What is Remote Physiologic Monitoring?
RPM and Home Health Care AgenciesThere has been a lot of talk about home health care agencies being able to bill Medicare for RPM services starting in 2019. It is Assured Medical's option that agencies will not be able to bill using these codes. Instead, agencies will be able to include the cost of providing RPM/telehealth as on operating expense on their annual cost report which will impact their cost per visit. Here at AMA, we see the following benefits of doing this:
- Agencies should be able to include the following as telehealth expenses
- Software purchased during that fiscal year for use with their telehealth program
- Implementation fees paid during that fiscal year for starting their telehealth program
- Telehealth equipment purchase or rental expenses
- In-home installation and patient training expenses
- The allocated portion of a telemonitoring nurse's salary
- Additional expenses incurred in delivering telehealth services such as cell phone, internet, laptop for the telemonitoring nurse since these services can be provided remotely
- The cost of a telehealth program will be spread across all patients, just not the ones being monitored
- Will reduce the amount of effort required to bill telehealth per patient
See the CMS Changes for 2019 link under Additional Resources for the 682 page document from Medicare that talks about telehealth on the cost report. This information starts on page 313.
RPM and PhysiciansAssured Medical Alliance has been providing remote monitoring equipment and services since 2012 and the number one question we get is "Is this reimbursed?" Well now we have a good answer - "YES!" This page provides information about billing codes that can be used when monitoring a patient.
In 2018, Medicare allowed for physicians to bill for RPM services using CPT code 99091. This code was "unbundled" which means that it is a separately payable service (does not need to be combined with another code).
Starting January 1, 2019, Medicare allows providers to bill for the use of telehealth equipment to more effectively and efficiently use RPM technology to monitor and manage patient care.
The 3 new CPT codes related to Remote Physiologic Monitoring are:
There are several additional codes that can be used when seeking reimbursement from Medicare. The table below shows the CPT Code and a brief description:
|99487, 99489, 99490||
Chronic Care Management (CCM)
|99491||New code for 2019 that allows for physician to bill in addition to the office staff doing 99490. May require 30 minutes of physicians time versus just 20 minutes as required by 99490.|
|G2012 initially called GVCI1||
|99451 and 99452||
Interprofessional telephone/Internet/EHR assessment and management service provided by a consulting physician. 5 or 30 minutes are required.
While this code is not specifically an RPM code, it can be used by physician when reviewing RPM data and making medication change.