CPT Code 99091
As of Jan 1, 2018, CMS will reimburse $59 per patient per service period (30-day) for Remote Patient Monitoring services. Although CMS has imposed a number of requirements with respect to CPT Code 99091, it is important to note that Remote Patient Monitoring is NOT subject to the same restrictions that currently govern reimbursement of general telehealth services under Medicare.
Specifically, reimbursement for RPM services is not limited by geography to rural or medically underserved areas, nor is there any “originating site” restriction for RPM services. In fact, RPM services can be provided anywhere the patient is located, including at the patient’s home.
Proposed Changes to RPM Reimbursement – FY 2019
Medicare is expected to begin reimbursing for the collection and analysis of physiological data captured via RPM technology in FY2019.
During this year’s request for comments, requestors proposed to add the following “Chronic Care Remote Physiologic Monitoring” codes to the list of Medicare services for 2019:
- CPT 990X0 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education of use of equipment);
- CPT 990X1 (Remote monitoring of physiologic parameter(s) (eg, weight, blood, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days); and
- CPT 994X9 (Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month).
It is important to note that these codes have not yet been finalized by CMS, and there is currently no proposed fee schedule associated with these changes. CMS is expected to provide a final ruling in November 2018. If approved, the codes would go into effect January 1, 2019.