This November, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule containing updates to the Physician Fee Schedule. This included a list of prices, reimbursement rates, and billing codes for various healthcare services, as well as costs related to remote patient monitoring (RPM). As changes occur you’ll also want to stay up to date on all the latest updates to CCM reimbursements.
Looking at 2024, let’s review the changes to Medicare and Medicaid reimbursements for remote patient monitoring.
How Is Remote Patient Monitoring (RPM) Different from Chronic Care Management (CCM)?
First, let’s cover the key difference between remote patient monitoring (RPM) and chronic care management (CCM). Since RPM providers collect patient data using remote devices, RPM codes give providers an opportunity to receive reimbursements for monitoring these devices.
Some examples of devices providers might use to monitor RPM patients include:
- Blood pressure cuffs
- Weight scales
- Pulse oximeters
- Heart monitors
- Blood glucose monitors
There are two important considerations when seeking reimbursement for RPM:
- RPM is home-based care – In RPM, patients receive care from home; they’re also monitored at home instead of in a clinical setting. RPM offers patients and providers an opportunity to overcome barriers related to transportation (and a number of other obstacles) to ensure high-quality care.
- RPM data can’t be self-reported – CPT requires providers to collect and electronically transmit data from the monitoring devices listed above: this information can’t be self-reported by patients. Thus, CPT provides billing codes related to the use and management of these devices.
Providers may be able to seek reimbursement for both RPM- and CCM-related costs—patients undergoing treatment for ongoing medical challenges may receive treatment in an in-person clinical environment in combination with at-home monitoring. However, RPM codes apply specifically to the devices and treatments used remotely.
Description of 2023-2024 RPM CPT Codes & Reimbursement Rates
2024 CMS RPM CPT codes will remain the same as they were in 2023. Here’s a quick table summarizing these codes, what they cover, and the average reimbursement rates:
|2024 RPM Reimbursement Rates
|What it Covers
|Initial setup of the remote monitoring device and educating the patient on how to use it, including connecting it to other devices, if needed.
|Monthly remote monitoring with daily electronic recordings of physiological data from the patient. At a minimum, a provider must receive RPM recordings for 16 days during the 30-day period in which services are billed.
|Remote patient monitoring treatment & management that includes dialogue between the clinical staff and patient and lasts at least 20 minutes, billed per calendar month.
|Each additional 20 minutes of patient monitoring treatment & management services provided, billed per calendar month.
|Clinical providers can bill for the time spent collecting, interpreting, and processing physiological data from patients. Here, patients must receive RPM services for at least 30 minutes every 30 days. This does not require interactive communication with patients.
Maximize Your RPM and CCM Model with Signallamp
Remote patient monitoring and chronic care management require efficient, supportive infrastructure for providers and patients —especially when it comes to correct billing. However, with high patient loads and changing regulations, providers need ample support for providing effective RPM and CPM services to patients.
This is where we come in. At Signallamp, we provide the robust RPM and CCM support structure that providers need to sustain (and scale) their programs YOY. Signallamp helps provider organizations take care further while also maximizing financial performance by streamlining enrollment and consent, assigning dedicated nurse care managers for monitoring and triage, and documenting directly in your EHR.
Ready to build a sustainable RPM program? Schedule a consultation with Signallamp today.
Department of Health and Human Services. Medicare and Medicaid Programs. https://public-inspection.federalregister.gov/2023-24184.pdf
CMS. Calendar Year (CY) 2024 Medicare Physician Fee Schedule Final Rule . https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2024-medicare-physician-fee-schedule-final-rule