WHAT ARE VIRTUAL HEALTH PROGRAMS?
Virtual health programs, like RPM, enable the patient and healthcare team to stay in touch between 1:1 visits and have proven effective at helping patients improve their health status. These programs save money on healthcare over the long term — especially when they prevent an ER or costly and debilitating hospital stay. At the same time, and with little time needed from the doctor’s staff, Medicare will pay up to $180 per month, per patient.
What is RPM?
Personal health and medical data collection from an individual with a chronic condition using FDA approved devices such as a blood pressure monitoring at home. The data is transmitted to their medical provider in a different location to assist in care and related support.
Why My Practice?
If your practice caters to a high volume of Medicare patients with chronic conditions then you can earn an additional $10 – $20k per month for each physician who participates in RPM. SCC understands the importance of ROI to physicians, especially during the PHC when less patients are coming into the office. Our platform was designed so there are NO upfront costs and NO risk of paying for any services not covered by a patient’s insurance.
What are the patient benefits?
Patients will benefit from having devices to use at home that sends data to their doctor automatically. Over time trends and logarithms are developed that assist clinicians in giving better patient care. The consumer facing app can also empower patients in improving their overall health.
CPT Codes for Billing RPM
In January, 2019, the Centers for Medicare and Medicaid Services (CMS) announced new reimbursement CPT codes for RPM. Below is a chart that explains the billing codes for RPM.
- is a one time fee for the device set up.
- is the monthly billing for the device itself. Medicare will pay for one device per month, however, at the physician option, more than one device may be used to assist in patient care. For example; an obese patient with hypertension may need a blood pressure unit and a weight/BMI scale.
- is used for the first 20 minutes of time spent reviewing patient data, checking for compliance, and other patient maintenance items. This may be done by a doctors staff member or any qualified healthcare professional (QHCP)
- can be billed for an additional 20 minutes of time for patients who require it. If a patient is using 2 devices then more time may be needed on the phone and for tracking the devices being used. This also may be done by a doctors’ staff member or any qualified healthcare professional (QHCP). CPT Code 99458 is a code that can be used more than once if more time is needed.