CMS Clarifies 2021 PFS Reimbursements for Remote Patient Monitoring

CMS Clarifies 2021 PFS Reimbursements for Remote Patient Monitoring

Posted Jan 21, 2021 from
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In the final rule, to qualify for reimbursement under CPT codes 99457 and 99458, CMS mandated at least 20 minutes of interactive communication time between provider and patient over a calendar month, but that interactive communication couldn’t be part of the 20 minutes of RPM care. The agency has now clarified that “interactive communication” can include both in-person and connected health channels.

Both the Alliance for Connected Care – which drew attention to this week’s corrections – and the healthcare team at Foley & Lardner criticized the initial guidelines when they were released in a preliminary draft last August.

In addition, CMS added more context to a requirement that bases RPM reimbursement on a minimum of 16 days of data collected over a 30-day period and said RPM services associated with CPOT codes 99453 and 99454 could be billed once per provider per patient per 30-day period.

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