The Ultimate Guide to Remote Patient Monitoring Billing

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Before you begin billing remote patient monitoring, you need to understand what remote patient monitoring is. Generally, remote patient monitoring is a clinical evaluation and management service available to clinicians. The U.S. medical system uses five-digit CPT codes to identify services, but remote patient monitoring is billed using its billing codes. If you don’t understand how to bill this service, you risk being denied reimbursement by CMS.

CPT codes

The Centers for Medicare and Medicaid Services (CMS) recently expanded reimbursement codes for remote patient monitoring services. This new care category covers remote monitoring services provided by physicians, clinical staff, or other healthcare professionals. CPT codes for remote patient monitoring billing cover both the equipment and time needed to install and operate the device. The CPT code for remote patient monitoring also includes time spent communicating with the patient, interpreting data, and overseeing management and service coordination.

Remote Patient Monitoring can now be billed through CPT codes, a new way for facilities to mitigate COVID-19 exposure and alleviate the strain on healthcare facilities during a global health crisis. The new code allows remote patient monitoring services to be billed every 30 days. For the best reimbursement, CPT codes for remote patient monitoring billing should be implemented as soon as possible. In addition, it is essential to note that remote patient monitoring is now covered under Medicare’s wellness programs.

The average reimbursement rate for remote patient monitoring

The monthly reimbursement rate for remote patient monitoring is $120 per Medicare beneficiary. However, reimbursement may vary. For example, Medicare will cover the first 20 minutes of monthly interaction with the patient, while private payers may only pay for up to 40 minutes. Nonetheless, Medicare reimbursement can be valuable to your practice. First, make sure to know your patient’s health status. Monitoring a patient daily can help them manage their condition more effectively.

Before implementing remote patient monitoring software, providers should evaluate their billing models. Consider potential issues if their organization’s billing model does not reflect the new CPT codes. Create a billing model for data-monitoring services that supports updated CPT codes, allowing seamless reimbursement. If your organization uses a third-party service, it should ensure that it employs clinical staff and medical professionals from one healthcare facility.

Devices used

The Centers for Medicare & Medicaid Services (CMS) recently approved new reimbursement CPT codes for remote patient monitoring. This policy allows providers to bill for the first 20 minutes of remote patient monitoring services and the second twenty-minute review of data. These new codes are stacked with other non-face reimbursements, such as telehealth. As a result, these new codes can help providers maximize reimbursement for remote patient monitoring.

The devices used for remote patient monitoring must meet the CMS definition of a remote patient monitoring service. Devices proprietary to the provider and not recognized by governing bodies cannot be used to bill for these services. Additionally, remote patient monitoring services must be performed for a minimum of 16 days in a billing period. Furthermore, primary RPM billing codes cannot be applied to the same patient’s account more than once within 30 days.

HIPAA compliance requirements

HIPAA compliance requirements for remote patient monitoring (RPM) billing have some specifics. Unlike billing for in-person care, remote patient monitoring (RPM) services must be provided to patients free of charge. They also must fit the definition of a medical device as outlined by the FDA. Additionally, billing for multiple devices is limited to once every 30 days. This rule applies whether or not the RPM services are furnished by auxiliary personnel under the general supervision of the billing physician.

Among HIPAA compliance requirements for remote patient monitoring, the provider must take reasonable steps to protect the patient’s privacy. The provider must first verify the identity of the member. They should then provide the member with basic information regarding the remote patient monitoring services. The telehealth practitioner cannot record the session without the member’s consent.¬†

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