The impacts of COVID-19 on healthcare systems encouraged a paradigm shift with our providers’ workflows. The rise of telehealth enabled providers to support their patients’ needs while remaining safe at home. Nowadays, providers do not need a large clinic to cater to their patients. Telehealth will not stop even if the COVID-19 pandemic is over.
Problems with revenue, however, continue to rise despite the widespread adaptation of telehealth. For example, a nationwide survey from the American Medical Association noticed a 32% drop in revenue, lower than pre-pandemic revenue.
Could Remote Patient Monitoring (RPM) be the missing link to telehealth?
RPM uses digital technologies to provide patient-generated health data such as blood pressure, weight, heart rate, blood oxygen saturation (sPO2), etc. Healthcare providers can view these to analyze and treat if needed. It is a subset of telehealth and gained popularity around 2017 to 2019 before the pandemic began. However, RPM utilization skyrocketed during the health crisis as the need to monitor COVID-19 patients while decreasing possible exposure. Therefore, RPM is the best fit without compromising patient care.
According to the Center of Connected Health Policy, RPM moves beyond being a simple physiologic monitoring device to reduce hospitalizations, readmissions, and length of hospital stay. In addition, RPM augmented the continuous care for chronic patients during the pandemic to lessen life-threatening symptoms and improve overall general wellbeing and health satisfaction.
How do doctors get reimbursements through RPM?
There are four Current Procedural Terminology (CPT) codes relevant to the RPM program:
- 99453 refers to the initial set-up of RPM devices. It also includes patient education on the use of RPM devices for their condition. Disregarding the number of RPM devices a patient uses or the number of providers caring for the patient, this CPT code is billed only once.
- 99454 refers to the transmission of vital sign monitoring (blood pressure, heart rate, weight, etc.) with an RPM device. Aside from the device classified under FDA’s classification system, the device must be ordered by a healthcare provider and filed once every 30 days.
- 99457 refers to monthly reimbursement for time spent doing at least 20 minutes reviewing patient records, including live communication with the patient by physicians thru phone or video call, analyzing data, and managing devices.
- 99458 is a supplement to 99457 and can be billed for each additional 20 minutes for RPM per month. This code cannot be billed as a standalone code and must always be used in conjunction with 99457.
Knowledge of these CPT codes can add significant revenues to medical practice, especially when many patients are reluctant to participate in in-person care.
Optimizing RPM in the post-COVID world
Providers can now closely watch high-risk patients thru RPM. DrKumo, the leader in next-generation RPM, provides a Watch List feature in their easy-to-use dashboard so providers can always keep tabs on their patients when necessary. It’s a win-win situation where the patient reduces overall healthcare costs, and the provider can increase revenue for their medical practice.
Sixty-eight percent (68%) of providers would still want to utilize telehealth in their practice. It will only be a matter of time before RPM will rise and expand globally because, in this rising era of telehealth, most patients are now willing to use phones for consult regardless of age. In the post-pandemic phase, a lot of physicians expressed their desire to continue remote patient monitoring for the following reasons: (1) chronic disease management; (2) improving care coordination; (3) preventative care; and (4) hospital or emergency department follow-ups.
It will always be challenging for lawmakers to be constantly updated to improve the growing needs of health access in our society. Finding solutions to parity problems is still far from being realized—it is easy to shy away from the benefits of remote patient monitoring when a patient has insufficient awareness of the current policies. Providers and insurance companies need to educate that telehealth regulations by state exist to reimburse remote patient monitoring.
In the post-COVID world, the success of remote patient monitoring will not be possible without the providers preserving patient relationships to extend care solutions and improve their overall health outcomes. Devices need not be inexpensive to drive revenue. Instead, adding clinical value with data analyzed to optimize services and giving patients better feedback with their conditions, and helping them with medication adherence is the best way to provide better care and outcomes.
About DrKumo® Inc.
DrKumo is a technology leader in massively scalable, continuous, real-time Remote Patient Monitoring solution for Chronic Disease Management, Acute Care, Post-Operation, and Hospital Care at Home.
It solves the most painful problems in healthcare with a user-friendly solution powered by its state-of-the-art, HIPAA-compliant, mobile-enabled, continuous real-time monitoring, and AI/ML engine. Then company’s Remote Patient Monitoring (RPM) technology enables patients to manage their health conditions in the comfort of their homes and supports healthcare providers with real-time intelligence for timely intervention. DrKumo revolutionizes the way people access quality health care across the world. With a culture that is innovative, collaborative, and technology-driven, DrKumo provides the most effective solutions to both patients and healthcare providers.