Remote Patient Monitoring Benefit in the Physician Fee Schedule
The Center for Medicare and Medicaid Services (CMS) released the 2018 Physician Fee Schedule, which effectively created a remote patient monitoring benefit. CMS unbundled 99091 from the CCM code. This means that starting in 2018 this code can be billed separately allowing a physician or other qualified care professional to get paid for monitoring biometric patient data transmitted digitally by a patient or caregiver. The code allows for $57 per month per patient for a cumulative 30 minutes of monitoring.
99091 Remote monitoring : Collection and interpretation of physiologic data (e.g. ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time.
Other qualified care professionals:
- Physician Assistant (PA) – subject to payment adjustment
- Nurse Practitioner* (NP) – subject to payment adjustment
- Clinical Nurse Specialist*
- Certified Registered Nurse Anesthetist* (and Anesthesiologist Assistant)
- Certified Nurse Midwife*
- Clinical Social Worker
- Clinical Psychologist
- Registered Dietician
- Nutrition Professional
Link to the regulation: https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-23953.pdf
Please contact Joy Cameron with any questions.