An Ounce of Prevention
The U.S. healthcare system has made some big advancements in the acceptance and usage of telemedicine and remote patient monitoring devices. While the benefits of these services are proving to be valuable for all patients, they are even more important for patients with chronic conditions, including those with lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), and bronchiectasis. With the looming threat of COVID-19 exposure, it may no longer be realistic or safe to continue permitting vulnerable patients to visit a practice for respiratory services. However, the exciting news is that peak expiratory flow can now be measured and monitored remotely with the help of a connected smart peak flow monitor.
The COVID-19 pandemic has fueled the adoption of telehealth, with millions of Americans taking advantage of virtual care options over the past several months — many for the first time. While rates of telehealth utilization have recently declined as in-person care resumed, EHR company Epic reported that telehealth visits still accounted for 21% of all visits in July compared to a rate of less than 0.01% prior to the health crisis. A significant contributor to this remarkable increase in usage of telehealth by consumers is the embracing of remote patient monitoring (RPM) by practices and patients, as well as payers and the federal government. When we look at some of the more common examples of remote patient monitoring applications, it is easy how RPM has the potential to transform the delivery of care in the United States.
LOS ANGELES, Oct. 1, 2020 -- Prevounce Health, creators of the Prevounce Care Coordination Platform, announces its release of a remote patient monitoring (RPM) module tailored to the needs of pulmonologists, their practices, and their patients.
Considering the vast challenges associated with confronting a global health crisis, it's no surprise that 2020 is bringing new advancements to the way healthcare is delivered in the United States. One of the more substantial developments concerns remote patient monitoring (RPM). RPM has technically been around since the early 1970s, but it's been thrown into the spotlight during the pandemic and is experiencing rapid adoption. That comes as no surprise considering the significant and wide-spread benefits of remote patient monitoring.
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.
The story below provides a brief overview of this breaking news. If you are interested in a more in-depth discussion and analysis, you can watch a recent webinar we hosted on the topic here. The Centers for Medicare & Medicaid Services (CMS) has released its 2021 Medicare physician fee schedule proposed rule, which includes many proposed changes to remote patient monitoring (RPM).
If your practice is considering adding a remote patient monitoring (RPM) program, you will need to take a number of essential steps in advance to help ensure the success of the new program. These include everything from choosing the RPM system that will drive your program to developing an effective mechanism for educating patients on RPM. There is also the not-so-small matter of understanding how you will get paid for your services. Once you learn the nuts and bolts of remote patient monitoring reimbursement, you may decide to move from considering an RPM program to launching a program as soon as possible. Here are four things to know about remote patient monitoring reimbursement.
In a recent Medical Economics column, I shared some of the most significant updates concerning remote patient monitoring (RPM). Among them: Remote patient monitoring is now one of the more lucrative Medicare care management programs, thanks to an overhaul of the RPM CPT codes (99453, 99454, 99457, and 99458). Medicare is making it easier for practices to provide RPM services, and private payer coverage of RPM is growing. The COVID-19 pandemic has helped drive adoption and use of remote patient monitoring devices in healthcare. A rapidly growing number of patients are interested in virtual care services like RPM, their interest fueled by the health crisis. The column concluded by asserting that the stars have aligned for remote patient monitoring, and it is an optimal time to consider launching or growing RPM programs. Another motivating factor for practices is that they now have several choices of remote patient monitoring medical devices to offer patients and include in their programs. From these options, practices can select the devices that will best meet the short- and long-term care needs of their patients and maximize RPM programs’ revenue potential.
Thanks to an overhaul of CPT codes in 2020, remote patient monitoring (RPM) became one of the more lucrative Medicare care management programs essentially overnight. If 100 patients are enrolled in an RPM program and each receives the minimum care management services each month, that will generate annual reimbursement approaching $150,000. One of the most important steps practices must complete to capture this reimbursement is proper coding of their remote patient monitoring services. This Prevounce Quick Guide outlines the current remote patient monitoring CPT codes and shares some tips for proper RPM coding.
Before 2020, remote patient home monitoring, also known as remote patient monitoring or RPM, was starting to generate some buzz. Healthcare providers were increasingly assessing the function that such virtual technology should play in the delivery of care. Pundits generally agreed that virtual care would eventually take on a significant role but that it would require some time before providers, payers, and patients fully embraced the concept. Then COVID-19 arrived, and virtual care became an essential service seemingly overnight. Now virtual care technology, including remote patient home monitoring, is expected to "redefine healthcare and public health," notes Healthcare IT News. This article includes some eye-opening statistics: The consulting firm McKinsey suggests that $250 billion in healthcare spending could shift to virtual care models and FAIR Health data indicates that telehealth claim lines increased more than 4,000% nationally from March 2019 to March 2020, growing from about 0.17% of medical claim lines to more than 7.5% over that period. The author of the column—who oversees a technology consulting firm —believes that 80 to 90% of all outpatient visits could eventually become "virtualized" in some fashion. Suffice it to say, remote patient home monitoring is not only here, but here to stay. Healthcare practices nationwide are exploring how to incorporate remote patient home monitoring into their services. The good news is that it is a great time to launch a remote patient home monitoring program. In 2020, remote patient monitoring CPT codes (99453, 99454, 99457, and 99458) were overhauled. This made RPM one of the most lucrative Medicare care management programs. Commercial payers are increasingly covering remote patient home monitoring (some by choice, some forced by law). And consumers are rapidly embracing virtual care technology and finding tremendous satisfaction with the experience.