Patients must meet certain criteria to be eligible for remote patient monitoring (RPM) services. This article explains who qualifies for remote patient monitoring and how healthcare providers can implement RPM. Also, we’ll talk about how healthcare providers can implement RPM. Understanding these key aspects will help patients seeking to leverage RPM and providers aiming to expand their telehealth offerings.
Who Qualifies for Remote Patient Monitoring?
Remote patient monitoring is a telehealth service that allows qualified healthcare professionals and patients to manage acute and chronic conditions. The Centers for Medicare and Medicaid Services (CMS) reimburse Medicare for RPM services. It defines RPM as using digital technologies to collect health data from patients in one location and electronically transmit that information securely to providers in a different location.
CMS outlines who qualifies for remote patient monitoring as follows:
- Individuals with chronic conditions like diabetes, hypertension, heart disease, asthma, or COPD.
- Post-surgical patients who need to monitor their recovery and wound healing.
- Geriatric patients, particularly those with multiple chronic conditions or limited mobility.
- Patients in rural or remote areas have difficulty accessing in-person care.
- Patients with acute conditions that require close monitoring, such as COVID-19.
Who Performs Remote Patient Monitoring Services?
Remote patient monitoring services must be ordered and billed only by physicians or non-physician practitioners. That includes qualified physicians and healthcare professionals such as nurse practitioners, certified nurse specialists, or physician assistants. Additionally, the practitioners must be eligible to bill Medicare for evaluation and management services.
To order remote patient monitoring services, the qualified healthcare professional must have a relationship with the patient. If the patient is new, an in-person examination is required before enrolling them in RPM. Patients who qualify for RPM will use medical devices. The devices measure and transmit their physiologic data to their providers for assessment. The following section explains which devices can be used for RPM.
Which RPM Devices Qualify for Remote Patient Monitoring?
Remote patient monitoring is not a replacement for in-person visits. Instead, it enhances patient care by addressing potential concerns between visits. This can be achieved because RPM devices monitor a patient’s vital signs and send them to their physician for at least 16 days per month.
Commonly used FDA-cleared RPM devices include pulse oximeters, blood glucose meters, blood pressure monitors, thermometers, peak flow meters, and weighing scales. Some devices may be familiar to patients, while others may require training and support. Providers should walk their patients through the process of operating the device or provide them with written instructions or videos. Providers can also outsource RPM services to a third party that can provide fulfillment, training, and technical support.
Patient vital sign data is collected and transmitted directly to the patient’s physician. Then, the data is analyzed, and the physician is notified if any readings fall outside set parameters. Medicare updated CPT 99457 to allow services that don’t require a physician to be outsourced to third-party RPM vendors. With outsourcing, there’s no need to increase staff workload or hire more staff. Instead, outsourced staff can perform some RPM services, such as technical support or device fulfillment.
Key Points
The benefits of remote patient monitoring extend to patients and providers. RPM reduces healthcare costs, increases access to care, enhances patient engagement, and improves quality of care. Providers who want to implement RPM in their practice should be aware of the CMS policies and reimbursement CPT codes for RPM services, as well as the best practices and tips for leveraging RPM technology. By incorporating remote patient monitoring, healthcare teams can focus on improved care between in-person visits while extending quality care to more patients.
Implementing RPM provides patients with increased communication channels, fostering adherence to treatment plans and chronic condition management. This enhanced connectivity enhances patient engagement and promotes better health outcomes. Chronic care, telehealth, and RPM software and services companies can discover how Tenovi can help improve your efficiency, outcomes, and revenue by scheduling a demo today. You can see how Tenovi can transform your partner’s healthcare delivery.
