Medicare reimburses both remote physiological monitoring and RTM, including the use of a Remote Surveillance Trailer in Watts CA. Remote patient monitoring is covered as a reimbursable Medicare program. As of January 2025, it is also covered by 42 state Medicaid programs, according to the Center for Connected Health Policy. An increasing number of commercial payers are also covering remote patient monitoring. Both Medicare and most private insurance companies cover remote patient monitoring, and reimbursement rates are often higher than those for telehealth and chronic care management.
Providers will have the patient data they need to provide them with better treatment, including real-time alerts about changes in patient outcomes. RPM tools result in better results, both for your patients and for your company. Medicare broadly covers remote patient monitoring (sometimes referred to as remote physiological monitoring) to collect any type of physiological data using a wide range of devices, in the case of chronic and acute illnesses. Remote patient monitoring (RPM) is the collection of a wide range of health data from the point of care, such as vital signs, weight and blood pressure. Data is transmitted to health professionals in facilities such as monitoring centers in primary care centers, hospitals and intensive care units, and skilled nursing facilities.
A little more than half of state Medicaid programs reimburse the cost of antiemetic treatment; however, its use is subject to numerous restrictions. The most common include offering reimbursements only to home health agencies, restricting clinical conditions where symptoms can be controlled, and limiting the type of monitoring device and information that can be collected. Most insurance providers cover at least some type of telehealth service. Contact the insurance providers you accept to see if they cover reimbursement for any telehealth service.
Ask patients to check their coverage before appointments. To find the most up-to-date regulations in your state, use this policy search tool. The program will require that a provider offering a remote ultrasound procedure or a stress-free remote fetal test use digital technology to collect any patient's health data and securely transmit the information electronically to a healthcare provider in a different location for interpretation and recommendations that comply with the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and are approved by the Federal Food and Drug Administration. For items or devices reimbursed separately to a medical provider, such as continuous glucose monitoring (CGM) systems for personal use, see the chapter on medical providers in the MDHHS Medicaid Provider Manual. Remote customer monitoring is the use of electronic information and communication technology to collect a client's personal health and medical information at a home facility and transmit it to a healthcare provider located in a remote location for use in treating and managing medical conditions that require frequent monitoring.
Remote patient monitoring (RPM) allows patients to collect their own health data (for example, blood pressure) using a connected medical device that automatically transmits the data to their provider. CO Medicaid covers home telehealth, which includes frequent and continuous self-monitoring by members using equipment that is left at the member's home and is designed to measure the common signs and symptoms of an exacerbation of the disease before a crisis occurs, allowing for timely intervention and management of symptoms. Bill Medicare for remote patient monitoring services using a general set of procedure codes, which represent the different components of monitoring. If, after implementation, the commission determines that a condition for which the commission has authorized the provision and reimbursement of home telemonitoring services under Medicaid under this section is neither cost-effective nor clinically effective, the commission may discontinue the availability of home telemonitoring services for that condition and stop reimbursing home telemonitoring services under Medicaid for that condition, without prejudice to Section 531 0216 or any other law. The provider is responsible for ensuring that the monitoring agency and the agency's team meet the requirements of this section. Each pilot participant, covering seven months and 60 Medicaid members with congestive heart failure, chronic obstructive pulmonary disease or diabetes, received a Vivify kit to monitor their health status and share data with their care managers in real time.
Physicians should report the electronic analysis of an implanted cardiac device using data obtained remotely, as described above, with the CPT codes 93731, 93734, 93741 or 93743, depending on the type of cardiac device implanted in the patient.
Remote monitoring
will help the person to fully integrate into the community, participate in community activities and avoid isolation. MassHealth expects to introduce remote patient monitoring coverage for the treatment of chronic diseases in the future. Since then, the number of patients receiving remote monitoring has increased significantly each year.Both remote physiological monitoring and remote therapeutic monitoring data can be transmitted electronically; however, the patient using the device can only self-report RTM data. While remote patient monitoring can be an important source of income, this will only be the case if your office minimizes expenses related to running the program and has processes in place to ensure that you are fully paid for the RPM services provided. The use of remote monitoring requires sufficient backup plans and the SCA will be responsible for ensuring that the member has at least two adequate backup plans before referring them for this service.
