Increase Practice Revenue without Extra Work: Mastering Medicare RPM Reimbursement

New technologies are revolutionizing how doctors can perform chronic care management (CCM). Remote patient monitoring (RPM) is one of them, giving doctors and nurses the ability to track patients’ health while those patients are at home. For this technology to be financially successful for your practice, your workers must understand the most recent CPT codes for RPM to get reimbursed, as well as the services you need to offer in order to bill for these codes. Mastering the latest billing codes and aligning your services with them unlocks greater financial returns for your RPM program, ensuring stability and improved patient care.

Maximize Your RPM Revenue in 2024

TriageLogic stands out as an industry leader for remote patient monitoring and coding. Our comprehensive RPM services offer healthcare providers two things:

1. Improved patient outcomes. Patients battling chronic disease can see their health deteriorate quickly. Our nurses act as an early warning system by reviewing vitals and notifying physicians when these changes are about to occur.
2. Higher profits. CMS currently reimburses for RPM at around $120 per person per month. With 50 RPM patients, that’s roughly $72,000 a year in potential revenue.?

Here’s a breakdown of the Medicare CPT codes for RPM that your team should know about, and how our program can manage them on your behalf.

CPT 99453: RPM Equipment Setup

Launching a successful RPM program starts with equipping patients with wearable devices and ensuring they understand how to use them effectively. This is covered by CPT code 99453. It’s a one-time fee that reflects the work needed to begin the monitoring process.?

It’s especially important that patients understand how to apply their devices, as using them improperly can generate inaccurate or incomplete data that puts their health at risk.

When it comes to patient onboarding and device setup, TriageLogic handles everything so that you’re free to focus on clinical expertise.?

CPT 99454: Collecting and Transmitting Data

Once device setup is complete, CPT code 99454 comes into play. It covers the collection and transmission of patient data to providers. Unlike CPT 99453, which is just a one-time fee, CPT 99454 is billed every month. However, to get paid, patients need to use their monitoring devices for at least 16 days of that month.?

This requirement demonstrates how important it is to providers that their patients know how to use their equipment.

TriageLogic will verify that RPM devices are working and that data is getting transmitted properly so that you’re able to bill for this code.?

CPT 99457 and 99458: Monitoring Services From Healthcare Workers

CPT codes 99457 and 99458 are about the time spent by your team in monitoring and managing patients’ remote care. CPT 99457 covers the first 20 minutes of monitoring in a month, while CPT 99458 covers each additional 20-minute period after that.?

These codes reflect the services required by your healthcare workers to make sure patients are doing well in lieu of physical examinations. Those services can include the analysis of RPM data, sharing that data with the rest of a patient’s care team, providing patients with updates on their progress, or making changes to their care plans and prescribed medications.

TriageLogic’s highly trained nurses can perform these monitoring services on your behalf. At the end of the month, we give a breakdown of how much time nurses spend with individual patients so that your doctors know which of these CPT codes for RPM to use.?

CPT 99091: Data Analysis From Doctors

Lastly, CPT code 99091 is applied when practitioners or other qualified health care professionals analyze the data collected by remote patient monitoring devices. They need to spend at least 30 minutes each month looking at RPM data for this code to qualify. They also need to understand what the data means so that they make more-informed decisions for patient care.

Our telehealth nurses use protocols specific to patient devices to ensure that doctors are alerted when patients require medical attention.?

Improve Care and Generate Greater Revenue?

We already mentioned how profitable an RPM program can be. Some of the work can be outsourced to give you a streamlined approach and more time to manage patient care, while we handle everything else.

Make sure that you receive accurate and compliant billing that uses the correct codes for remote patient monitoring, all while guiding your patients through the proper applications of their respective devices.?

Need Help Getting Started? My Team can Help You

Navigate the complexities of remote patient monitoring with confidence. Our experts in coding regulations and industry best practices will help you:

• Unlock maximum reimbursement with our in-depth knowledge of CPT codes for RPM.
• Simplify compliance and stay ahead of evolving regulations.
• Focus on patient care while we handle the administrative burden of RPM.

Partner with TriageLogic for an RPM program that delivers better outcomes for you and your patients. Contact me today to learn more.