DSMES Learning Series: Remote Patient Monitoring Reimbursement
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If you have questions, please email Laurene Hendricks at firstname.lastname@example.org.
Upcoming DSMES Webinars
February 16 DSMT Reimbursement
DSMES program staff.
Research repeatedly shows that people with diabetes benefit from on-going follow-up medical care, education and support. Medicare has expanded its Remote Patient Monitoring benefit to include 4 procedure codes for specific services. Why should DCESs and RDs M.O.V.E. to deliver RPM services in outpatient settings? To realize:
- More reimbursement
- Outcomes improvement
- Valued diabetes care specialist recognition
- Ensure expanded roles and responsibilities
This presentation reviews all the detailed Medicare reimbursement rules for all the 4 CPT codes, and the recommended workflows to deliver the highest quality RPM services.
- Describe the Medicare beneficiary eligibility for the four RPM procedure codes.
- List the Medicare coverage guidelines for each of the four RPM procedure codes.
- Describe the workflow for DCESs and RDs to maximize the quality of RPM services.
Description of the Medicare Remote Patient Monitoring (RPM) benefit
The 3 services that comprise the Medicare Remote Patient Monitoring benefit
CMS - Distinction between active technologies covered by RPM vs. passive platforms or devices that collect but do not virtually transmit health date in real-time
Who can order and bill for Medicare RPM
Who can furnish Medicare RPM
CPT definitions of procedure codes 99453, 99454, 99457, 99458
Frequency limits of procedure codes 99453, 99454, 99457, 99458
Requirement for number of days beneficiary must do RPM in order to bill 4 codes
Example of RPM equipment defined by FDA
Types of RPM equipment being considered by Medicare (will issue further guidance) (e.g., smart phone apps)
Direct supervision by billing provider changed to general supervision - Expands use of RPM services as provider does not have to be in practice setting while services furnished
Medicare unadjusted 2020 reimbursement rates for the 4 RPM procedure codes
- Identified Gap(s): Successful implementation and insurance reimbursement for Medicare RPM is critical for enhancing the value of DCESs and RDs, and thus help to ensure employment, promotion and working at the top of their license. DCESs are lacking in knowledge of the specific required Medicare coverage guidelines for RPM, how to establish a successful workflow and how to document the RPM interventions furnished.
- Description of current state: DCESs and RDs should be responsible for promoting services that both improve patient care and revenue for the practice, and this includes increasing reimbursement success for services that are rendered.
- Gaps to be addressed by this activity: Knowledge, Skills, Practice.
Mary Ann Hodorowicz, RD, LDN, MBA, CDE, CEC
Ms. Hodorowicz is a professional consultant, educator, speaker, writer and spokesperson for the health and food industry. She is a registered, licensed dietitian, certified diabetes educator and certified endocrinology coder with multiple skills and years of experience in the food, nutrition and diabetes care and healthcare industries. Her clients include both small or large organizations and individuals in private practice.
Ms. Hodorowicz's consulting and training services are designed to provide you with a high level of expertise to achieve your short or long-term goals in a cost-effective and timely manner. Mary Ann's excellent verbal and written communication skills, expertise in project management and a creative spirit all combine to meet your unique needs and goals.
- Nurse: Des Moines University is Iowa Board of Nursing approved provider #112. This live activity has been reviewed and approved for 2.0 continuing education contact hour(s). No partial credit awarded.
No commercial interest company provided financial support for this continuing education activity.
Relevant to the content of this educational activity, the following individual(s) have no conflict(s) with commercial interest companies to disclose.
- Alexandra Grossman, MA, RDN, LD, moderator and planning committee member
- Laurene Hendricks, activity director and moderator
- Mary Ann Hodorowicz, RDN, MBA, CDCES, CEC, speaker
The speaker(s) will disclose if any pharmaceuticals or medical procedures and devices discussed are investigational or unapproved for use by the U.S. Food and Drug Administration (FDA). Determination of educational content and the selection of speakers is the responsibility of the activity director.
The information provided at this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. The content of each presentation does not necessarily reflect the views of Des Moines University.
- 2.00 CE Contact Hour(s)
- 2.00 IBON