Remote Patient Monitoring: The path toward sustaining effective patient monitoring programs for lower socioeconomic populations.
Traditionally, patients from lower socioeconomic status tend to have an outsize effect on readmissions.1 Payers and providers are aware that this population faces unique challenges around non-medical needs like food insecurity, home issues and acquiring medications. These social determinants are known and can be somewhat mitigated with 3 rd parties and dedicated clinical resources. However, the cost to make these sustainable programs has always been an issue.
With the recent remote patient monitoring codes, we believe this to be the most effective way to make your care management programs go the distance. In January 2018 CMS unbundled a code for patient monitoring that has been around for 16
years. CPT code 99091 is defined as the “collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time. This code typically pays $60 per patient per month.
Also slated for final approval for January 2019 are 3 new codes that more accurately reflect how RPM is implemented today.
The new Chronic Care Remote Physiologic Monitoring codes are:
- CPT code 990X0: “Remote monitoring of physiologic parameter(s) (e.g, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.”
- CPT code 990X1: “Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.”
- CPT code 994X9: “Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.”
These new codes allow providers to effective receive reimbursement for monitoring patients at home to ensure compliance. Studies 2 show that patients with COPD, among other chronic conditions, that utilize RPM have experienced a 54 percent decrease acute hospital readmissions. A typically hospital managing 200 patients can also expect revenue of $12,000 a month in addition to the cost savings from readmission reductions.
With lower socioeconomic populations putting an undue pressure on hospital budgets it is wise to partner with a company to help guide you toward additional revenue while helping your patients take charge of their own health.
SynsorMed provides a complete solution for our clients. Not only do we provide a platform that quietly tracks a patient’s progress and monitors clinical areas of concern, but we are able to provide mobile and connected devices for patients who are in need. With our clinical staff, we are able to handle simple patient requests for medication refills, home concerns, and patient transportation needs through local third-party partners.
Our complete care management turnkey product and service allows us to partner with our hospital clients to increase revenue through the new CPT remote patient monitoring codes.
To get started today reach out to us at firstname.lastname@example.org
1. Socioeconomic status and readmissions: evidence from an urban teaching hospital. Hu J, Gonsahn MD, Nerenz DR Health Aff (Millwood). 2014 May; 33(5):778-85.
2. White Paper: Hospitals of Distinction, Fraser Health uses new technologies to help COPD patients ‘BreatheWELL at Home’. November 30, 2013