Current Procedural Terminology (CPT) Codes were introduced by Centers for Medicare & Medicaid Services (CMS) in 2018 to reimburse providers for delivering RPM services to their patients. Since then, codes ensure that RPM becomes a sustainable and financially viable program for healthcare service providers. Below, we highlight the five primary RPM codes and every year new clarifications and changes are made to these.
Let us look first look at what CPT codes look like in 2021:
*While this CPT code is still valid as per CMS, the codes listed above better represent the various situations that require billing.
Prerequisites for RPM Billing
Before providers bill the above codes, you must consider the following requirements of RPM billing.
- Patients consent to receiving the RPM services. A single annual consent must be obtained to fill this prerequisite.
- While the device does not need to be FDA approved, it must meet the FDA’s definition of a medical device. This implies that the device fulfills the criteria defined by Section 201(h) of the Federal Food, Drug and Cosmetic Act to be reliable and valid.
- Data is collected and transmitted electronically and should not be self-reported.
- Data is reported for over 16 days within a 30-day period to be eligible for billing.
- Services are initiated by a healthcare provider, such as a physician or any healthcare professional.
What is SenSights.ai?
LocateMotion Inc. developed SenSights.AI, an easy-to-use mental health & well-being intelligence platform for seniors & caregivers. Our dedicated platform allows us to enable better digital health accessibility. It tracks the progress of early cognitive decline by capturing vitals, daily notes, medication effects, feelings, behaviour. Finally, it assesses virtual interventions based on risk-levels.
Additionally, SenSights.AI offers virtual care services that help at-risk providers, home health, skilled nursing and long term entities increase their capacity by complementing virtual care with physical visits. Our services also reduce readmission rates and avoid wandering and fall episodes through proactive monitoring and risk profiles along with smart alerts.
How SenSights.ai meets RPM requirements for CPT billing:
By allowing providers to use non-FDA approved devices, that nonetheless fulfil the FDA requirements, providers can expand access to care given the cost-effectiveness and easy availability of non-FDA approved devices such as FitBits and AppleWatches. SenSights.AI‘s device agnostic design offers an all-in-one experience across many devices and systems without the need for special adaptations. This accounts for the input method, connection speed, resolution and any limitation that could be encountered on a device.
Furthermore SenSights.AI provides seamless 24/7 remote monitoring of multiple biometrics, is equipped with personal emergency interventions and real-time alerts and provides access to physicians and data collection, ensuring that your practice receives accurate and consistent patient information. This is an essential feature as electronic collection and transmission of data is crucial to CPT billing. Moreover, our real-time predictive analytics will enhance your business’ operational efficiencies. We also provide detailed analysis reports based on our comprehensive databank of clinical and behavioural understanding. This includes complete guidelines on better healthcare interventions, and results.
Thus, with regular clarifications and extensions of CPT codes, RPM will remain a permanent feature of our healthcare set-up, with adoption likely to accelerate over the years. It is not only essential for physicians and practices to remain in touch with the latest codes changes to expand their care network but also partner with analytics platforms. SenSights.ai. is one such platform that is globally scalable, device agnostic, provides real-time monitoring and is simultaneously business and consumer focused.
Book a demo today to learn more about LocateMotion (SenSights.ai) and how our proactive monitoring solutions can work for you at Sensights.ai/demo
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Contributors: Mariam Javed