Remote Patient Monitoring (RPM)
Frequently Asked Questions

FAQs for Patients

The advantages of remote patient monitoring include: 

  • Easy access to patient data 
  • More capacity to manage chronic illnesses
  • Decreased expenses
  • Greater efficiency

Now care teams can remotely monitor patients, ensuring their patients have fast access to the teams as needed. With real-time patient health data, care providers can better detect and treat problems before they become severe. In addition, the care team may comprehensively know a patient's condition and make better choices using technology to connect with the patient's physician. Sometimes, the staff may notify the patient's loved ones if anything alarming occurs on site.

Patients with chronic conditions such as obesity, COPD, heart disease, and diabetes can benefit from remote patient monitoring. Proactively managing these conditions improves patient quality of life and decreases total healthcare costs via reduced hospitalization.

As the older population continues to expand, there is a greater need for their safety and comfort. Using remote patient monitoring helps elderly patients stay in close contact with physicians and nurses. The monitoring also assists nurses in keeping track of patients' medical problems and accessing suitable treatment when necessary.

Medicare, twenty-one state Medicaid programs (as of January 2021), plus a rising number of commercial payers pay for RPM. Some jurisdictions, like Louisiana, require all private insurers operating within the state to provide RPM coverage.

  • Diabetes 
  • Hypertension
  • Cancer
  • Chronic Obstructive Pulmonary Disease (COPD)

By adopting an effective RPM system under the direction of a care coordinator, healthcare practitioners may observe their patients and intervene as required.

We offer remote monitoring gadgets for free or at a minimum cost, and they come with our professional customer support that is just a call away.

FAQs for Payers & Care Coordinators

Remote patient monitoring (RPM) software is a clinical instrument that enables clinicians to see and manage patient data remotely. Clinics, hospitals, and other healthcare facilities implement RPM programs to enhance treatment efficiency and quality. Doctors also take advantage of it as an extension of basic care practices.

An EMR collects patient information, documents changes in patients’ health conditions, and creates reports that can be shared with other medical practitioners.

FAQs for Billing & Reimbursement

A growing number of commercial payers, including Medicare and 21 Medicaid programs (as of January 2021), are paying for RPM. Louisiana, for example, requires all private insurers operating within the state to offer RPM coverage. The RPM CPT codes were revised in 2020, made it among the most profitable Medicare care management systems.

A nominal fee is charged for the initial registration of patients, for the maintenance of the device, and the readings of patients. An additional service is available for every 20 minutes of clinical staff-provided care management.

As of March 2021, the following are true:

CPT code 99453 (Setup)
Remote tracking of physiologic parameter (s); initial, setup, and educating patient. Medicare reimburses $21 for the first RPM device setup and educating the patient.

CPT code 99454 (Device & Monitor)

It entails supplying devices with regular recordings or transmitting programmed alerts for 30 days regularly. Medicare compensates $64 monthly for tracking patient data while it streams in from a device.

CPT code 99457 (Patient Engagement)

Each calendar month, the clinical staff, physician, or other qualified healthcare professional should spend 20 minutes or more on remote physiologic monitoring treatment management services with interactive conversations with the patient/caregiver. Medicare reimburses $55 monthly for monitoring data and overseeing care for 20 minutes per month.

CPT code 99458 (Additional 20 Minutes).

Every calendar month, the clinical staff/physician/other competent health care professional must have an interactive conversation with the patient/caregiver; an additional 20 minutes are needed. For every additional minute spent past 99457's first 20 minutes up to a total of 60 minutes, Medicare compensates $44 per month. 

CPT 99091 was the initial code for billing remote patient monitoring. Because of the availability of the above newer codes, CPT 99091 had been infrequently reported during the past many years. Since CMS now allows billing CPT 99091 alongside the latest codes, the Medicare physician fee schedule final rule for 2021 may alter the number of times the code will be billed. Clinicians may claim for "complex" RPM management when they must devote considerable time to maintaining the patients’ RPM care plans. CMS further showed that 99091 might be invoiced each month anytime such complicated provider management happens without compromising the practice's capability to charge clinical staff time using CPT 99457.

Yes, CPT code 99453 covers them.

99457 reimburses the billing physician, QHCP, or clinical staff for the time performed in line with applicable legislation.

No. RPM services may be recommended to any patient who might benefit from them.

The code 99454 reimburses providers for the ongoing supply of devices and remote patient monitoring. The code is billable monthly but only once per patient regardless of the patient's number of devices.

Yes, Medicare recipients have a 20% beneficiary copayment. However, this copayment may be paid if the patient has supplementary insurance or Medicaid.

To provide RPM services, care teams must obtain patients' informed consent.

To complete the documentation for CPT 99453, add:

  • Practitioner's order regarding the deployment of the gadget
  • Ailment (s) for which the patient is under observation
  • Device identification
  • Date of device delivery to the patient 
  • The date(s) on which the patient undergoes training

For CPT 99457 and 99458—the time-based codestrack the duration of each procedure.

No, CMS has described interactive communication as a real-time conversation with synchronous, bilateral interactions that video or other forms of data may augment, as described by CPT codes 99457 and 99458. Some RPM providers and suppliers believe that texting is suitable for providing billable interactive communication time. This has been changed in the final rule for the Medicare physician fee schedule for 2021. Texting with patients can qualify as RPM management time but does not meet the criteria for interactive communication. RPM codes require verbal communication with patients or caregivers for billable time.

No. Based on the final rule of the 2020 Medicare physician fee schedule, different providers might charge RPM services for the same patient if the patient used various RPM devices, causing misunderstanding around this subject. In 2021, CMS wanted to clarify that only a single provider may charge CPT codes 99453 and 99454 for 30 days. Suppose one or more providers want to charge for remote patient monitoring services for a patient already getting RPM services from a different provider. In that case, the claims may probably be refused. Repeated effort to charge for RPM in this manner may cause compliance issues.

Patients are not allowed to report their own remote patient monitoring. Self-reporting measures into a patient portal or app or manually transmitting measurements to doctors may be eligible for other Medicare-covered treatments. Still, data collected in this manner cannot be included in Medicare RPM. Without patient transcription, RPM device readings must automatically synchronize with a provider's remote patient monitoring system.

CMS made the unexpected statement early in 2021 that it would issue a revision to its 2021 Medicare physician fee schedule final rule. The change was appreciated as it cleared various areas of misunderstanding about billing obligations for remote patient monitoring and expanded coverage.

The five most crucial RPM Medicare codes are CPT codes:

  1. 99453 
  2. 99454
  3. 99457
  4. 99458
  5. 99091

Remote Patient Monitoring (RPM) standard codes are 99453, 99454, 99457, and 99458. The codes were available for RPM solutions before the COVID-19 outbreak. 

  • CPT Code 99453 is for the initial set-up, whereas CPT Code 99454 is for the distribution of the device, acquisition, synchronization, and report/summary to the physician. 
  • The CPT codes 99457 and 99458 represent clinical staff/MD/QHCP remote physiologic monitoring services.
  • NP or MD has to provide these codes with general oversight.

Yes. As with all Medicare treatments, patients handle any necessary copayments based on the services provided. During the COVID PHE, providers may forgo RPM copayments.

The codes are not restricted to chronic illnesses alone.

Yes, both new and established patients can use the RPM.

There are many alternative ways to charge for the service, and each has advantages and disadvantages. Here are the three recommendations to help you charge for remote patient monitoring most effectively:

1. Use a Simple Software
Billing software differs in terms of their usability and usefulness. Choose the method that will be the simplest for you to comprehend and use.

2. Bill Accurately
Billing errors might cause expensive penalties or even legal action. Ensure that you charge accurately to prevent lawsuits or penalties.

3. Observe Your Records
During remote patient monitoring, keep track of all patient contacts to identify any billing issues in the future.

Medicare and Medicaid pay clinicians for remote patient monitoring through various devices. The remote health care provider's frequency and duration of out-of-hospital visits often decide the compensation.

The following medical professionals can implement remote patient monitoring:

  • Primary care providers (PCP)
  • Speciality providers
  • Home healthcare providers
  • Palliative and hospice care providers
  • Physicians and practice groups

Depending on patients’ preferences, anyone who needs to contact a patient may use a remote patient monitoring system, including:

  • Family members
  • Friends
  • Healthcare professionals
  • Emergency medical services personnel

Any patient with a chronic or acute ailment can get RPM treatment if the clinician prescribes/orders RPM to manage the patient's condition.

The Centers for Medicare & Medicaid Services stated Medicare does cover remote patient monitoring. That implies Medicare would also cover warnings sent by a patient's doctor besides their usual email notifications. Before certification, the supplier must also be registered with CMS and undergo quality control testing.

Yes, permission must be obtained and recorded in patients' medical records. Medicare permits verbal consent, while other payers may need written permission.

The following 12 specialties provide remote patient monitoring solutions:

  1. Radiology
  2. Psychiatry
  3. Internal Medicine
  4. Neurology
  5. Family Practice
  6. Internal Medicine
  7. Geriatrics
  8. Allergy & Immunology
  9. Endocrinology
  10. Infectious Conditions
  11. Urology
  12. Occupational Medicine

The providers must comply with HIPAA's security and privacy rules as with any other healthcare program. In addition, the providers must verify that their RPM devices and technologies adhere to FDA regulations.

Yes, a physician may charge for RPM and CCM CPT codes 99457 and 99490. CMS affirms that the evaluation in RPM services is a valuable addition to CCM and other care management solutions.

General FAQs

Using RPM systems and technology, a healthcare practitioner may follow a patient's health via the electronic health information they get from the patient's health monitoring devices. Based on the data, they can evaluate and make recommendations.

The most prevalent RPM devices are:

  • Blood pressure monitors
  • Blood glucose meters
  • Pulse oximeters 

For RPM, a formal diagnosis is not compulsory. A physician or other ordering provider may prescribe RPM for any patient who might benefit from it.

With RPM, care teams collect information, such as: 

  • Physical activity
  • Weight
  • Blood sugar levels
  • Blood pressure
  • Vital signs
  • Heart rate

The most prevalent RPM devices are:

  • Blood pressure monitors
  • Blood glucose meters
  • Pulse oximeters

Remote patient monitoring uses digital technology to track and gather patients' medical and other health data and digitally transfers the information to the care teams for analysis, prescriptions, and directions.

Yes, remote patient monitoring falls within the category of telehealth. Unlike remote patient monitoring, telehealth refers to the entire business, technique, and technology that enables healthcare.

As of January 2021, Medicare, 21 state Medicaid programs, and many commercial insurers cover RPM. In certain jurisdictions, such as Louisiana, all private insurers are legally bound to offer RPM coverage.

Remote patient monitoring (RPM) allows healthcare professionals to gather patient data remotely. RPM systems capture patient data through sensors sharing information with a central database. The information helps care teams monitor patients for future health problems and provide feedback. By regularly collecting data, the RPM system detects early indicators of disease worsening that can be treated with early intervention. In addition, the RPM program offers patients education and help, improving their overall health and well-being.