In 2024, the Centers for Medicare and Medicaid Services (CMS) approved billing for remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) services by federally qualified health centers (FQHCs) and rural health centers (RHCs). This change opens new opportunities to enhance patient care and add to FQHCs’ financial stability.
This article outlines 10 key points for RHC and FQHC remote patient monitoring programs.
Understanding FQHC Remote Patient Monitoring Programs
Remote Patient Monitoring uses digital technologies to collect medical and health data from patients in one location and electronically transmit that information securely to healthcare providers in a different location for assessment and recommendations. For RHCs and FQHCs, which often serve underserved populations, FQHC remote patient monitoring can aid in managing chronic conditions and reducing hospital readmissions.
Billing for RPM: 10 Key Tips for FQHCs
1) New Billing Code
HCPCS code G0511 is used for billing for RHC and FQHC remote patient monitoring services. This code covers various non-face-to-face care management services, including RPM. Billing staff should become familiar with this code and its proper usage to ensure accurate reimbursement.
2) Reimbursement Rate
The national average reimbursement for G0511 is set at $72.98 for 2024. This rate reflects the resources required to provide comprehensive FQHC remote patient monitoring services. FQHCs should carefully track their RPM costs to ensure this reimbursement adequately covers their expenses.
3) Multiple Billing Opportunities
With G0511, FQHCs can bill for multiple services simultaneously. For example, if a patient is enrolled in chronic care management and remote patient monitoring, both services can be billed under this code. This allows for more comprehensive care and potentially increased revenue.
4) Time-Based Billing
G0511 may be billed by FQHCs and rural healthcare clinics multiple times in 20-minute time blocks. This allows for flexibility in billing based on the actual time spent providing RHC or FQHC remote patient monitoring services. Accurate time tracking is crucial for proper billing.
Implementing FQHC Remote Patient Monitoring
To successfully implement and bill for RPM and RTM services, FQHCs should consider the following:
5) Documentation Requirements
Thorough documentation is needed for RPM billing. This includes recording the time spent on RPM activities, the specific services provided, and the medical necessity of these services. Implementing a robust documentation system can help ensure compliance and support billing claims.
6) Technology Infrastructure
Invest in reliable, HIPAA-compliant RPM platforms. This may include secure data transmission systems, patient portals, and integration with existing electronic health record systems. Ensure the chosen technology is user-friendly for both staff and patients.
7) RPM Devices in RHC and FQHC Remote Patient Monitoring
Choose the proper remote patient monitoring devices for your FQHC remote patient monitoring population. Consider factors such as device accuracy, ease of use, and compatibility with your chosen RPM platform. Establish processes for device distribution, maintenance, and troubleshooting. Providing adequate patient support for device usage is crucial for program success.
8) Staffing and Training
Ensure your team is well-versed in RPM procedures and RHC and FQHC billing requirements. This may involve hiring additional staff or training existing staff on new technologies and remote patient monitoring workflows. Consider designating RPM coordinators to oversee the program and act as points of contact for patients and providers.
9) Patient Education
Engage patients in understanding the benefits of RPM and how to use the technology effectively. Develop educational materials and provide ongoing support to encourage patient participation and adherence to RPM protocols.
10) Measure FQHC Remote Patient Monitoring Program Success
Establish metrics to evaluate the effectiveness of your FQHC remote patient monitoring program. Regularly review these metrics to identify areas for improvement and demonstrate the value of RPM to stakeholders.
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- Provider satisfaction
- Patient satisfaction
- Population health clinical outcomes
- Individual clinical outcomes
- Meeting the program budget
- Return on investment (ROI)
The Future of Remote Patient Monitoring for FQHCs
As this billing change takes effect, we’ll likely see increased adoption of RPM services across FQHCs. This could improve patient outcomes, especially those with chronic conditions, and potentially reduce healthcare costs.
FQHCs interested in implementing RPM should start by assessing their patient population’s needs and current technological capabilities. Consulting with healthcare technology experts and billing specialists can help ensure a smooth transition to offering and billing these valuable services.
By embracing RPM, FQHCs can enhance their care delivery model, improve patient engagement, and strengthen their financial position while continuing to fulfill their crucial role in community health.
Whether your healthcare partners are interested in adopting RPM for RHCs or FQHCs to increase patient engagement, create a more efficient workflow, or increase revenue, Tenovi can help you find the best RPM device and software solution. Choose from a growing list of Tenovi and partner FDA-cleared RPM devices. Book a free demo today.
