Remote Physiologic Monitoring (RPM) in Long-Term Care
Here is an overview of the things you need to know in order to get you up to speed for remote physiologic monitoring.
Promoted by CMS
Reduction in Readmission Rates
Improves Patient Outcomes/Satisfaction rate
Increases coordination of care opportunities
Improves quality of care
Recent Changes for Distant Site Physicians
Telehealth can fulfill the face-to face visit requirements
FDA Clearance of Monitoring devices during PHE
Changes to remote patient monitoring consent
Licensed Clinical Social Workers
Occupational and Physical Therapist
Remote Patient Monitoring
Remote monitoring and treatment management during a calendar month.
Services can include initial set up, patient education, monitoring of the data and treatment management of the data.
Evaluation and Management Service Codes (999201-99215). During PHE, prior relationship exemptions
Follow- up to inpatient telehealth consultations
Online visits conducted through an online patient portal
Established patients only
Brief patient requested check in with provider via telephone or other device to decide if other services are needed
Remove evaluation of recorded video or images provided by the patient
Recent changes allow for New and Established patients
HOW TO BILL
Distant providers may bill for services using standard telehealth CPT codes.
The place of service should reflect the place of service code used if the patient was seen in person
The appropriate modifier of 95 should be used on all telehealth service codes
Obtain Consent once on an annual basis. This can be obtained and documented by auxiliary staff
Remote Patient Monitoring
CPT 99457: Remote physiologic monitoring treatment and management services 20 minutes or more of provider time in a calendar month requiring interactive communication within the month.
CPT 99091: Collection and interpretation of physiologic data digitally stored and transmitted by the patient or caregiver requiring a minimum 30 minutes of time each 30 days.
Providers must list the CPT code that reflects the services rendered regardless of the patient’s location and/or status. To include initial nursing facility and/or domiciliary rest home assessments, inpatient visits and hospice recertifications
Telehealth services cannot substitute for the in-person home visit ordered as part of the plan of care. However, the plan of care can be revised to include a weekly telehealth video consultation.
Physician’s in a contractual agreement with an HHA to provide virtual visits for patient’s in their home may bill for services using the telehealth visit codes. The payment would be made to the billing physician who then would provide payment to the HHA. Services under this arrangement are not considered home health visits as long as the patient is not currently under a home health episode of care.
Patient initiated online evaluations conducted via a patient portal
99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5–10 minutes
99422: Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 11– 20 minutes
99423: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes
G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes.
G2010: A brief (5-10 minutes) check in with the practitioner via telephone or other telecommunication device
G2012: A remote evaluation of images and/or video or images submitted by the patient