Remote Patient Monitoring

Remote Patient Monitoring (RPM) is By Medicare

The ScopeData smartphone app makes it easy for patients to complete physician-designed surveys from the comfort of home or facility - and instantly transmit the data to their physician for review, interpretation and action if necessary.
Under CPT Code 99453, Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; and set-up and patient education on use of equipment is reimbursable.
ScopeData is interfaced with EPIC and other EMRs, seamlessly updating patients’ medical records, creating a customizable dashboard - informatively guiding physicians and staff.
Under CPT Code 99454, 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 is reimbursable.
ScopeData collects and manages patient–reported data, tracks physician and staff time spent, and prepares the billing information.
Under CPT Code 99091, 30 minutes of time per patient / per month spent accessing, reviewing and interpreting electronically reported data, modifying treatment plans, communicating with patient / caregiver, etc. is now reimbursable.
Under CPT Code 99457, 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 is reimbursable.

Core requirements for RPM services under CPT 99457

Patient Consent

The practitioner must get the patient’s consent (oral or written) for RPM services and document consent in the patient’s medical record.

Face-to-face visit within prior year

For new patients or patients not seen by the practitioner within one year prior to billing RPM, the practitioner must first conduct a face-to-face visit (e.g., an annual wellness visit or physical). E/M services levels 2 through 5 (CPT codes 99212 through 99215) should qualify for this face-to-face visit. Transitional care management (TCM) services should also qualify.

Services not involving a face-to-face visit by the billing practitioner or not separately payable under Medicare (e.g., online services, telephone and other E/M services) would not qualify as an initiating visit.

20 minutes per calendar month

CPT 99457 should be reported no more than once in a calendar month per patient.

To qualify, a minimum of 20 minutes of time must be spent by the clinical staff, physician or other qualified healthcare professional on data accession, review and interpretation, modification of care plan as necessary (including communication to patient and/or caregiver), and associated documentation.

May be billed during same service period as CCM& BHI

CPT 99457 can be billed once per patient during the same service period as chronic care management (CCM) services because CMS recognizes the kind of analysis involved in furnishing RPM services is complementary to CCM and other care management services.

NOTE: Time spent furnishing these services cannot be counted towards the required time for both RPM and CCM codes for a single calendar month (i.e., no double counting).

Patients may use the ScopeData app from anywhere

RPM services are not considered telehealth services under Medicare, therefore the patient can be at his/her home, and need not be in a rural area or qualifying originating site.

Use SCOPEDATA for Remote Patient Monitoring (RPM)