The future of remote patient monitoring hinges on reimbursement

The future of remote patient monitoring hinges on reimbursement

Providers are using remote patient monitoring to extend care for chronic care patients in underserved areas but reimbursement for the services is far from certain. Remote patient monitoring can help providers extend care for patients in underserved areas and improve outcomes, but only if it’s a reimbursable service. During the COVID-19 pandemic, remote patient monitoring adoption soared among Medicare beneficiaries, according to an August 2022 study in JAMA Internal Medicine. From February 2020 to September 2021, usage of remote patient monitoring increased from 91 claims per 100,000 enrollees to 594 claims per 100,000 enrollees, according to the study. But as adoption has increased, reimbursement of the technology faces an uncertain future. The Centers for Medicare & Medicaid Services has expanded payment for remote patient monitoring since 2018 by adding billing codes that cover some of the services under Medicare fee-for-service health plans. But reimbursement value for some of those codes decreased in the 2023 Medicare Physician Fee Schedule by more than 10% and could again in 2024.

Medigy Insights

Remote patient monitoring has the potential to extend care for chronic patients in underserved areas and improve outcomes, but reimbursement for the service remains uncertain. During the COVID-19 pandemic, RPM adoption increased significantly among Medicare beneficiaries. However, the Centers for Medicare & Medicaid Services reduced reimbursement value for some RPM billing codes by over 10% in the 2023 Medicare Physician Fee Schedule and may do so again in 2024, which could impede the adoption and utilization of RPM services. Policymakers and healthcare payers must work towards ensuring adequate reimbursement for RPM services to promote its utilization and enhance the quality of care for patients in underserved areas.


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