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
  • Audiologists
*Includes Advanced Practice Registered Nurse (APRN)

Link to the regulation: https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-23953.pdf

Please contact Joy Cameron with any questions.


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