Effective January 2018, CMS began recognizing medical group practices that use digital health tools to monitor and analyze patient physiological data. CMS opened the door to reimbursement for remote patient monitoring (RPM) services by unbundling CPT code 99091, which is described as the collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored or transmitted by the patient to a qualified healthcare professional. To be reimbursed for RPM services, practices must meet certain billing requirements, such as obtaining and documenting patient consent and spending a minimum of 30 minutes of time on RPM. Additionally, for patients who are new or have not been seen within one year, providers must initiate RPM services in a face-to-face visit.
To learn more about RPM services and additional Medicare service updates for the 2018 payment year, download MGMA’s analysis of the 2018 Physician Fee Schedule.