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For providers Preparing patients for telehealth

Telehealth and remote patient monitoring

The ability to monitor certain aspects of a patient's health from their own home has become an increasingly popular telehealth option. Remote patient monitoring lets providers manage acute and chronic conditions. And it cuts down on patients' travel costs and infection risk.

How to use remote patient monitoring with telehealth

Remote patient monitoring pairs well with telehealth when patients need to be monitored for certain health conditions. It can also prevent health complications in patients who aren’t able to easily travel.

There are many symptoms and conditions that can be tracked through remote patient monitoring, including:

  • High blood pressure
  • Diabetes
  • Weight loss or gain
  • Heart conditions
  • Chronic obstructive pulmonary disease
  • Sleep apnea
  • Asthma

Many of the devices that patients will use may be familiar to them, including:

  • Weight scales
  • Pulse oximeters
  • Blood glucose meters
  • Blood pressure monitors

Other conditions require more complicated devices that will require patient training, including:

  • Apnea monitors
  • Heart monitors
  • Specialized monitors for dementia and Parkinson’s disease
  • Breathing apparatuses
  • Fetal monitors

As the popularity and convenience of telehealth grows, so does remote patient monitoring. More providers are implementing remote patient monitoring for several reasons, including:

  • Advanced medical technology
  • A growing awareness of telehealth for providers and patients
  • More insurance coverage during the COVID-19 public health emergency
  • The ability to monitor and prevent serious complications in remote locations

How to help patients use at-home health monitors

Remote monitoring may be new for your patients, and for you also. The best way to help your patients is to be informed about the devices you will be using. This includes how they work and how you will receive the data from the device.

Make sure patient understands why you are prescribing at-home health monitors

There are a number of ways to share information with your patients:

  • A telehealth appointment before they begin using the device
  • A follow-up telehealth appointment after they’ve been using the device for several days
  • An email or downloadable PDF explaining remote patient monitoring for their condition or symptoms

Help your patient understand how to use their device

Some products, such as a weight scale, may not need a lot of explanation. But other devices may be more high tech or confusing for patients. Here’s a few tips:

  • Walk your patient through operating the device in a telehealth appointment
  • Refer your patient to an at-home medical equipment provider in their area who can set them up with the device and provide support
  • Tell your patient what types of readings you will get from their device and how you will receive that information
  • Make sure your patient has written instructions they can refer to, including paper copies, email, or downloadable PDF
  • Encourage your patient to write down their questions and either call your office, email you the questions through a patient portal, or request a follow-up telehealth appointment
  • Have a member of your staff let your patient know when you are receiving their information correctly from the device

Talk to your patients about the benefits of remote patient monitoring

Some patients will need in-person testing, diagnostics, or monitoring. This depends on their condition, Internet capabilities, or personal preferences and abilities. But there are many ways that remote patient monitoring can help with chronic conditions, pregnancy complications, and short-term illness.

These benefits include:

  • Reduced hospitalizations
  • Shorter hospital stays if the patient can be discharged with a remote monitoring device to use at home
  • Fewer visits to the emergency room
  • Better health outcomes for patients in rural areas
  • Better preventative management for chronic conditions
  • Reduced risk of COVID-19 exposure, along with other illnesses, for patients and health care workers

Tip: Medicare uses the term, “remote physiologic monitoring” in their coding and billing language. Remote physiologic monitoring (RPM) is a set of codes that describes non-face-to-face monitoring and analysis of physiologic factors used to understand a patient’s health status. For example, the RPM codes allow remote monitoring of oxygen saturation levels in patients with COVID-19. CPT codes 99453, 99454, 99457, and 99458

Billing and payment for remote physiologic monitoring

Billing for Medicare

While private insurance companies set their own terms, Medicare has its own payment policies.

They include:

  • An established patient-physician relationship is required. But there does not have to be an established relationship between the patient and physician for the duration of the public health emergency
  • Consent to receive remote physiologic monitoring services at the time services are furnished is allowed
  • Physicians and non-physician practitioners who are eligible to furnish evaluation and management services (E/M) may bill for remote physiologic monitoring services

Guidelines for remote physiologic monitoring services billed to CPT codes 99453 and 99454

  • Physiologic data must be electronically collected and automatically uploaded to the secure location where the data can available for analysis and interpretation by the billing practitioner
  • The device used to collect and transmit the data must meet the definition of a medical device as defined by the FDA
  • Remote physiologic monitoring data must be collected for at least 16 days out of 30 days. During the public health emergency for COVID-19, if a patient is suspected or diagnosed with COVID-19, data can be collected over as few as two days
  • Remote physiologic monitoring services must monitor an acute care or chronic condition
  • The services may be provided by auxiliary personnel under the general supervision of the billing practitioner

For specific codes and requirements for Medicare’s remote physiologic monitoring coverage, visit the billing and coding page from the Centers of Medicare & Medicaid Services.

Billing for private insurance

Check with the patient’s insurance company for information on their billing and reimbursement policies.

Billing for Medicaid

Each state has its own remote patient monitoring billing and reimbursement policies. Providers can check their state’s policies at the National Policy Center - Center for Connected Health Policy exit disclaimer icon .

Last updated: April 22, 2022

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