Remote Patient Monitoring (RPM)
Remote Patient Monitoring is designed for patients to use their own mobile or desktop device to easily navigate through care pathways, biometric measurements and appropriate educational content.
On January 1, 2018, physicians were permitted to start billing separately for 99091, a code that is separate from, and can be billed concurrently with, CMS’s Chronic Care Management (CCM) program that reimburses for time spent on patient-generated data collection and interpretation.
As of 2019, CMS also added a new level of CCM management, CPT 99491, and increased the weighting of RPM as a practice improvement option under the Merit-based Incentive Payment System (MIPS).
In September 2018, CMS approved three of the new codes for RPM, 99453, 99454 and 99457. In the 2019 Medicare fee schedule, these codes are for general physiological remote monitoring of chronic conditions. These new reimbursements were long-overdue, because they finally allow practices to bill “incident to” for any clinical staff that implement and manage RPM, instead of just physicians. The new codes also do not make restrictions about where the patient needs to be located, such as a rural area or in a medical facility, for the monitoring. The new codes followed a two-year study (published in November 2017), of the CCM program that showed millions in cost savings and an increase in patients’ awareness of their chronic conditions. The report’s findings have likely been a major driver of the new RPM codes for CCM, since they are a less costly way for physicians to manage their patients’ chronic conditions when compared with more frequent face-to-face visits.