medicare & Medicaid Services (CMS) has announced a new voluntary primary care initiative that further demonstrates its intent to invest in and grow chronic care management (CCM).
Two Medicare administrative contractors (MACs) that co-hosted a multi-jurisdictional meeting to discuss efficacy of remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) have announced they will not pursue a local coverage determination (LCD) on RPM and RTM for non-implantable devices.
On May 11, 2023, the U.S. COVID-19 public health emergency (PHE) came to an end. While the declaration was largely symbolic, coming more than three years after the PHE was declared, it was still significant from a regulatory perspective in areas including remote patient monitoring (RPM) and telehealth.
MultipleMedicare administrative contractors (MACs) recently held a virtual, multi-jurisdictional meeting to discuss efficacy of remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM). The meeting lasted two-plus hours and included commentary from more than 50 subject matter experts, mostly physicians from various specialties who have experience with RPM and RTM.
Over the past several years, the stars have aligned for remote patient monitoring (RPM). An overhaul of the RPM CPT codes (99453, 99454, 99457, and 99458) made RPM into a lucrative Medicare management program. Medicare is making it easier for organizations to provide RPM services, and private-payer coverage of RPM is growing. The COVID-19 pandemic helped drive the adoption and use of remote patient monitoring devices in healthcare. Finally, a rapidly growing number of patients are interested in virtual care services like RPM, their interest largely fueled by the public health emergency. These factors and others make it an optimal time to consider launching or growing RPM programs — especially when RPM is included in a more comprehensive care management program. Another motivating factor for organizations is they now have many choices of remote patient monitoring medical devices to offer patients and include in their programs. From these options, organizations can select the devices that will best meet the short- and long-term care needs of their patients and maximize RPM programs’ revenue potential.