Remote Patient Monitoring Compliance Guide
Understand the rules for remote patient monitoring compliance to get paid and avoid legal jeopardy
The rapid rise of remote patient monitoring over the past several years has been a boon for patients and practices. For RPM, also described as remote physiologic monitoring, has provided faster and easier access to healthcare services, all from the safety and comfort of their homes. For organizations, RPM is one of the more lucrative Medicare care management programs that also helps improve patient outcomes.
But with this rise has brought increased scrutiny of RPM by the federal government, including audits of Medicare Part B telehealth services like remote patient monitoring. The good news is there's no reason to fret: Organizations that work to ensure they understand and consistently follow RPM's rules and requirements and partner with vendors that do the same can reap the many benefits of remote patient monitoring while staying on the right side of the law.
This guide developed by the RPM compliance experts at Prevounce can help you do just that! It provides fundamental information about remote patient monitoring compliance that will help ensure your RPM program is properly coding, billing, and getting paid for RPM.
Topics covered in this detailed remote patient monitoring compliance guide include the following:
- Current state of remote patient monitoring
- Breakdown of RPM CPT codes and their definitions
- Detailed discussions about RPM guidelines on key topics, such as the definition of "interactive communication" and device requirements
- Update on rules concerning patient consent and engagement
- Information on RPM copayment requirements
- Notes on HIPAA and FDA
Disclaimer:
Health economic and reimbursement information provided by Prevounce is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.
Prevounce encourages providers to submit accurate and appropriate claims for services. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently.
Prevounce recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.
The coding options listed here are commonly used codes and are not intended to be an all- inclusive list. We recommend consulting your relevant manuals for appropriate coding options.
The Health Care Provider (HCP) is solely responsible for selecting the site of service and treatment modalities appropriate for the patient based on medically appropriate needs of that patient and the independent medical judgement of the HCP.
