Since 2016 Medicare incentivizes providers who are willing to leverage technology to regularly monitor patients remotely. Medicare’s Remote Patient Monitoring program compensates providers for recommending and reviewing data. Remote patient monitoring simply refers to the use of technology to record health data for review by a provider. It allows physicians caring for patients who are suffering from chronic conditions and can benefit from the program. CMS allows the physician to determine who would benefit from the program.
As every patient has unique needs the duration of the program too varies. The duration of the program will be determined by you and your caregiver/provider. Patient or the provider have the right to terminate this program at any time.
According to the Centers for Medicare & Medicaid Services (CMS), RPM is for “patients with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, that place the patient at significant risk of death, acute exacerbation/decompensating, or functional decline.”
Yes, this is a new covered service by Medicare. You are provided with all equipment and devices. You are liable to return the devices at the termination of the program or you may be billed for the cost of the equipment (up to $150 per device). You are also responsible for taking the readings as prescribed by your physician.
Your remote monitoring data is securely transmitted to the patients caregiver/provider and the care team who will regularly analyze the data to identify any gaps in care.
CMS pays up to $129 per patient per month (See chart of how much a practice can make).
|CPT CODE||YOU GET||1000 PATIENTS||2500 PATIENTS||5000 PATIENTS|
|CPT 99453||$20 one time||$20,000||$50,000||$100,000|
|CPT 99454 +
CPT 99457 + Or
|$60 – $ 65 / Mo||$60,000 – $65,000 / Mo||$150,000 – $162,500 / Mo||$300,000 – $325,000 / Mo|
|CPT 99458||$40 / Mo||$40,000 / Mo||$100,000 / Mo||$200,000 / Mo|
|CCM CPT 99490||$20 – $42/ Mo||$20,000 – $42,000 / Mo||$50,000 – $105,000 /Mo||$100,000 – $210,000 / Mo|
|TOTAL ANNUAL REVENUE||$1.5M – 1.8M||$4.1M – $ 5.2M||$7.1M – $10.4M|
Nothing – it is FREE for eligible Medicare patients. If a patient does not have a secondary coverage for the gap then they may have a small copay.
Device to the patient can be given in two ways based on what works best for the you and the patient:
- Direct shipment of Device to Patient’s address after enrollment
- You or your staff handover the devices supplied by Augment Health to the patient in your office
This is entirely up to the physician to advise their patient about the frequency of taking the readings based on their condition.
AHT team will help with the training needs of your staff as well the patient when the device is given to the patient.
AHT team will first help in troubleshooting the device working with the patient to resolve the issue. If the device is found to be faulty, AHT will ship another device to the patient’s address.
You or your staff will get notified via email about the readings based on the notification rules set up (out of control reading) for the patient.
In this case, AHT has a set of devices that work with Wifi at the patient’s home.
Yes, we can have multiple people in your staff to monitor the patients in our portal.
AHT team will take care of any training needs of you and your staff for operating the devices as well as management of devices.
You can track all of your enrolled patient’s readings received from the devices in your account on our portal.
Yes, AHT team will send you the monthly report for all your enrolled patients who have taken at least a reading in a month.
Once the patient is enrolled in the RPM Program, you will need to review the monthly report, take any action (if needed) on the alert notifications and bill Medicare for the service.