REMOTE PATIENT MONITORING*

Efficiency in care through innovation

The Center for Medicaid and Medicare Services (CMS) has indicated they believe Remote Patient Monitoring (RPM) can deliver lower costs while maintaining quality of care.

“Once information is freely flowing from the patient to the provider, it will help to spur innovation in the entire digital health information ecosystem…, and the advances in coordinated, value-based and patient-centric care will be even greater than anything we can imagine today.”
– Seema Verma, Administrator, Centers for Medicare and Medicaid Services

The CMS has put forth guidelines and reimbursement dollar values for new Common Procedural Terminology (CPT®) codes to incentivize clinicians to adopt RPM in providing lower cost, high-quality patient-centric care**. The following table lists the potential monthly reimbursement amounts based on the national averages for 2021.

CPT Code 99453

Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), plus initial set-up and patient education on use of equipment.

~$21

CPT Code 99454

Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. (Initial collection, transmission, and report/summary services to the clinician managing the patient.)

~$69

CPT Code 99457

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month, requiring interactive communication with the patient/caregiver during the month; first 20 minutes.

~$53

CPT Code 99458

Each additional 20 minutes (List separately in addition to code for primary procedure.) Note: Can be billed no more than twice per month.

~$43

Furthermore, guidelines allow for the noted ‘care’ to be delivered by qualified healthcare professionals (QHP) under the supervision of the HCP, rather than the HCP themselves. This allows HCPs to focus on the patients who need the most care while still providing practice workflow efficiency to support all patients.

Compliance and RPM

The patient and practice management benefits of Remote Patient Monitoring (RPM) can only be realized if key requirements are met. Specifically, RPM depends on the availability of a data set that is both clinically relevant and validated from an FDA cleared or approved device.

The availability of data to support RPM has previously been limited by patient compliance. When patient compliance falls off with wearable technologies and data is not available, the ability to provide quality care through RPM is no longer realistic.

As an implant, canturio™te is designed to maximize patient compliance. There is virtually nothing for patients to remember to charge, wear or sync. With canturio™te you get effortless compliance to ensure availability of data to support RPM.

canturio™te provides validated, kinematic data which represents clinically relevant gait parameters with unparalleled accuracy through application of FDA-reviewed special controls and market clearance process. Having remote access to these patient-specific metrics can provide unprecedented insight into a patient recovery to enable the potential for earlier intervention and highly-customized rehabilitation, all in the service of faster, better patient care*.

Practice management support

Implementing RPM for your practice might sound daunting given rigorous requirements of the Common Procedural Terminology (CPT®) codes. Collecting, managing, interpreting and acting on data can be expensive and time-consuming. This is where the Canary Medical™ Summatix™ data management platform, comes in.

Summatix™ aggregates, analyzes and provides secure access to RPM data, but it doesn’t stop there. It also integrates the rigorous requirements of the CPT codes that allow clinicians to be reimbursed for RPM.

Canary has programmed canturio™te and designed the Summatix™ analytical algorithms and clinician interface to meet these highly specific requirements with adaptive capability should these requirements evolve. As a result, clinicians treating patients fitted with a canturio™te can download Summatix reports to support their utilization of RPM codes in the delivery of care for their patients.

Canary – Putting the Pieces of the RPM Puzzle Together

As the RPM landscape evolves and develops over time, you can count on Canary to update our practice management support to keep you informed and supporting your RPM reimbursement decisions.

* WARNING – The kinematic data obtained from this device have not been demonstrated to have clinical benefit. It is not intended to be utilized for clinical decision-making, and no data have been evaluated by FDA regarding clinical benefits.

** See: https://www.cms.gov/newsroom/press-releases/cms-takes-action-modernize-medicare-home-health-0