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