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Remote Patient Monitoring (RPM) Billing and Coding with 2023 Updates

Session Information:
By: Dr. Irina Koyfman, DNP, NP-C, RN
Format: On-Demand Webinar
Duration of the training: 60 Minutes

Conference Material (Password Required)

Remote Patient Monitoring (RPM) programs are becoming increasingly popular, supported by growing clinical evidence and financial benefits to providers. Simply put, Remote Patient Monitoring is a Medicare-covered service that involves the collection and analysis of patient physiologic data in real time. Clinic staff can remotely monitor patients in between office visits. This virtual and real-time monitoring enables providers to truly meet the needs of their patients and provide timely care. Multiple studies have demonstrated improved patient outcomes and increased compliance while reducing hospital admission and readmissions. Providers also benefit financially as this is a well-reimbursed service.

RPM uptake among providers has been rapid, particularly during the COVID-19 pandemic and limited in-person care. RPM companies have been coming to marker weekly if not daily in the past 12 months. However, there is a lot of information providers need to know before contracting with the RPM vendor to be compliant. After all, the billing is done under the provider and the provider will be the one audited.

Learning Objective:
  • Review CMS’s RPM requirements
  • Examine the Scope of Services required to bill Medicare for RPM services
  • Identify how RPM can close care gaps and engage patients
  • Assess the financial and quality implications of incorporating RPM in your practice
Areas Covered in the Session:
  1. Remote Patient Monitoring
    • Sobering Statistics
    • History of RPM
    • What is RPM
    • RPM Workflow
    • Requirements of Successful RPM program
    • Who can bill for RPM?
    • Who can NOT bill for RPM?
    • Benefits of Implementing RPM
  2. CPT Codes
    • Clinical Staff CPT Definition
    • CPT 99453- Service Initiation
    • CPT 99454- Data Transmission
    • CPT 99457- Treatment Management
    • CPT 99458- Treatment Management
    • CPT 99091- Interpretation and Analysis
  3. Consent
  4. Example of Consent Template
  5. Medical Necessity
  6. Example of Order/Documentation
  7. Interactive Communication
  8. Reimbursement Opportunities
  9. Reduction in Reimbursement
Suggested Attendees:
  • Physicians
  • Nurses
  • Doctors
  • Nurse Practitioner
  • Population Health Officers
  • Innovation officers
  • CNO/CMO
  • Billers
  • PCP (MD, NP, PA)
  • Specialists (MD, NP, PA)
  • Nurse Managers
  • C-Suite Healthcare Executives
Presenter Biography:

Dr. Koyfman is an enthusiastic and emotionally intelligent Nurse Practitioner with 20 years of nursing and 15 years of executive experience with excellent communication skills. She presents with a sense of humor and practical examples. Dr. Koyfman is an expert in the Patient-Centered Medical Home (PCMH), Home Health, Healthcare Start-ups, Transitional Care, Community Health, Chronic Care Management, and Care Coordination. She is considered a Subject Matter Expert in Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) and has been consulting in the space of remote patient management for many years.