Remote Patient Monitoring
Remote monitoring helps healthcare professionals understand how the patient is progressing during recovery and helps the patient access and receive better care at a lower cost. The largest benefit is the increased volume and timeliness of information available to healthcare professionals and patients, which can help with medical discussions and decisions.
Example: A total knee arthroplasty (TKA) patient who is walking with difficulty at three weeks after surgery but had a good two-week follow-up visit may benefit from changing their physical therapy program. With remote monitoring, the healthcare professional and patient can see there is a need to change the care plan and intervene before the scheduled six-week follow-up visit.
Current procedural terminology (CPT) codes for Remote Patient Monitoring (RPM), also known as Remote Physiological Monitoring, were established in 2019 for use beginning in 2020.
Definition: RPM is the collection of physiologic data digitally stored and/or transmitted by the patient or caregiver or both.
- The medical device must be cleared by the Food and Drug Administration (FDA).
- Data must be digitally and automatically recorded and uploaded to the secure location where the data can be available for analysis and interpretation by the billing practitioner.
- Patient consent must be obtained at the time the remote monitoring services are furnished.
- There must be an established patient-physician relationship.
- Physicians and Qualified Health Professionals who are eligible to provide Evaluation and Management services may order and bill RPM services.
- The services may be provided by auxiliary personnel under the general supervision of the billing practitioner.
- RPM data must be collected for at least 16 days out of 30 days.
- RPM monitoring services must monitor an acute care or chronic condition.
|RPM CPT CODE||Description||Requirements||2023 CMS|
|99453||Practice expense code. Setup. Service Initiation / Patient Education. Billed one time per patient.||Patient consent to participate; Base station transmitting data.||$16 – $27|
|99454||Practice expense code for collection of remote monitoring data. Billed once each 30 days.||Data must be automatically collected/transmitted for a minimum of 16 of the 30 days.||$42 – $70|
|99457||Professional code. Care / treatment management. Remote monitoring treatment management services, first 20 minutes of qualified HCP time in a calendar month. Billed once per month.||Interactive communication between the patient and HCP is required. Total time, including data review, discussion, physician review, scheduling, is at least 20 minutes.||$44 – $61|
|99458||Professional code. Care / treatment management. Remote monitoring treatment management services, each additional 20 minutes of qualified HCP time in a calendar month. Billed up to 2x per month after 99457.||Interactive communication between the patient and HCP is required. Total time, including data review, discussion, physician review, scheduling, is at least 40 minutes (first billing) or 60 minutes (2nd billing).||$36 – $51|
*Note, the Centers for Medicare and Medicaid update the physician fee schedule quarterly and fees vary depending on location, cost of living and quality measure reporting. To find local payment information, go to https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched. Values shown in this chart are sourced from the January 2023 update to the physician fee schedule, accessed March 30, 2023.
Billing for private insurance:
Check with the patient’s insurance company for information on their billing and reimbursement policies. Depending on the patient’s insurance, they may have a copay.
Billing for Medicaid:
Each state has its own remote patient monitoring billing and reimbursement policies. Healthcare Professionals can check their state’s policies at the National Policy Center – Center for Connected Health Policy at https://www.cchpca.org/topic/remote-patient-monitoring/.
The summary information contained herein is for information purposes only and, in all instances, is subject to the specific requirements set forth in applicable laws and regulations. Nothing herein is intended to, or shall, constitute medical advice. Each healthcare professional must use his or her own medical judgment and expertise with respect to all decisions pertaining to medical treatment and/or care of patients under his or her care.
https://telehealth.hhs.gov/providers/preparing-patients-for-telehealth/telehealth-and-remote-patient-monitoring, accessed May 31, 2023.
Canary™ Quantiles™ Remote Monitoring platform has everything you need to actively track and manage your patients’ recovery post-surgery.
At a quick glance, see if a patient is on track with typical recovery trajectories or may be falling behind.
Provides data reporting that is easy to analyze and interpret so healthcare professionals can adjust and personalize recovery plans.
Comparative patient data gives healthcare professionals an objective tool to help engage patients in their recovery and increase patient satisfaction.
Canary™ Recovery Curves™ analytics
Recovery Curves allow healthcare professionals to view how a patient’s gait parameter data compares to patients like them by age group, gender and number of weeks since surgery.
Adjust patient comparison parameters to view by:
- The entire patient population with Zimmer Biomet Persona IQ® (PIQ)
- Specific age and gender cohorts
Recovery Curve Features
- View patient population percentile color comparison bands.
- Tooltips appear over patient data for easy access to specific details.
- Patient data is presented by number of weeks post surgery for easy trend assessment.
Recovery Curve Examples
Recovery Curves analytics allow healthcare professionals to identify when a patient’s gait dramatically changes from baseline levels or to identify a patient that has an above average gait.
The illustration above shows a patient whose walking speed falls from above the 90th percentile to below the 25th percentile during the 7th and 8th week after surgery.
The illustration above shows a patient whose walking speed recovers towards the 90th percentile as they approach 12 weeks post-operation.
View each patient’s latest full week of sensor data post-surgery including: qualified step count, tibia range of motion, functional knee range of motion, stride length, distance, walking speed and cadence.
Canary™ Quantiles™ Sort & Filter
One convenient interface to view your patients’ recovery post-surgery.
- Quickly identify PIQ patients who may be trailing typical recovery expectations and need a review.
- Confirm patients who may be ahead of the curve and need less immediate attention.
Identify your PIQ patients who may be falling behind with typical recovery trajectories without having to go to each individual patient Recovery Curves page. Includes one-click access to their detailed Recovery Curves for additional analysis.
Choose which parameters your practice would like to sort and filter to identify patients who meet specific criteria. Any patients whose Recovery Curves data matches that criteria will be highlighted for easy review.
How it works
Set your data and sorting parameters to identify patients who meet your criteria.
- Weeks Post Operation
- Patient Name or ID Search
- All Patients or by Gender and Age
- And/Or Toggle
- Greater than or = to, Less than or = to toggle
7. Canary™ Recovery Curves Percentile
- Qualified Step Count
- Walking Speed
- Stride Length
- Canary™ Recovery Curves Percentile
- Functional Knee Range of Motion
- Tibia Range of Motion
- Clear Sort & Filter parameters
- Show only patients who meet criteria in the list
- One click links directly to view a patient’s Recovery Curves page
- Patients who meet your criteria will be identified in pink
Note: the next time you visit the Sort & Filter page, it will retrieve your previous settings
* 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.
Canary™ Quantiles™ Remote Monitoring platform is non-device clinical software offered to aide health care professionals with patient-specific analysis of recovery data using reports, customized and automated from parameters set by the healthcare professional. For prescribed medical device instructions for use, indications, precautions and warnings go to https: https://canarymedical.com/patients/patient-documents/
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The information contained in this document is provided solely for the purpose of acquainting you, as its recipient, with Canary Medical and its subsidiaries (the “Company”, “we”, “us” or “our”) and its executive personnel. This document does not constitute an offer to sell, or a solicitation of an offer to buy, any securities of the Company, nor will we make any offer, solicitation or sale of such securities in any state, province or jurisdiction in which such an offer, solicitation or sale would be unlawful prior to registration or qualification under the securities laws of any such state or jurisdiction. All Trademarks are the exclusive property of Canary Medical and its affiliates with the exception of Persona IQ® The Smart Knee®, and The Personalized Knee® which are trademarks of Zimmer Inc.