Prevounce Blog

Looking to leverage FCC funding to launch or expand a remote patient monitoring program (RPM)? Pylo devices by Prevounce are fully qualified for FCC reimbursement, and the Prevounce platform makes it easy to deliver RPM services and connect to your EMR. Want to learn more? Click here to schedule a meeting. The Federal Communications Commission (FCC) has announced it will provide $249.5 million in FCC telehealth "grants" for healthcare providers delivering telehealth services. The application window is open from noon ET on Thursday, April 29, through noon ET on Thursday, May 6 (seven calendar days).

Chronic disease has been quietly waging war on American lives throughout the entire 21st century, quickly rising to the top of the most common causes of death in the United States. Some of the major chronic diseases, such as heart disease, chronic lung disease, and type 2 diabetes, are preventable, yet 6 out of 10 American adults still have at least one chronic disease and 4 out of 10 suffer from two or more chronic diseases. Furthermore, the prevalence of chronic diseases crushes our healthcare system with a confounding $3.8 trillion in annual healthcare costs, leading chronic disease to act as a tremendous drain on both staffing and financial resources. Want to learn more about providing and getting paid for preventive services? Check out our detailed guide!

Just saying the word "audit" is a surefire way to make a practitioner's heart skip a beat. So, while we apologize for including the word in our title, we're glad to have grabbed your attention. It was only a matter of time before remote patient monitoring (RPM) received federal scrutiny. That’s why it wasn’t surprising to see RPM included in a January 2021 announcement by the Office of Inspector General that the Centers for Medicare & Medicaid Services (CMS) would be conducting a series of audits of Medicare Part B telehealth services in two phases (with RPM part of the second phase).

Chronic care management (CCM) made its debut in 2015 when it was rolled out by the Centers for Medicare and 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.

The use of telemedicine and telehealth, fueled by the pandemic, are quickly solidifying its place as a permanent facet of modern healthcare. Within telehealth, some of the most positive — and exciting — developments are occurring with the use of remote patient monitoring (RPM). The expanding usage of RPM, also referred to as remote physiological monitoring, is improving patient health outcomes, reducing the overall cost of healthcare, and improving the quality of life for many patients with chronic diseases. One of the most beneficial uses of RPM is for those suffering from heart failure. Outpatient care techniques that leverage home monitoring for heart failure management are proactively working to reduce the rates of acute exacerbation, keeping heart failure patients out of the hospital and healthier for longer than ever before.

In an unusual development — albeit a welcomed one — the Centers for Medicare & Medicaid Services (CMS) has issued a correction to the 2021 Medicare physician fee schedule final rule that clarifies several areas of confusion concerning the billing requirements for remote patient monitoring (i.e., remote physiological management). 

Update: The story below provided a brief overview of this breaking news. As of 2022, the information remains accurate. If you are interested in learning about noteworthy changes for 2022, view an on-demand webinar here.

Whether your practice is already delivering or is planning to deliver RPM services to Medicare and/or Medicaid patients this year, you must understand the CMS rules for remote patient monitoring services in 2020. Without this knowledge, you run the risk of not getting paid appropriately for remote patient monitoring by CMS (Centers for Medicare & Medicaid Services) and possibly running afoul of requirements that can jeopardize your reimbursement and lead to regulatory headaches. To help ensure you receive appropriate and timely payments for remote patient monitoring from CMS and avoid legal scrutiny for RPM services, here are three key things to know. 

Healthcare providers have found themselves under immense pressure to maintain continuity of care during the COVID-19 crisis, but many aspects of the U.S. health system were not designed to support such an effort. To help providers more effectively deliver care that will not only keep patients healthy but also in their homes and away from hospitals, which are largely focused on treating COVID-19 patients, government agencies, commercial payers, and other healthcare organizations have worked to change the system. Approaches taken include the creation of new and expansion of existing telehealth and remote tools and support, including remote patient monitoring (RPM). For example, we have seen federal waivers and revised state regulations that greatly expand the ability for healthcare providers to deliver telehealth and remote services; commercial payers revising their policies to pay for these services, and healthcare companies offering resources to help providers more effectively leverage telehealth and remote services during the crisis. If your practice is considering launching or growing an existing telehealth and/or remote services program during the pandemic, here are five things you should know.

The annual wellness visit (AWV) is an important tool for providers to track and help manage the health and wellbeing of their Medicare patients. Social distancing is crucial to combat our current health crisis, but so is maintaining continuity of care with your most vulnerable patients. Fortunately, Medicare understands the importance of the AWV, and included it in it's initial §1135 waiver so that it can be performed entirely via telehealth on any Medicare beneficiary. As of 4/30/20, Medicare further waived restrictions, and now allows Annual Wellness Visits to be conducted via audio-only telehealth (i.e. over the telephone) for the duration of the waiver.