Telehealth and remote patient monitoring | ALl there is to Know

For providers

Preparing patients for telehealth

Remote patient monitoring (RPM) and telehealth

With remote monitoring, healthcare professionals can manage acute and chronic conditions at home. It reduces patients’ travel expenses and risks associated with hospitalization.

Remote Patient Moni­toring (RPM) is an effective way to monitor patients remotely.

Remote patient management works best when paired with telemedicine services. It can help prevent health complications in people who don’t live near medical facilities.

Remote patient monitoring systems can track many different types of health issues, from heart attacks to sleep apnea.

  • High blood pressure
  • Diabetes
  • Weight loss or gain
  • Heart conditions
  • Chronic obstructive pulmonary disease
  • Sleep apnea
  • Asthma

Glossary about remote patient monitoring

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Patients who use these technologies may already know some of the equipment they’ll need to use.

  • Weight scales
  • Pulse oximeters
  • Blood glucose meters
  • Blood pressure monitors

For example, some conditions may need more complex devices requiring patient education before they’re used.

  • Apnea monitors
  • Heart monitors
  • Specialized monitors for Alzheimer’s and Parkinson’s diseases
  • Breathing apparatuses
  • Fetal monitors

With the growing use of telehealth comes the increasing use of remote patient monitoring. For several reasons, including:

  • Advanced medical technology
  • Telehealth is becoming increasingly popular among both health care professionals and their patients.
  • More coverage for coronavirus (COVID-19) during the pandemic
  • The ability to monitor patients remotely and intervene when necessary

An easy-to-follow tutorial for remote patient monitoring

You can learn some basic, essential tips for leveraging telehealth in your practice (PDF). These include applications for care management, implementation of best ­practises, and more.

How to help people who are using at-home health monitors get the most out of them.

You need to know how remote monitoring works so that you can provide the right support for your patients. Also, you need to know how you will get the data from the device so that you can interpret it correctly.

Be sure the patients understand why they need an at-home health monitor.

There are several different methods for sharing information with your patients.

  • Before they start using the device, set up an initial visit for them to use the device.
  • After they’ve used the device for several days, a follow up telehealth visit is recommended.
  • A document explaining remote patient monitoriing (RPM) for their condition or symptoms.

Help your patient understand how to use their device

For some products, such as a digital blood pressure monitor, they might not require too much explanation. However, other products may be more complex or confusing for patients. So here are a few tips:

  • During the consultation, walk your patient through using the device during an actual visit.
  • If you refer your patients to an at-home health care professional in their area who can help them set up the device and give them instructions for using it, they may be able to get the best results from it.
  • Let your patients know what type of information they will be able to view on their devices and how you will receive them.
  • Make sure your patients have clear, easy-to-follow directions for taking their medication, including paper copies, emails, or downloadable PDFs.
  • Encourage patients to ask any additional health care related question they may have by calling your practice, sending them an email through your patient portal, or requesting a follow-up telemedicine appointment.
  • Make sure that your patients know when they’re receiving their information correctly from your device.

Discuss the advantages of remote patient monitoring with your patients.

There are many different ways that remote patient health care services can be used for chronic conditions, pregnancies, and short-term illnesses.

These benefits include:

  • Reduced hospitalizations
  • If patients can be safely discharged with a remote monitor to use at home, they’ll likely spend less time in hospitals.
  • Fewer trips to the emergency department
  • Better health care for patients living in rural areas
  • Better preventive management for chronic conditions
  • Reduced risk of COVID-19 infection, along with other illnesses

Tip: Medicare utilizes the expression « remote physiological monitor » in their coding and billing terminology. Remote physiological monitor (RPM) is an array of codes that describe non-face-to face assessment and analysis of physiologic elements utilized to comprehend patient wellbeing. For instance, the RPM codes permit remote examination of blood stream oximetry in patients with COVID 19. CPT codes 99450,99451,99452,99453,99454,99455,99456,99457,99458

Remote physiological monitoring billing and payments

Billing for Medicare

Private insurers may charge different rates for the same service depending on whether they’re offering coverage through an HMO or PPO plan.

They include:

  • A doctor-to-doctor relationship is not necessary. However, if you’re able to establish one during the public health emergency, that would be helpful.
  • You may consent to receive remote physiological monitoringservices when they’re provided.
  • Physiologists and non-physiologist providers who are eligible to provide evaluation and medical services (E/M), including telemedicine, may be reimbursed for providing remote physiological monitoring services.

Remote physiological monitoring services billed under CPT code 99453 (for patients who are not hospitalized) and CPT code 99454 (for patients who are hospitalized)

  • Physiological measurements must be electronically recorded and automatically uploaded to a secure location where they can be accessed by the billing practitioner.
  • The device used to gather and transmit the patient’s health information must be considered a medical device under federal law.
  • If a patient has been confirmed to have COVID-19, remote physiological monitoring data can be recorded during the first two consecutive nights after admission.
  • Physiologic monitors must be able to monitor patients who may require acute care or chronic conditions.
  • The services may be offered by auxiliaries who are supervised by the billers.

To see which specific code(s) and/or requirement(s) are needed for Medicare’s remote physiological monitoring (RPM) services, visit CMS’ billing and coding page.

Billing for private insurance

Contact the patient’s health insurer for details on its billing and reimbursement policies.

Billing for Medicaid

You can learn more about each state’s remote health care policy by visiting the National Policy Center -Center for Connected Health Policy.

More resources:

The evidence base for telehealth during the coronavirus pandemic has been growing rapidly.

FDA has issued an enforcement policy regarding noninvasive remote monitoring devices used to support patient monitoring during the COVID-19 public health emergency.

CDC’s Telehealth Program


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