How to Get Reimbursed from Medicare for Remote Patient Support

Clinicians who treat seniors now have a new reimbursable option that helps them get paid for providing critical support in-between patient visits. Effective January 1, 2018, Medicare approved reimbursement for Remote Patient Monitoring or as we call it, “RPM” via CPT® code 99091.  

Remote patient monitoring is the use of digital technologies for collecting patient generated health data and the electronic transmission of that data to health care providers for review, assessment, recommendations and support. RPM services involve the interpretation of medical information without a direct face-to-face interaction between the provider and the patient. Interactions can be via video, phone, email, text or even via messages sent to a mobile app.

My parents are seniors and both have been diagnosed with chronic diseases, which means frequent doctor visits. As you can imagine, this is a big task to manage with their retirement travel schedule, grandkids and the normal fatigue that comes with chronic disease.  Like many people with chronic diseases, sometimes all they need is a little support, rather than a full visit. RPM can deliver more immediate, accurate and cost-saving medical care without the need for frequent in-office clinician visits. For people with diabetes (PWD) this can mean receiving valuable input on adjusting a medication, managing insulin therapy, food or exercise advice, discussing issues and challenges or just checking in on glucose levels. It also can improve patient satisfaction at significantly lower costs because it offers the help they need, quickly, and in a personal way.

For those healthcare professionals that use it, we’ve seen RPM have a positive impact on the overall health outcomes of their patients with diabetes. This means improved glycemic control, reduced occurrences of both hyper and hypoglycemia, more time in range and better overall personal satisfaction with their healthcare experience.

How can you set-up an RPM practice?

First, setting up your team to provide this service is critical. This means making sure there is a medicare approved, eligible provider available for remote interactions with patients. It is recommended that having certain individuals dedicate specific time each day to schedule remote “check-ins” results in the most effective patient impact. Next, inviting patients to be a part of the remote support service is important. Providing patients with a mobile app (like Glooko) where they can upload and track their diabetes data both helps them better manage their self-care, and also provides the on-demand data that the clinician needs to have a quick and efficient interaction with the patient.

Eligible billing providers must obtain the patient’s written consent prior to initiating remote patient monitoring, they must document and upload the signed consent letter in the patient’s medical record and give a copy of the signed letter to the patient.

How do you bill for RPM?

The 99091 code can be billed by the eligible billing provider when 30 minutes of remote patient monitoring activities have been accrued and documented in each billing month the billing date does not need to be the 30th or 31st day of the month. It can only be billed once a month per patient per 30 minutes of RPM.

In order to easily track and manage this time, we recommend that providers document all time spent on all remote patient monitoring activities furnished each month. These activities can include:

  • Teaching patients how to use RPM tools like Glooko.
  • Reviewing patient generated health data in your EHR and/or uploaded remotely into Glooko.
  • Counseling and educating the patient in response to their data and what you learn from them when you talk.
  • Modifying the patient’s care plan.
  • Communicating care plan changes to the patient or the patient’s caregivers.
  • And more!

Because Glooko has been used by providers to deliver RPM, we have worked hard to meet CMS requirements, which means providers can get reimbursed for using Glooko.

We have the tools and resources to help clinicians get reimbursed for remote care of Medicare patients. Whether you use Glooko or not, these tools can help you determine how to get started!

Learn More
Join us for a webinar on Friday, Sept. 21, 2018 9:00 AM – 10:00 AM PDT to learn how you too can provide important remote support, get paid for it and have happier and healthier patients as a result!

Michelle deHaaff

Michelle is passionate about customer happiness, creating great software and spending time with her 3 sons. She is the VP of Marketing and Customer Success at Glooko - the leading Unified Platform for Diabetes Management. See how thousands of patients and providers make diabetes management easier with Glooko.