FAQ Hub: RPM Technology

Here are the commonly asked question on RPM, Billling and remote patient monitoring related questions.

Table of Contents

DrKumo FAQs

What makes DrKumo unique?

DrKumo is a multi-award-winning leader of Connected Health Technology. We are recognized for our HIPAA-compliant AI-driven Remote Patient Monitoring that features multicast live data streaming of patient-generated health data. You will be able to monitor your patients continuously in real-time while improving their engagement, satisfaction, and overall health outcomes.

DrKumo’s technological platform is equipped with strong cybersecurity framework. It develops the world’s first highly-secure RPM application that supports Disease Management Protocols (DMP) and automates the collection and secure transmission of objective and subjective health data to Intelligent Cloud Service.

DrKumo is trusted by prestigious networks of healthcare providers, health and technology partners, government entities, hospitals, Military Veterans, and Native American Veterans.

(See Press Releases for awards, partnerships and CSR activities.)

What is real-time continuous monitoring? What is its advantage?

Continuous monitoring is the live streaming of patient data from a doctor’s dashboard provided by DrKumo. As your patient takes measurements at home using medical devices, you will be able to see their vital signs and other health readings in real-time using our platform with rich visualizations and advanced data analytics.

This technological advancement in RPM allows you to monitor your patients in real-time to see if their health readings are in the normal range or not, and provide timely medical intervention when needed. This reduces health deterioration, which leads to hospitalization or readmission.

Read more: 4 Ways Continuous Real-Time Remote Patient Monitoring Saves Lives in 2022

What are the devices that you provide to our patients?

DrKumo provides easy-to-use medical devices that are already familiar to your patients. They will be able to operate them by themselves or with minimal assistance from their families.

Our devices include, but not limited to, blood pressure monitor, blood glucose meter, pulse oximeter, digital weight scale, military-grade smartwatch, and thermometer. All these devices are connected to DrKumo mobile application, which records and transmit health data in real-time.

Do patients need to pay for these devices?

No, these devices come for free when they onboard in your remote patient monitoring program. They receive a device/s appropriate for their chronic or acute disease health readings.

Is your RPM platform secure?

Yes. DrKumo is a HIPAA-compliant RPM provider and it utilizes a strong cybersecurity platform to avoid security breaches for both healthcare professionals and patients.

Read more: The 5 Functions Needed to Securely Implement Remote Patient Monitoring Based on the NIST and NCCoE Cybersecurity Framework

How does DrKumo solve the US problems in healthcare today?

The USA faces problems such as barriers in healthcare access to rural areas, shortages in healthcare workers, risks of COVID-19 cross-infection for both providers and patients, increasing healthcare costs, and an increasing number of patients with chronic diseases.

DrKumo’s mission is to save more lives through state-of-the-art Remote Patient Monitoring and to help save more healthcare costs. We provide continuous real-time monitoring of patient health data to enable healthcare providers and care coordinators to keep track of patients’ health condition even at the comfort of their homes. This allows doctors to provide timely medical intervention, modifications in diet and medications, thus reducing the risk of hospitalization and readmission.

The COVID-19 pandemic accelerated the adoption of virtual visits, telehealth and RPM. Everyone, especially seniors and chronically ill patients, was required to stay home to avoid virus cross-infection. This leads to missed appointments and further health deterioration. DrKumo RPM reduces cases of patient no-shows and provides bridge access to patients who live in rural areas and patients who cannot travel to the hospital for check-ups. Patients will now be able to stay connected to their providers as their providers monitor them from afar.

Patients and doctors do not need to worry operating AI-driven healthcare technology. DrKumo’s RPM medical devices and mobile application are secure, easy to understand and to operate. Even the elderly will be able to take measurements and automatically send data without too much assistance from their family members or caregivers. Providers will be able to receive data from their dashboard with rich visualization, easy filter functions, and color-coded alert system.

How can providers get reimbursed for RPM services?

Remote Patient Monitoring is most commonly covered by patient insurance and government-funded healthcare programs such as Medicare. Practitioners bill Medicare for Remote Patient Monitoring services provided to Medicare patients. Practitioners can bill Medicare for a variety of services by submitting CPT codes.

Read More: Five Primary Medicare Remote Patient Monitoring CPT Codes You Should Know

How can start my RPM program with DrKumo and onboard my patients?

Thank you for your interest. This can be done in just 20 minutes over the phone or online platform you prefer. DrKumo will provide you with a dedicated team that will set up your RPM program. Contact us for more information.

More FAQs and best paractices for you and your clinic

General RPM FAQs

What is Remote Patient Monitoring or RPM?

Remote Patient Monitoring (RPM) or remote physiologic monitoring is the use of electronic devices or digital technologies to capture and monitor patients’ health data and transmit it to their health provider to receive, analyze, and evaluate the data for assessment and recommendations. For instance, through RPM, a patient can measure his/her blood pressure regularly using a blood pressure monitor and digitally, usually automatically, send measurements to their clinician. RPM devices allow providers to monitor, report, and analyze their patients’ acute or chronic conditions from outside the hospital or clinical setting.

How remote patient monitoring RPM works?

Remote patient monitoring solution provides a bridge between patients and physicians using digital technology. At various intervals during the day, patients monitor themselves by taking measurements, and then electronically submit such data to their clinicians or care coordinators.

The information is then analyzed by medical professionals in their primary care clinics, hospitals, intensive care units, nursing homes, or off-site monitoring centers in order to provide daily, or in some cases, hourly recommendations. They can also provide much-needed reassurance that treatment is working by continuously refining each treatment plan or medication. They can also provide rapid notifications to alter prescriptions or direct patients to the ER if necessary.

In some cases, RPM is also used after a patient is discharged from the emergency room or a care facility. RPM devices enable doctors to continue monitoring and making adjustments with the treatment plan, often avoiding the need for the patient to be readmitted.

When doctors are able to monitor weight, blood pressure, blood sugar, blood oxygen saturation, heart rate, and electrocardiograms from any point of care, they are able to collect data more frequently and reliably than they could during traditional in-office patient sessions. This quick, real-time information transmission could be a lifesaver.

What are the common devices that can be used for RPM?

RPM can use wired or wireless medical devices. The most common RPM devices are blood pressure monitor cuffs, ECG, pulse oximeters, weighing scales, thermometer, wearable (activity trackers and continuous monitoring) blood pressure monitors, cardiac implants, and blood glucose meters.

Who qualifies for RPM?

Although CMS initially defined RPM services as those provided to patients with chronic conditions in the 2019 PFS final rule, CMS clarified in the 2021 Proposed Rule that practitioners may provide RPM services to remotely collect and analyze physiologic data from patients with acute and chronic conditions.

Who pays for Remote Patient Monitoring?

Remote Patient Monitoring is most commonly covered by patient insurance and government-funded healthcare programs such as Medicare. Practitioners bill Medicare for Remote Patient Monitoring services provided to Medicare patients. Practitioners can bill Medicare for a variety of services by submitting CPT codes.

Who can furnish RPM?

While CPT code 99091 can only be provided by a physician or other qualified healthcare professional, CPT codes 99457 and 99458 can be provided by a physician or other qualified healthcare professional, as well as clinical staff under the physician’s general supervision.

In the 2021 Proposed Rule, CMS proposed allowing auxiliary people, in addition to clinical staff, to provide services defined by CPT codes 99453 and 99454 under the general supervision of the billing physician or practitioner. Other individuals who are not clinical staff but are employees, leased or contractual employees, are referred to as auxiliary personnel.

What are the main CPT codes used for RPM?

The Centers for Medicare & Medicaid Services (CMS) has established CPT codes for remote patient monitoring (RPM). RPM tracks patient vitals outside of the healthcare setting to allow providers to intervene and improve health outcomes. CPT codes exist for all components necessary for the provision of RPM, they include:

CPT Code 99453: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; setup, and patient education on the use of equipment. (Initial set-up and patient education of monitoring equipment)

CPT Code 99454 : Device(s) supply with daily recording(s) or programmed alert(s) transmission, every 30 days. (Initial collection, transmission, and report/summary services to the clinician managing the patient)

CPT Code 99457: 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; first 20 minutes

CPT Code 99458: Each additional 20 minutes (List separately in addition to code for primary procedure)

CPT Code 99091: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/ regulation (when applicable) requiring a minimum of 30 minutes of time, every 30 days.

Read More: 4 Main Medicare CPT Codes for Remote Patient Monitoring

Billing and Reimbursement FAQs

What are the common examples of RPM devices qualified for Medicare?

Blood pressure monitors, weight scales, pulse oximeters, and blood glucose meters are some of the most common RPM devices. The health monitoring device must meet the FDA’s definition of a medical device as described in section 201(h) of the Federal, Food, Drug and Cosmetic Act. There is no language in the CPT Codebook indicating the device must be FDA-cleared, although such clearance may be appropriate. To be eligible for Medicare, the RPM device must digitally (that is, automatically) upload patient physiologic data and cannot be self-recorded or self-reported by the patient.

Should the patient have a chronic condition to qualify for RPM?

Although CMS previously defined RPM services as those provided to patients with chronic diseases in the 2019 PFS final rule, CMS clarified in the 2021 Proposed Rule that practitioners may provide RPM services to remotely collect and analyze physiologic data from both acute and chronic patients.

Who can order and bill for RPM services?

RPM codes are classified as Evaluation and Management services (E/M). They may be ordered and billed only by physicians or nonphysician practitioners who are Medicare-eligible to bill for E/M services, according to CMS.

Who can furnish RPM and obtain consent?

CPT codes 99457 and 99458 may be provided by a physician or other qualified healthcare professional, as well as by clinical staff working under the physician’s general supervision.

Can RPM be used on both new and established patients?

As stated in CMS 2021 Final Rule, RPM services are available only to “established patients.” However, CMS asserted, in support of this position, that a physician who has an established relationship with a patient would likely have had an opportunity to provide a new patient E/M service. During that new patient E/M service, the physician would have gathered relevant patient history and performed a physical exam, if necessary. As a result, the physician would have the information needed to understand the patient’s current medical status and needs prior to ordering RPM services to collect and analyze physiologic data and develop a treatment plan. CMS waived the “established patient” restriction during the Public Health Emergency (PHE), but declined to extend such waiver beyond the PHE in the 2021 Final Rule. The CMS waiver implies (but does not explicitly state) that practitioners may perform RPM services during the PHE without first performing a new patient E/M service. After the PHE waiver expires, a patient-practitioner relationship must be established in order to bill Medicare for CPT 99453, 99454, 99457, and 99458. This usually necessitates the practitioner performing a new patient E/M service.

What is the scope of “interactive communication” with the patient?

CMS clarified that 20-minutes of intra-service work associated with CPT codes 99457 and 99458 includes time spent by a practitioner on “interactive communication” as well as time spent on non-face-to-face care management services during the month. Additional information about CPT codes 99457 and 99458 can be found in our article “3 FAQs about CPT 99457, 99458, and 99091.

The required 20 minutes of “interactive communication” with the patient would make RPM an outlier in comparison to other similar services, such as chronic care management services (CCM), for which CMS has stated that the time-based requirements include a combination of patient interactive communication, monitoring, and management of the patient’s care plan.

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