Remote Patient Monitoring Reimbursements: Driving Connected Health Adoption

An aging population with chronic health conditions has driven the healthcare industry to increasingly adopt remote patient monitoring technologies over the past few years. While providers were aware of the many benefits of connected health for remote patient monitoring, they weren’t easily paid for these services under the previously available code from the Centers for Medicare and Medicaid Services (CMS).

New Codes Introduced for 2019

CMS established three new billing codes for remote patient monitoring in 2018 that would be added to the 2019 Physician Fee Schedule. The three new Current Procedural Terminology (CPT) codes were:

• CPT code 99453, which covers “remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.” The Medicare payment for these services is $21.
• CPT code 99454, covering “remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.” The Medicare payment for these services is $69.
• CPT code 99457, which covers “remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.” The Medicare payment for these services is $54. 

Expanded Reimbursement Opportunities for 2020

These new CPT codes for remote patient monitoring went into effect on January 1, 2019. Later in 2019, CMS proposed a new rule for the 2020 Physician Fee Schedule that would further expand the opportunities for remote patient monitoring reimbursement under the existing codes and create a new one. The new code for 2020 was:

• CPT code 99458, which covers “remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes.” The Medicare payment for these services is $42.

The new rules make it much easier for providers to be reimbursed for remote patient monitoring services because they can be delivered by clinical staff under the “general supervision” of a physician, rather than in the same location. This makes remote patient monitoring more cost-effective for healthcare providers, which has helped accelerate the adoption of IoT connected health solutions. 

IoT Connected Health Solutions

With the expanded opportunities for reimbursement for remote patient monitoring services, the healthcare industry is adopting IoT connected health solutions more rapidly than ever. Delivering cutting-edge healthcare for modern patients requires an expert approach to IoT. KORE offers a suite of solutions that help providers ensure compliance, reduce costs, and improve care.

Remote patient monitoring has the potential to deliver more affordable, reliable, and efficient healthcare services. KORE enables remote patient monitoring by providing the healthcare industry with a seamless, compliant way to deploy connected health solutions. 

Download the eBook, "Remote Patient Monitoring: Steady Revenue for Healthcare, Better Patient Outcomes," to learn more about how CPT codes can broaden the use of remote patient monitoring and what is needed for successful deployments.