What Is Remote Patient Monitoring (RPM)?
In the United States, RPM is a reimbursement method that allows qualified health plans to pay for critical patient care provided by clinical staff. The services can be billed incident to care, with a physician not required to be present. These services include interactive communication with patients and primary caregivers, interpreting and assessing received data, and organizing treatment programs.
Physicians
RPM services allow physicians to monitor physiologic data on chronic disease patients and detect potential problems before they develop. RPM services like the CoachCare remote patient monitoring are billed as part of a patient’s chronic care management plan. Medicare covers RPM services for established and new patients. Physicians can bill RPM services on a separate line item or in conjunction with CCM services.
The role of RPM is increasing in the delivery of care. It is expected that new federal and state rules will further strengthen the role of RPM services. However, the key is to design flexible programs to meet the needs of both patients and providers. In addition, some providers need clarification about what conditions qualify as RPM.
To bill RPM services, providers should first determine if they are eligible for reimbursement. Providers can bill for RPM services if they meet all eligibility requirements. In addition, the services must involve a face-to-face visit with the billing practitioner. This visit can be a part of a new patient’s Annual Wellness Visit or an Initial Preventive Physical Exam. The services must be performed at least 16 days out of every 30 days.
Home Health Agencies
RPM is a form of remote patient monitoring that is performed by a healthcare professional and can be performed in a patient’s home. The services require the practitioner to visit the patient in their home regularly, and these visits may also include a face-to-face visit.
Although RPM services are usually associated with chronic conditions, they are also appropriate for patients with acute illnesses. These illnesses are not as serious as those that require hospital care. Acute illnesses may only last a short period. In such cases, remote patient monitoring may be beneficial. But, it is important to note that the services provided by home health agencies are not always covered by insurance.
RPM services benefit patients, providers, and healthcare facilities. They increase patient health and lower healthcare costs. With remote monitoring, patients no longer need to visit the hospital for medical care. This lowers hospital costs for everyone involved. The services also increase patient autonomy.
Private Payers
The reimbursement for Remote Patient Monitoring (RPM) services varies depending on the payer. Medicare patients are generally covered up to 20% of the RPM costs. However, Medicaid and other private payers can also cover this cost. Additionally, a physician must authorize the service. Private payers may have their own rules regarding co-payments for RPM services.
RPM services offer a real-time, patient-focused view of their health data. These services also feature RTM monitoring, which enables doctors to make real-time adjustments to therapeutic care. The amount of time spent speaking with the patient is also included in this code. The minimum 20-minute period includes this time.
Remote patient monitoring (RPM) is an innovative technology that helps healthcare providers gather patient health data. It can monitor vital signs, weight, blood sugar levels, and physical activity. Several healthcare specialties utilize this technology, including cardiology, pulmonology, and endocrinology. It can also be used to manage chronic conditions like hypertension.
Outsourced Providers
The third option for healthcare organizations is to partner with a third-party provider for remote patient monitoring (RPM). These providers can provide the parts of an RPM program and additional services such as proprietary patient interfaces, educational resources, and monitoring capability. While the latter model provides greater control and potential economies of scale, partnering with an outsourced provider offers several benefits. For instance, an outsourced provider can streamline complex strategic matters, assist with patient supply, and provide ongoing assistance.
Another advantage of working with an outside provider is using more than one technology. Unlike traditional practices, outsourcing RPM services allows you to choose from various technologies. To implement RPM effectively, your vendor must be knowledgeable about CPT codes and billing processes. In addition, the provider should provide ongoing support and training.
RPM services utilize digital technologies to collect physiologic data from patients. These data are then electronically transmitted to healthcare providers. This enables them to track patient health after they have been released from a hospital or clinic. With this information, they can monitor the patient’s condition, make recommendations, and adjust care plans as needed.
