Remote Patient Monitoring

Telehealth is the future. As experienced through the recent COVID-19 crisis; remote care is no longer a future possibility for the healthcare space, but a necessity to maximize the experience for patients and healthcare professionals. Dr. Irina Koyfman has been building a Remote Patient Monitoring Implementation program unlike any other that will transform the continuum of care for patients, practices, providers and point of care.

How Can We Help

It has never been more important to improve your patients’ outcomes, especially to decrease readmissions. There are a lot of questions about Remote Patient Monitoring (RPM) implementation including required elements, billing, software, staff, and more. Dr. Koyfman has been consulting large and small companies on RPM. Click here to schedule introduction call @ https://calendly.com/dr_irina/30min

What is Remote Patient Monitoring (RPM - Remote Physiological Monitoring)

Remote Patient Monitoring (RPM - Remote Physiological Monitoring) is defined as using technology via medical devices to collect and analyze patient physiologic data used to develop and manage a treatment plan related to a chronic and/or acute health illness or condition.
The physiologic data (e.g., blood glucose, blood pressure) must be digitally, which CMS defines as automatically transmitted to the practice. This is not the patients or caregivers calling to self-report vitals and involves a technology vendor.
Click to schedule introduction call @ https://calendly.com/dr_irina/30min

Required Elements of CMS compliant RPM program

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Medical necessity still applies, meaning treatment must be supported as necessary for the diagnosis or treatment of the patient’s illness or injury or to improve the functioning of a malformed body member.
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RPM services must be initiated during a face-to-face visit (or telehealth during the PHE) for patients not seen within the past year.
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Obtain and document patient consent for services.
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The RPM device must meet the FDA’s definition of a “medical device” (does not have to be FDA-approved, but must still meet the definition).
The medical device must be used to collect and transmit reliable and valid physiologic data that allow understanding of a patient’s health status to develop and manage a plan of treatment.
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CMS designated CPT 99457 and 99458 as care management services, which require the use of interactive communication.
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As with other care management services, clinical staff's time associated with CPT 99457 and 99458 may be provided under the billing provider's general supervision. Clinical staff refers to a person who works under the supervision of a physician or other qualified health care professional and who is allowed by law, regulation, and facility policy to perform or assist in the performance of a specified professional service but does not individually report that professional service. Refer to the CY. To furnish and bill for RPM services (CPT 99453 and 99454) requires 16 days of data; each 30 days must be collected and transmitted. CMS clarified the 16-day requirement will remain their final policy after the PHE ends.
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RPM can be billed in conjunction with Chronic Care Management (CCM) , Transitional Care Management (TCM), and Behavioral Health Integration (BHI) services as long as time and effort are not double-counted.
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Per CPT, do not count any RPM time on a day when the billing provider reports an Evaluation & Management (E/M face-to-face service).
During the PHE, CMS waived the 16-day minimum requirement to bill for RPM services, but only for patients who have suspected or confirmed COVID-19. In such cases, CMS recognized the value of short-term monitoring (no less than two days) for acute conditions and is allowing payment for CPT codes 99453, 99454, 99091, 99457, and 99458.

Benefits

RPM, done right, is the best way to increase your practice revenue, decrease hospital readmissions, along with increase patients’ satisfaction.

Remote patient monitoring (RPM) enables patients to remain at home while receiving optimal healthcare services to manage and treat their conditions, track signs of new symptoms, and intervene when needed.

The remote care program allows physicians to monitor patients' diabetes, heart disease, hypertension, cancer, weight gain, weight loss, and more.

In contrast to other telemedicine and telehealth methods, Remote Patient Monitoring services do not require direct video communication between a provider and a patient, nor do they have specific geographical restrictions.
The only requirement for Remote Patient Monitoring is to collect data from the patient, such as blood pressure cuffs, glucometers, pulse oximeters or activity trackers, and to transmit and visualize the physiological data.
Using Patient Monitoring devices, data can be continuously sent to providers - who will receive automatic alerts when there is a change in a patient's health requiring attention, follow-up, or an adjustment to treatment.

Remote Patient Monitoring Billing Codes

Remote patient monitoring is billed using Current Procedural Terminology (CPT) codes. Specified codes determine and categorize treatment procedures, care services, and billing rates.

Code

Summary

Payment Average

99453

Remote monitoring of physiologic parameters (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education on the use of equipment.

$20

99454

Device supply with daily recordings or programmed alerts, during a 30-day period.

$63

99091

Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and transmitted by the patient and/or caregiver to the physician or other qualified health care professional, requiring a minimum of 30 minutes, each 30 days.

$56

99457

Remote physiologic monitoring treatment management services, clinical staff, and physician or qualified health care professional time in a calendar month requiring interactive communication with the patient/ caregiver during the month, first 20 minutes.

$51

99458

Each additional 20 minutes (this is an add-on code which can only be billed in conjunction with CPT 99457).

$41

Remote Patient Monitoring Reimbursement

To help providers respond to the growing shift and demand for virtual care, the Centers for Medicare and Medicaid Services (CMS) have been expanding reimbursement codes available for remote patient monitoring (RPM) for a number of years.

With financial reimbursement available to support remote care, providers can use the referenced CPT codes to implement and scale RPM programs quickly.
Physicians and qualified medical professionals can use CPT codes to be reimbursed for the time and equipment used for remote patient care.

How Can We Help

It has never been more important to improve your patients’ outcomes, especially to decrease readmissions. There are a lot of questions about Remote Patient Monitoring (RPM) implementation including required elements, billing, software, staff, and more. Dr. Koyfman has been consulting large and small companies on RPM. Click here to schedule introduction call @ https://calendly.com/dr_irina/30min

What RPM Means for Doctors, NPs

Remote Patient Monitoring complements the work of Doctors, Nurses & Clinicians:

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Remote Patient Monitoring enhances clinicians' work by providing more interaction and easier access to information.
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Remote Patient Monitoring allows doctors and nurses to communicate with patients in a more efficient and productive manner.
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Remote Patient Monitoring could help alleviate the doctor shortfall by allowing more doctors to treat more patients, more effectively, by removing geographical restrictions.

Testimonials

Dr. Irina Koyfman helped implement Chronic Care Management Services for my practice - home-based primary care practice. I was not aware of CCM prior and was not billing for all the services I was providing for my patients between visits. Ever since I have implemented what Dr. Koyfman had suggested, I have been able to spend more time with my complex patients, increased my revenue, increased patient satisfaction and overall, I increased my work-life balance. I recommend every primary care provider implementing CCM and hiring Irina as a very capable consultant.

Slava K, Nurse Practitioner, President, Maryland.

Dr. Irina Koyfman Irina has been providing consulting services to ChronWell on Chronic Care Management program for several months. From the very first interaction, it is obvious that her goal as a consultant is to delight the customer and bring value every step of the way. She is knowledgeable, innovative, thinks outside the box, is quick to grasp the context of the organization and provide relevant guidance. She brings a unique blend of business savvy and clinical expertise.

Marina S, VP or Product Management, Florida.

Dr. Koyfman had helped to implement Remote Patient Monitoring Program in my practice, for which I am very grateful. Dr. Koyfman has a way to explain complex issues, so I could understand and quickly implement them. She also told me about few things that I could add (annual wellness visits and cognitive assessments and care plans) and immediately I was able to do so. Dr. Irina Koyfman is generous with sharing her knowledge. I paid for RPM but received so much more.

Vicky, B. NP CEO, Maryland.

Dr. Irina Koyfman came to my mother’s house to assess her cognitive status and she was able to shade light on her diagnosis of moderate dementia and helped us with understanding of the disease progression, treatments, resources, and plan for the future. Dr. Koyfman was very kind with my mother, she was patient with us and we just loved her bed-side manner and her knowledge. Although, it is not easy to know that your mother is not well, but it is very helpful to have someone like Dr. Koyfman on our side.

Lyudmila, daugther of a patient, Maryland.

Questions about patient monitoring program? Dr. Irina Koyfman has the RPM answers!