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AMA Weighing Substantial Expansion of Remote Patient Monitoring Codes

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Daniel Tashnek

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AMA Weighing Substantial Expansion of Remote Patient Monitoring Codes

The American Medical Association (AMA) has announced the agenda for its second quarter 2024 CPT Editorial Panel meeting in May, and it includes discussion on what would be a significant and welcome expansion of remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) CPT codes.

What is Chronic Care Management: Definition and Key Concepts

Thinking about launching a chronic care management program? Looking to grow an existing CCM program? Don't miss our special webinar, "What Chronic Care Management Success Looks Like in 2024," on March 26. Learn more and register! Chronic care management (CCM) made its debut in 2015 when it was rolled out by the Centers for Medicare & Medicaid Services (CMS) as a separately paid service under the Medicare fee schedule. The rationale behind its inception was to offer an avenue of compensation for practitioners who provided care to their patients outside of the normal confines of the average office visit. The introduction of CCM coincidentally led to a more efficient means of care teams proactively engaging and managing patients with problematic chronic diseases, in turn improving outcomes and reducing treatment costs. CCM also gave providers a new opportunity to generate meaning and recurring revenue. Chronic care management has been a win-win for patients and practitioners — and the healthcare system as a whole — for nearly 10 years now.

AMA CPT Panel Meeting to Discuss Redesign of Remote Patient Monitoring Codes

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1, 2024 update: The AMA issued an unexpected and unusual notice that the application for the RPM code redesign had been withdrawn and would not be covered in its 2024 CPT Editorial Panel meeting.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.

Developing an FQHC or RHC Remote Patient Monitoring Program: 10 Things to Know

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.

Osteoarthritis & Rheumatoid Arthritis: Role of Remote Care Management

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.

CMS's Proposed Services for Health-Related Social Needs: What to Know

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.

CMS Proposes New 'Principal Illness Navigation' Service

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.

New CMS Primary Care Model Goes Big On Chronic Care Management

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).

MACs Back Off Plans to Pursue RPM and RTM Local Coverage Determination

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.

End of the PHE: How It Affects Remote Patient Monitoring & Telehealth

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.

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