Remote Patient Monitoring for Cardiology: Maximizing Reimbursement with RPM Billing Codes

Remote Patient Monitoring for Cardiology: Maximizing Reimbursement with RPM Billing Codes
remote patient monitoring

How RPM can help to manage cardiac diseases:

Did you know that cardiac diseases are the leading cause of global mortality? 

Unfortunately,  According to a study of the global burden of diseases (GBD); prevalent cases of total cardiovascular diseases (CVD) nearly doubled from 271 million in 1990 to 523 million in 2019, and the number of CVD deaths steadily increased from 12.1 million in 1990, reaching 18.6 million in 2019. This is not including the Covid 19 pandemic impact (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7755038/).

According to the Centers for Disease Control and Prevention (CDC)  Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups. One person dies every 33 seconds from cardiovascular disease. In 2022, 702,880 people died from heart disease. That's the equivalent of 1 in every 5 deaths. Heart disease had a total cost of $252.2 billion from 2019 to 2020. This includes the cost of healthcare services, medicines, and lost productivity due to death. One positive outcome of the COVID-19 pandemic has been the growing recognition of the importance of telehealth and remote patient monitoring (RPM). In this article, we will guide you through various approaches to treating cardiology patients using these innovative methods.

This data not only demonstrates the growth of the incidence of heart disease; but also demonstrates that these tools are needed more than ever.

 In cardiac diseases (CVDs), scientific research has demonstrated that high blood pressure is associated with the strongest evidence for their causation. Accordingly, remote blood pressure monitoring is of high importance, and providing the right method for constant blood pressure monitoring devices is very important. (​​https://www.vitalera.io/use-cases/learn-about-marias-case )

Remote patient monitoring (RPM) refers to the use of advanced technology to track and gather health data from patients without requiring them to visit a healthcare facility. This data is sent directly to healthcare providers, allowing them to monitor chronic conditions and enhance patient care in real time. RPM represents a significant shift in healthcare from reactive treatments to proactive management, playing a crucial role in modern telehealth systems. But we are not just speaking about technology, we are also speaking about the transformation of care in the way patients are treated. (You can download our free guide for remote patient monitoring from here https://www.vitalera.io/academy/remote-patient-monitoring-a-comprehensive-guide ).

This shift in providing healthcare to patients from the comfort of their homes is at the core of providing quality healthcare services with people-centredness as a driver and primer focus.

How can I reimburse remote patient monitoring with Medicare or medicaid? 

Enhance your practice with vitalera's Remote Patient Monitoring (RPM) solution, and get reimbursed for the care you provide.

Our RPM platform allows healthcare providers to remotely monitor patient health using advanced digital devices, ensuring continuous care and timely interventions. Reimbursement is available through specific RPM billing codes, recognized by Medicare and Medicaid, although Medicaid coverage may vary by state. See here the main codes:

  1. Initial Setup (CPT 99453): This code covers the one-time setup of the RPM equipment and educating the patient on its use.
  2. Device Supply and Monitoring (CPT 99454): This code is for the monthly supply of the monitoring device and the transmission of data from the patient to the provider.
  3. Patient Monitoring and Interaction (CPT 99457): This code covers the time spent each month by healthcare providers reviewing patient data and interacting with the patient to make health decisions.
  4. Additional Time for Monitoring (CPT 99458): This code covers any additional time spent interacting with the patient and reviewing their data beyond the initial period covered by the previous code.

To qualify for RPM reimbursement, the device must actively collect and transmit patient data to the healthcare provider either daily or at regular intervals, with consistent monitoring and documentation. For Medicare, the patient is typically required to use the RPM device for at least 16 days within 30 days to be eligible for reimbursement.  

Vitalera ensures the facilitation of reimbursement through direct billing, to provide the trustability and workflow integration that are needed to provide affordable solutions and in alignment with regulatory compliance. 

Remote Patient Monitoring , are the future of connected health

(Contact us to learn more about the codes we can offer.) 

Curious about how you can ensure reimbursement for your RPM services? Contact us today, and we’ll guide you through the process, helping you navigate Medicare and Medicaid requirements with ease.

How can RPM can improve cardiology care? 

Our product Vitalera is an API-based medical software crafted by 10 years experience of and dedication to reach a level of cutting edge in the detection of critical events. 

  1. Personalized health data: Our focus is on personalized health data collected remotely from patients outside the clinical settings saving huge amounts of cost to healthcare facilities. Especially with the fact that cardiovascular disease costs are expected to exceed 1 trillion USD dollars by 2035. (https://www.sciencedaily.com/releases/2017/02/170214162750.htm)This cost is a cause of a huge burden to healthcare providers.
  1. Readmission reduction: Remote patient monitoring enables huge possibilities in cutting those costs and elevating the burden through reimbursement through remote patient monitoring programs (payment healthcare providers receive from insurance companies, Medicare, or Medicaid for offering remote monitoring services to patients). 
  1. Patients connected while increasing adherence: Through vitalera user-friendly interface, patients stay engaged with their health. They receive reminders, insights, and educational content, which helps them understand the importance of staying on track. In previous work we have demonstrated it can improve up to 90%, thanks to the reminders and notifications, among other services our solution delivers to patients. 

Contact us for any other question.

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