Billing for Remote Patient Monitoring


Published by Accuhealth on 09/11/2020

How to remain in compliance with medical billing codes with remote monitoring of clinical patients.

While deploying a remote patient monitoring program can be an exciting opportunity for clinics to expand their offerings, many providers experience anxiety in regards to the seeming complexities of billing for RPM.

One of the most common areas of confusion related to RPM is how to remain in compliance with billing codes while providing remote monitoring services, and how third-party providers fit in to this revenue model.

While these are important and legitimate concerns to take into consideration, telehealth providers are leading the way in eliminating the ambiguity surrounding RPM billing, and are automating processes to be in full compliance with current and proposed changes to physician fee schedules.

Fears Regarding Compliance

A growing concern amongst providers considering remote monitoring for their clinics is the potential for error in properly billing for RPM services. 

Fears surrounding incorrect coding and eventual auditing issues result in many providers simply dismissing RPM program implementation as being too much of a risk to take on. These anxieties, and the ambiguity surrounding how to properly bill for RPM, leads to many clinics missing out on the real and immediate increase in revenue they could benefit from in implementing RPM at their locations. While these common fears are understandable, the reality is that RPM program implementation is risk-free with the right third-party provider.

The best service providers have designed their solutions to keep clinics and doctors safe from potential coding and billing risks. These providers, like Accuhealth, provide full-service, turnkey solutions for remote patient monitoring, which remove all liabilities and potential for errors through effective program and platform design.

Automatically Removing Risk

Effective RPM providers design their platforms to be auto-timed, so that services perfectly fit into the time-based coding requirements of RPM. This creates a system that makes it impossible to incorrectly bill service provision, as the attestation of time spent on care is completely automatic.

In this capacity, these platforms actively remove audit risk, and make implementing and scaling remote patient monitoring programs simple and secure.

With providers like Accuhealth, doctors don’t have to stress about learning yet another program, or be inundated with a complicated new system that is difficult to navigate. Instead, these third-party services lead clinics and providers through the whole process, and manage remote patient monitoring programs in their entirety so that there is no room for mistakes.

This model guarantees safety in deployment by providing the exact framework and guidelines to remain completely compliant with all billing codes.

Anticipating Regulatory Changes

Not only do the best third-party providers ensure compliance with all current coding for remote patient monitoring, but they also anticipate future changes to coding and billing requirements. This ensures that clinics aren’t left to pick up the pieces when regulatory requirements inevitably change.

The current proposed changes to the Medicare Physician Fee Schedule are a great example of how third-party providers like Accuhealth are future-proofing their services.

RPM has gained new attention in recent months due to the global pandemic and the necessity it has created for providing remote care. These developments have led to specific regulations surrounding the billing of RPM to be reassessed on federal, regulatory levels, such as for Medicare and Medicaid billing.

The newly released 2021 Proposed Medicare Physician Fee Schedule specifically seeks to define which providers can bill for RPM services, and what conditions must be met to properly maintain billing compliance. Within the proposed changes, several key shifts have taken place in relation to how clinics must manage their RPM billing codes.

New Developments

One major change noted in the new MPFS is that RPM has now been defined as falling under Evaluation and Management services. This means that only practitioners who are qualified providers of E/M services are permitted to bill for Remote Patient Monitoring.

This is especially good news for primary and speciality care doctors, who will not be impacted by this change, and who are the most likely to benefit from implementing their own RPM programs.

These regulatory changes also state that RPM services are officially available and billable for patients with acute and chronic medical conditions, opening doors for clinics around the country to provide compliant RPM services for a large demographic of existing patients.

Other changes include regulations surrounding device allowance, how much data must be collected, the acceptance of patient consent, and interactive communication functionality, all of which must be met in order to bill for RPM compliantly.

Future Proofing Changes in Billing Codes

Effective RPM providers like Accuhealth already address these shifts in billing coding, as their platforms and services were originally designed to anticipate these eventual standards of remote care provision.

Providers who effectively future-proof their RPM solutions for clinics use FDA approved devices that are both accessible to patients of all ages, and that allow for the utmost quality of interactivity between patients and providers.

In fact, the most reliable suppliers of RPM programming are not only supported under these regulations, their systems exceed minimum requirements of quality and effectiveness in all capacities of program implementation.

Features like Accuhealth’s proprietary calling feature, which allows clinics to have unlimited audio and/or video interaction with their patients, is one example of telehealth service providers exceeding current and future standards of quality for RPM regulations.

The Bottom Line of RPM Billing

Clinics hoping to implement their own remote patient monitoring programs can easily do so without the anxiety of billing compliance. By choosing the right telehealth provider, clinics can safely and easily orchestrate their own RPM services while remaining completely compliant with coding requirements, even as they shift over time.

Accuhealth is designed to support the ever-changing landscape of regulatory billing requirements for remote patient monitoring. Our industry-leading tools and services quickly adapt to meet current and future adherence requirements for CPT Codes 99453 and 99454.

With Accuhealth, our platform also tracks the thirty (30) day billing cadence automatically, eliminating the need for manual tracking and removing room for error. This, and other features, allow clinics to have peace of mind in knowing their RPM programs are always in compliance with all CMS rules.

Remote Patient Monitoring is a major step in scaling clinics and improving revenue. While there are many considerations to take into account, providers like Accuhealth take the risk out of the process, so your clinic can focus on reaping the benefits of RPM, instead of taking on the stress.

Find out more about how Accuhealth can guide you through the process of RPM program implementation, risk-free. Visit accuhealth.tech


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