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Definition Explained: What is Remote Patient Monitoring (RPM)

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Definition Explained: What is Remote Patient Monitoring (RPM)

One of the silver linings of the COVID-19 pandemic was the increased adoption of virtual healthcare services and delivery systems. This includes remote patient monitoring, or RPM. Remote patient monitoring was a concept foreign to most individuals before the health crisis, but that is rapidly changing as providers increasingly adopt the service and enroll their patients. Yet many people still lack a firm understanding of remote patient monitoring, so we thought it would be helpful to dedicate a blog that focuses on the definition of RPM and contrasts the concept of remote patient monitoring with other terms frequently associated with it.

HCPCS G0438 & G0439: Tips To Improve Coding the Annual Wellness Visit

You schedule a patient's first Medicare annual wellness visit (AWV). The patient comes into your organization, or perhaps you meet via telehealth. You furnish the AWV, seemingly checking all the boxes necessary to deliver this critical yearly appointment that helps prevent illness and get your organization paid. And yet a few weeks after submitting your claim to Medicare for the service, it's denied. The reason: You incorrectly used HCPCS code G0438. Denials can lead to increased days in accounts receivable, write-off rates, and overall cost to collect, among other headaches. A study revealed thatmany AWVs conducted and billed may fail to meet compliance requirements set forth by CMS, which can trigger denials or more serious ramifications. If you want to better ensure that your annual wellness visit claims are not denied, you must know how to properly code them. In this piece, we provide you with the HCPCS codes you need to use for annual wellness visits. We also share guidance that should help reduce the likelihood that your organization will experience denials associated with this service and another service commonly associated with the AWV that may trip you up: the initial preventive physician examination (IPPE).

Billing for a Medicare Annual Wellness Visit: Codes G0438 and G0439

The importance of using preventive medicine to improve the health and ultimately lives of patients is widely recognized. The Medicare annual wellness visit (AWV) plays an important role in helping Medicare beneficiaries stay current with their health and take actions that can prevent illness and reduce risk. An essential piece of the process required to ensure offering and providing preventive services remains financially viable is for organizations to complete the Medicare annual wellness visit reimbursement coding process accurately. Doing so can help ensure providers receive their earned reimbursements and protect them against possible penalties they might incur from failed coding audits. We know some organizations struggle with meeting compliance requirements set forth by the Centers for Medicare & Medicaid Services. In this blog post, we take a look at what's required for compliant AWV coding. While this is by no means a comprehensive guide to Medicare annual wellness visit reimbursement, it provides organizations with information that can assist them in avoiding some of the most common AWV coding mistakes that result in rejected claims, lost revenue, or failed audits — all of which can be mitigated when using Prevounce software.

4 Remote Patient Monitoring Devices to Know When Launching a Program

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.

Rules for CPT 99490 & Other Chronic Care Management Codes: 2023 Update

If you've come to read this blog post, you're presumably looking for the rules you should be following to perform proper chronic care management (CCM) billing and coding. That's good. While the federal government has been increasingly supportive of care management programs, they are also more closely scrutinizing CCM reimbursement by auditing instances and causes of overpayment associated with incorrect billing of the service.

History of Remote Patient Monitoring: How It Began & Where It's Going

It's no secret that technology has vastly improved healthcare. In just the past few years, we've seen telehealth essentially transform the delivery of care. From increased access and improved patient outcomes to reductions in care costs, telehealth technology like remote patient monitoring (RPM) is driving healthcare evolution, helping practitioners improve the ways in which we interact with patients every day. Thanks to the ingenuity and creativity of technology thought leaders and innovators, we can now reach more people than ever before, including previously difficult to access rural patients, and do so more effectively and efficiently.

Omnibus Bill Includes Big Telehealth Developments: 3 Things to Know

Right before Christmas, the U.S. Congress approved the Consolidated Appropriations Act of 2023. Within this $1.7 trillion omnibus appropriations bill are a few significant developments affecting telehealth. Here are three things to know about the telehealth-related laws included in the bill.

Why Medicare Does Not Cover the Annual Physical Exam

A Kaiser Health News (KHN) article tells the story of Medicare beneficiary Beverly Dunn. She scheduled her annual physical exam, believing that Medicare would cover the checkup. Then Dunn received the bill and quickly learned the shocking piece of information many patients discover: Medicare does not cover annual physical exams.

New Medicare Chronic Care Service: Chronic Pain Management (CPM)

There were a number of significant changes affecting the delivery and billing of remote care management in the 2023 Medicare Physician Fee Schedule (PFS) final rule, as we covered in this webinar. One of them was the Centers for Medicare & Medicaid Services (CMS) finalizing the coverage for chronic pain management and treatment services (CPM) — new services that were introduced in the 2023 Medicare PFS proposed rule.

In Defense of the Medicare Annual Wellness Visit

Medicare's annual wellness visit (AWV) has had a rocky ride since its introduction in 2010 and started in 2011 as part of the Affordable Care Act. As with many big healthcare changes, the new service was met with resistance and steeped in confusion, leading to terribly slow uptake and obstacles that still unjustly plague the service more than a decade later. When Medicare beneficiaries do not receive their AWV, this is not only a disservice to these patients, but practices and the healthcare system as a whole lose out on important and impactful benefits.

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