Over the past few years, there have been significant changes in the way healthcare is delivered, and this has been accelerated by the COVID-19 pandemic.
One of the biggest changes has been the rise of remote patient monitoring (RPM) and telehealth, which allow patients to receive care remotely from the comfort of their homes. As a result, the Centers for Medicare and Medicaid Services (CMS) has made several big payment changes to support and incentivize healthcare providers to offer RPM and telehealth services to their patients. In this article, we will discuss these changes and what you need to know about them.
Expanded Coverage for Telehealth Services
One of the biggest changes that CMS has made is the expansion of coverage for telehealth services. Prior to the COVID-19 pandemic, Medicare only covered telehealth services for patients living in rural areas, and only for certain services, such as mental health and follow-up visits. However, in response to the pandemic, CMS expanded coverage for telehealth services to all Medicare beneficiaries, regardless of their location. This means that patients can now receive care through telehealth from their home, nursing home, or other locations.
Increased Reimbursement for Telehealth Services
Along with the expanded coverage for telehealth services, CMS has also increased reimbursement rates for telehealth services to incentivize providers to offer these services. For example, CMS has increased reimbursement rates for telehealth visits to the same rate as in-person visits. This means that providers can receive the same payment for telehealth visits as they would for in-person visits, which can help offset the costs of offering these services.
New Codes for Remote Patient Monitoring Services
CMS has also created new billing codes for RPM services, which allow providers to receive payment for monitoring patients remotely. These codes cover a wide range of services, including remote monitoring of blood pressure, weight, and glucose levels, as well as medication adherence and chronic care management. These new codes are designed to encourage providers to offer RPM services, which can improve patient outcomes and reduce healthcare costs.
Increased Reimbursement for Remote Patient Monitoring Services
Along with the new billing codes, CMS has also increased reimbursement rates for RPM services. Providers can now receive payment for RPM services at the same rate as in-person visits. This means that providers can be reimbursed for the time and resources required to monitor patients remotely, which can encourage more providers to offer these services.
New Requirements for Telehealth and RPM Services
Finally, CMS has introduced new requirements for telehealth and RPM services to ensure that they are delivered safely and effectively. For example, CMS has issued guidance on the use of telehealth and RPM services for patients with opioid use disorder, and has created new requirements for the use of telehealth services in nursing homes. These requirements are designed to ensure that patients receive high-quality care through telehealth and RPM services.