Remote Physiologic Monitoring (RPM) in Long-Term Care
What is Remote Physiologic Monitoring?
In general, remote physiologic monitoring (RPM) is a subset of telehealth, where patient health data is collected, transmitted, evaluated, and communicated by electronic devices. These devices may include wearable medical devices, embedded devices, and wearable sensors.
Here is an overview of the things you need to know in order to get you up to speed for remote physiologic monitoring.
How can RPM Help Your Practice?
- Promoted by CMS
- Reduction in Readmission Rates
- Improves Patient Outcomes/Satisfaction rate
- Increases coordination of care opportunities
- Improves quality of care
- Improves time management (a very important metric for your practice)
- 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
Eligible RPM Providers
- Nurse Practitioners
- Clinical Psychologist
- Licensed Clinical Social Workers
- Occupational and Physical Therapist
What Should an RPM Service Include?
Remote Patient Monitoring
- Remote monitoring and treatment management during a calendar month.
- Services can include initial setup , patient education, monitoring of the data, and treatment management of the data.
- Evaluation and Management Service Codes (999201-99215). During PHE, prior relationship exemptions
- Telehealth Consultations
- Follow-up to inpatient telehealth consultations
- Online visits conducted through an online patient portal
- Established patients only
- Brief patient requested check-in with the provider via telephone or other devices 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
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How to Bill Remote Physiologic Monitoring?
- 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
In the section below we will share some tips on how to bill each of the RPM services provided:
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 of 30 minutes of time every 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.
- Physicians in a contractual agreement with an HHA to provide virtual visits for patients in their homes 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, a 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, a 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, a 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, a cumulative time during the 7 days; 21 or more minutes.
- G2010: A brief (5-10 minutes) check in with the practitioner via telephone or another telecommunication device
- G2012: A remote evaluation of images and/or video or images submitted by the patient
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