Remote patient monitoring allows a patient to collect their own health data, like blood pressure, weight, and glucose levels, using a connected medical device that automatically transmits the data to their health care provider. The provider then uses this data to treat or manage (remotely monitor) the patient’s condition.

There are 3 main components:
1.    Education and setup: Education about how to use the device and transmit the health data helps ensure that patients use the device appropriately to collect accurate data.
2.    Device supply: The internet-connected device, including the collection and transmission of at least 16 readings every 30 days, ensure that you get the appropriate health information. Examples of these devices include connected blood pressure cuffs, weight scales, and pulse oximeters. Without the connected device or an adequate number of readings, you may be left with insufficient or no data to make informed treatment decisions.
3.    Treatment and management: Treatment management ensures that you review the health data and use it to manage the patient’s condition.
 

Medicare broadly covers remote patient monitoring (sometimes called remote physiologic monitoring) for the collection of any type of physiologic data using a wide range of devices, for chronic and acute conditions. 

To be eligible for remote patient monitoring, a patient must:

-    Have a chronic or acute condition that requires monitoring

-    Use an internet-connected device that:

     o    Meets that FDA’s definition of a medical device and digitally uploads data
     o    Collects and transmits health data at least 16 days every 30 days
 

1.    A Medicare patient has high blood pressure (hypertension).
2.    The patient’s provider determines that the remote patient monitoring is medically necessary to treat his hypertension and the patient consents to getting it.
3.    The provider supplies a connected blood pressure cuff to the patient.
4.    The provider educates the patient on how to set up and use the connected blood pressure cuff.
5.    The patient regularly uses the device to connect his blood pressure readings, and the device automatically transmits the data to his provider.
6.    The provider then reviews the data, makes decisions about the patient’s treatment, and communicates with the patient. For example, the provider may decide that the patient’s blood pressure medication needs to be adjusted and calls him to adjust this change.
 

Bill Medicare for remote patient monitoring services using a general set of procedure codes, which represent different components of the monitoring. We pay for each of the 3 main components separately and pay the same rate, regardless of the type of device the patient uses or the health data they collect.

We don’t require that physicians or other qualified health care providers order the services or that the information of the ordering provider be included on the claim.

Medicare started covering remote patient monitoring starting in 2018. Since that time, the number of patients getting remote patient monitoring has increased significantly each year. When providing for and billing the services, be sure you provide all 3 main components. Many patients don’t get education or help with device setup.