
@ShahidNShah
Remote patient monitoring has the potential to improve clinical outcomes by giving providers the ability to improve care management outside the hospital or doctor’s office, but its growth is being stymied by low reimbursement.A report released earlier this year by the Bipartisan Policy Center gives the government and the healthcare industry a blueprint to address that roadblock.While RPM has seen tremendous growth coming out of the pandemic, its future is in question. The Centers for Medicare & Medicaid Services (CMS) offers only a handful of CPT codes for remote physiological monitoring and remote therapeutic monitoring, enabling care providers to recoup.To make matters worse, the American Medical Association’s CPT Editorial Panel, which governs CPT codes, has hit a roadblock on new codes that would expand reimbursement opportunities.
CMS should work with medical specialty societies to evaluate the evidence and determine appropriate coverage mechanisms to guide the optimal use of RPM, including for which patients and over what duration. This work could include collaborating with Medicare Administrative Contractors (MACs) or issuing National Coverage Determinations (NCDs).As more evidence emerges about the appropriate use of RPM devices, the Health and Human Services Secretary should recommend a diverse set of billing codes so providers have more options for the time they spend on the data and the number of minimum days of data required.CMS should clarify current policies regarding appropriate coding and billing of RPM and RTM.
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Even as telehealth adoption and utilization soared amid the in-person care restrictions of the COVID-19 pandemic, it quickly became apparent that expanding telehealth access equitably is easier said …
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