Telehealth and remote patient monitoring (RPM) are quickly becoming go-to resources for both patients and providers. They not only provide a convenient option; they also improve access for patients in rural and remote areas. But telehealth and RPM are not without challenges. How can providers incorporate these approaches into their practices to improve both the provider and patient experience?
Telehealth and RPM
As the name suggests, telehealth is a remote method of meeting with patients that does not require an in-person interaction. Typically, telehealth visits are conducted via video conference using a computer, tablet, or smartphone.
Remote patient monitoring is a subset of telehealth. According to the U.S. Government Accountability Office, "Remote patient monitoring refers to a coordinated system that uses one or more home-based or mobile monitoring devices that transmit vital sign data or information on activities of daily living that are subsequently reviewed by a healthcare professional."
In other words, RPM uses technology to remotely capture patient data. It is often used for chronic health conditions, such as diabetes or kidney disease. The federal government uses both telehealth and RPM in various healthcare programs, including Medicare, Medicaid, Veterans Affairs, and the Department of Defense, which provides services to active-duty personnel and their dependents.
Benefits of telehealth and RPM
Telehealth improves access to healthcare. It has been available for a decade, but until the pandemic made it a must-have, it was simply a little-used option. Although in-person healthcare is returning, many patients prefer the availability and convenience of telehealth. People in rural areas, without easy access to a healthcare facility, find it especially useful. And RPM provides tremendous value for patients with chronic conditions and their providers by capturing vital information that can inform next steps for patient care. Telehealth and RPM also reduce costs, improve outcomes, and increase patient satisfaction. But how do patients, providers, and payers navigate all the rules and regulations?
Billing and reimbursement
In January 2021, new regulations made it easier for providers to get reimbursed for telehealth services. To qualify for reimbursement under CPT codes 99457 and 99458, Medicare requires patients to be present at a medical facility (originating site) and providers to be located at a separate location (distant site). Providers and patients must have at least 20 minutes of interactive communication over a calendar month. Providers must submit claims in the service area where their distant site is located. The new regulations also clarify how healthcare providers will be paid for using RPM platforms to monitor health from a patient’s home.
The Centers for Medicare and Medicaid Services (CMS) continues to evaluate telehealth services that were temporarily added to its list of covered services during the COVID-19 pandemic. The CMS has confirmed that certain telehealth services will be covered through December 31, 2023. This will give CMS time to decide which services will be permanently added to the Medicare list of covered services.
To add to the complexity, each state has their own rules and regulations concerning covered telehealth. For more guidance on optimizing your healthcare revenue cycle with telehealth options, visit TruBridge.com or call 877-543-3635.
