Remote Patient Monitoring Coaching with Dr. Irina Koyfman
Definite Guide to Remote Patient Monitoring Program
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.
What is Remote Patient Monitoring (RPM)
Remote Patient Monitoring (RPM) 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.
According to a study with diabetes patients, the ease of use and unobtrusiveness of the transmission device play an important role in patient openness to Remote Patient Monitoring.
Many patients are already familiar with the use of some monitoring devices and will have to get used to a transmission device as well.
It should be easy to set up and fairly hands off in daily use.
Required Elements of CMS compliant RPM program
•
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.
•
RPM services must be initiated during a face-to-face visit (or telehealth during the PHE) for patients not seen within the past year.
•
Obtain and document patient consent for services.
•
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.
•
CMS designated CPT 99457 and 99458 as care management services, which require the use of interactive communication.
•
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.
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.
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 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.
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.
Each additional 20
minutes (this is an
add-on code which
can only be billed
in conjunction with
CPT 99457).
$41
* CPT Code 99453 is an initial code and can only be billed once per patient at the start of services.
CPT Code 99453 is the setup code for Remote Patient Monitoring and reimburses physicians for the time it takes to help patients set up and learn how to use their devices.
CPT 99453 can be billed only once per episode of care where an episode of care is defined as “beginning when the remote physiologic monitoring service is initiated and ends with attainment of targeted treatment goals.”
* CPT Code 99454 covers the provisioning and supply of devices for RPM programs, and it may be billed once every thirty days.
CPT Code 99454 covers the costs associated with leasing a home-use medical device(s) to and for the patient.
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.
RPM involves the collection and analysis of patient physiologic data that are used to develop and manage a treatment plan related to a chronic and/or acute health illness or condition.
The five primary Medicare RPM codes are CPT codes 99091, 99453, 99454, 99457, and 99458.
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. Irina Koyfman has been consulting large and small companies on RPM.
Click here to schedule introduction call @ https://calendly.com/dr_irina/30min
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.