The latest final rules from CMS — the 2018 Quality Payment Program (QPP) Final Rule and the 2018 Physician Fee Schedule (PFS) Final Rule — offered changes to past policies that went into effect at the beginning of 2018.
Notably, the unbundling of CPT code 99091 in the PFS Final Rule offers physicians an opportunity to be reimbursed for monitoring remote patients. This means it is no longer required to use 99091 in conjunction with codes intended to bill for in-person care. The change to the code states that physicians may be reimbursed separately for time spent on the collection and interpretation of patient-generated health data (PGHD), given they spend at least 30 minutes reviewing – meaning physicians may be reimbursed more easily for their time spent caring for patients remotely.
In addition, the QPP Final Rule also upgraded the use of PGHD to a “high” rating, which gives physicians more points in the Clinical Practice Improvement Activities (CPIA) category for using technology to engage their patients, a change lending itself to the growth of remote monitoring.
These updates are a part of a continuous improvement process by the Center for Medicaid and Medicare Services (CMS) in order to help physicians during the transition to value-based care and allow them to be reimbursed for their time spent caring for patients, whether in-person or otherwise.
To find out more about the most recent CMS updates and the implications these changes hold for the future of remote patient monitoring, read our long-form post here.
Learn more about Validic Impact, the lightweight remote monitoring platform that enables remote care capabilities for existing clinical systems.