Healthcare is Adopting Remote Care in 2020
Updated: Nov 6, 2020
Increased Reimbursement Options for Telemedicine and Remote Patient Monitoring (RPM)
Money is tight for many practices due to the shift to value-based care. This shift away from fee-for-service, combined with increasing regulations and higher patient self-pay requirements, means that practices are looking to increase efficiency and find new reimbursement opportunities. One such option is reimbursement for telemedicine and remote patient monitoring (RPM), which allows clinicians to generate additional revenue for their practices while increasing patient engagement and satisfaction.
RPM includes the use of our simple and completely free app, Mobile Angel, which improves medication adherence and early toxicity mitigation, resulting in fewer ER and hospital visits and better quality of life for patients. This RPM can save clinic staff more than 60 minutes/day and offers reimbursement north of $250/patient/month.
Before realizing the benefits of telemedicine and RPM, many offices have worked to increase revenue by shortening appointments to 15 minutes and adding more patients into the daily schedule. However, this often results in a poor experience for both patients and physicians when providers fall behind schedule and end up focusing solely on illness instead of preventative care and overall wellness – which is the intended direction of healthcare.
Other practices have started extending office hours to see more patients, but those extra hours combined with increased demands for charting and EMR reporting often leads to clinician burnout. The compounded effects of burnout have led individuals to leave practice earlier in their career than anticipated, exposing the healthcare system to vulnerability. With an aging population, the risk of a doctor shortage puts more pressure on the entire healthcare system.
If extended office hours and cramming more patients into the schedule aren’t the answers, then what options remain? Many practices are turning to telemedicine solutions and RPM to relieve some of the burden, especially for those who see Medicare patients.
RPM allows clinicians to interact with patients in-between office visits and track the overall wellness of their patients over time, instead of the snapshot taken from short in-person visits. RPM includes remote calls for check-ins, but the real power comes from continuously and intelligently collecting patient reports and the resultant early warnings before conditions become severe. This type of RPM has been shown in peer-reviewed studies to decrease costs, improve outcomes, and improve patient quality of life. It also saves the staff time by continuously presenting a prioritized list of patients that need attention.
All patients can benefit from the time gained from a quick telemedicine visit, where the entire process is completed in 20-30 minutes, versus the patient having to take an average of 2.5 hours out of their day for a simple visit. In addition, clinicians can get a better overall picture of a patient’s health through a few automated questions each day that the patient can answer in minutes and then connect with their care team as needed through secure messaging.
The Centers for Medicare and Medicaid Services (CMS) also recognizes the benefits of telemedicine and RPM and is adjusting its regulations and reimbursements accordingly.
CMS is moving away from previous reimbursement models that were limited by type and geography with complex billing requirements. The goal is to improve care and reduce costs to provide value-based care, especially for patients in Medicare Part B and Medicare Advantage plans.
Mobile Angel is an intelligent early warning triage system for cancer care. Our RPM app connects the clinic and patients to provide proactive care between clinic visits and minimize delays in helping distressed patients. The free mobile app helps clinics to track medication adherence and monitor symptoms in real time and quickly communicate with patients in a virtual care environment. With Mobile Angel, clinics can increase reimbursement options while improving patient outcomes and satisfaction.
New CMS 2020 Billing Codes
Chronic Care Remote Physiologic Monitoring
(99453, 99454, 99457, & 99458)
Device set-up and patient education, the monitoring device(s), and standard and extended RPM services.
Practices can bill for 5-10 minute technology-enabled remote conversations between established patients and physicians or qualified healthcare professionals.
Chronic Care Management (CCM)
(99490, 99478, 99489, GCCC1 & G2058)
Can apply to working with patients who have two or more conditions in CCM programs for non face-to-face time.
Principal Care Management (PCM)
Working with patients who have one chronic disease or high-risk condition.
Transitional Care Management (TCM)
Covers prompt contact with patients within 2 days of discharge.
Behavioral Health Integration (BHI) and Psychiatric Collaborative Care Management Services
(99492, 99493, 99494, 99484)
Helping to remove obstacles to patient activation and engagement in their care.
Monthly Telehealth ESRD-related Dialysis Clinical Assessments
(90951, 90952, 90954, 90955, 90957, 90958, 90960, 90961, 90963 & 90970)
Monthly assessments from nephrologists for patients on dialysis with ESRD.
Opioid and Substance Abuse Disorders
(G2086, G2087, G2088)
Office visit is no longer required for substance abuse disorder assessments.
Note: CMS can make updates to billing codes throughout the year. Confirm current information with CMS.