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.
What is the meaning of RPM in medical terms?
If you look up a definition of "RPM," you are likely to encounter the definition of "revolutions per minute," which is the definition RPM is most frequently associated with. To help you gain a better understanding of remote patient monitoring in the healthcare space, let's look at how several medical organizations, associations, and publications describe remote patient monitoring:
- The U.S. Government Accountability Office states, "Remote patient monitoring refers to a coordinated system that uses one or more home-based or mobile monitoring devices that transmit vital sign data or information on activities of daily living that are subsequently reviewed by a healthcare professional."
- A Medical Group Management Association (MGMA) blog states, "In simple terms, RPM is a device that collects patient data and transmits it via the internet to a physician. The collected data allows a physician to monitor changes in patient vital signs and act accordingly."
- The Center for Connected Health Policy states, "Remote patient monitoring (RPM) is the collection of a wide range of health data from the point of care, such as vital signs, weight, and blood pressure. The data is transmitted to health professionals in facilities such as monitoring centers in primary care settings, hospitals and intensive care units, and skilled nursing facilities."
- A column in the Nashville Business Journal states, "Remote patient monitoring is the use of portable and wearable medical devices to monitor biometric indicators."
- A DocWireNews blog says that RPM is "… the use of portable, high-tech devices to track and relay data to your healthcare providers on such metrics as glucose levels, heart rate, blood pressure, and blood oxygen levels."
Based on these definitions and the extensive research we at Prevounce conducted as part of the development of our remote patient monitoring software and connected patient device program, we came up with our own definition. The following is shared on our remote patient monitoring FAQs page: "RPM is the use of digital technologies to monitor and capture medical and other health data from patients and electronically transmit this information to healthcare providers for assessment and, when necessary, recommendations and instructions. RPM allows providers to continue tracking healthcare data for patients once they are discharged. It also encourages patients to take more control of their health."
RPM vs. Telehealth
While the RPM definition may seem straightforward, there is some confusion about the concept, including how it differs from telehealth. Distinguishing between remote patient monitoring and telehealth is important for several reasons, including coding and billing purposes.
Let's tackle this question: "How is remote patient monitoring different from telehealth?" A Medicaid resource states, "Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and interpretation. While they do not meet the Medicaid definition of telemedicine, they are often considered under the broad umbrella of telehealth services."
An article in Pharmacy & Therapeutics notes that "traditionally, telehealth delivery is segmented into four modalities: real-time, store-and-forward, remote patient monitoring (RPM), and mobile health (mHealth)." The publication defines telehealth as "… the remote delivery of health care to a patient through technology…" and states that the RPM modality "… collects patient information electronically and transmits it to a provider at another location to allow tracking and monitoring of that patient."
In our FAQs, we distinguish between the terms by writing, "RPM is the use of a device for interaction between providers and patients outside of the provider’s organization. Telehealth is the use of electronic information and telecommunications technologies to support long-distance clinical care, patient and professional health-related education, public health, and health administration."
Remote Patient Monitoring Coding Descriptions
We can further appreciate the difference between RPM and telehealth by briefly reviewing Medicare coding and billing guidelines. There are essentially four CPT codes covering RPM: 99453, 99454, 99457, and 99458. None of these codes are included in the lengthy list of Medicare telehealth services codes, which cover everything from individual and group kidney disease education services; to psychiatric diagnostic interview exams; advance care planning; smoking cessation services; psychoanalysis; and the annual wellness visit (AWV).
Looking at the four core remote patient monitoring CPT codes helps us gain a better understanding of what's included in RPM services. The RPM codes, their descriptions, and 2023 reimbursement rates are as follows:
- CPT 99453 — Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment. 2023 reimbursement rate: $18.84
- CPT 99454 — Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. 2023 reimbursement rate: $48.93
- CPT 99457 — Remote physiologic monitoring treatment management services, clinical staff/physician/ other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; initial 20 minutes. 2023 reimbursement rate: $47.60
- CPT 99458 — Remote physiologic monitoring treatment management services, clinical staff/physician/ other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes. 2023 reimbursement rate: $38.68
Providers delivering remote patient monitoring services will want to ensure they use these RPM CPT codes properly when submitting claims. (Note: If you are interested in learning more about coding and billing for remote patient monitoring, download our free RPM Billing Guide).
Remote Patient Monitoring vs. Patient Monitoring
Another important point about the RPM definition: Remote patient monitoring is sometimes confused with patient monitoring. While the concepts do overlap in some regards, their difference is important.
The National Cybersecurity Center of Excellence (NCCoE), part of the National Institute of Standards and Technology, does a nice job of simplifying RPM vs. patient monitoring when it states the following: "Traditionally, patient monitoring systems have been deployed in healthcare facilities, in controlled environments. Remote patient monitoring (RPM), however, is different in that monitoring equipment is deployed in the patient's home. These new capabilities, which can involve third-party platform providers utilizing video conferencing capabilities, and leveraging cloud and internet technologies coupled with RPM devices, are used to treat numerous conditions, such as patients battling chronic illness or requiring post-operative monitoring."
Setting Your Remote Patient Monitoring Program Up for Success With Prevounce
Now that you have a stronger grasp of what remote patient monitoring is (and is not), it’s easy to understand why adoption of RPM is on the rise. It's a great service for patients, clinicians, and payers. Remote patient monitoring programs can maximize their health and financial benefits with the help of RPM software like Prevounce, the preferred technology for a growing number of organizations. Let us guide you through a demo of how Prevounce will help streamline the process for getting patients the RPM equipment they need and provide you with a solution that seamlessly integrates remote patient monitoring into your existing practice.
For more information on remote patient monitoring, download this comprehensive guide.
Disclaimer
Health economic and reimbursement information provided by Prevounce is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.
Prevounce encourages providers to submit accurate and appropriate claims for services. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently.
Prevounce recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.
The coding options listed here are commonly used codes and are not intended to be an all- inclusive list. We recommend consulting your relevant manuals for appropriate coding options.
The Health Care Provider (HCP) is solely responsible for selecting the site of service and treatment modalities appropriate for the patient based on medically appropriate needs of that patient and the independent medical judgement of the HCP.
