A bipartisan bill that would reduce Medicare's data collection requirement for billing remote patient monitoring (RPM) has been advanced through the House Energy and Commerce subcommittee on health for consideration by the full Energy and Commerce Committee.
The bill, H.R. 5394 — Expanding Remote Monitoring Access Act — calls for reducing the required minimum duration for RPM data collection from 16 days to 2 days within a 30-day period for Medicare billing. Medicare previously permitted 2 days for billing but only for patients with a suspected or confirmed diagnosis of COVID-19. This new bill would apply to all Medicare RPM patients.
The drafters of the bill included data to justify the decision to lower the measurement collection threshold because of the many clinical conditions that can benefit from shorter monitoring durations. In addition, the current 16-day requirement is not only excessive for some conditions, but it is often a burden for providers with RPM programs.
Consider a program supporting 150 patients with hypertension. During the 30-day reporting period, 100 of the patients deliver 16 or more recorded days of device data while the remaining 50 patients deliver 2-15 recorded days of device data. Under current rules, the practice administering the RPM program can only bill for the 100 patients with 16 or more days of device readings, thus losing out on billing for those 50 patients who failed to reach the 16-day minimum — despite providing services to support those patients. If the law is passed, the practice would be able to bill for all 150 patients enrolled in its RPM program.
H.R. 5394 was one of 21 pieces of telehealth extension legislation passed by the Energy and Commerce Committee. The bill's passage comes just days after the American Medical Association (AMA) delayed consideration of a significant overhaul of the RPM codeset. Permitting billing for 2-15 recorded days of RPM data was one of the changes under consideration.
While we wait to see what happens with this legislation, its bipartisan, unanimous passage through the subcommittee on health is welcome news. It further demonstrates that policymakers recognize the value of supporting remote patient monitoring and encouraging its adoption. The bill cites several positive RPM findings, including the use of RPM by the Department of Veterans Affairs to reduce bed days and hospital admissions, increased access to care, improved patient health outcomes, and reduced long-term health costs.