49 groups urge CMS to set codes to cover remote monitoring

Coalition urges agency to accept 3 CPT codes to reimburse providers for digital health services.

Some 49 provider organizations, IT professional groups and vendors are urging the Centers for Medicare and Medicaid Services to designate reimbursement codes that will enable reimbursement for remote monitoring services.

Such a step would ensure payment for digital health services provided by hospitals and clinicians to ensure that they are paid for using technology that enables them to monitor patient health when they are not at a medical facility.

The designation by CMS would establish payments that are separate and distinct from telehealth services. Organizations signing the letter include the American Medical Association, the American Heart Association, the American Telemedicine Association, the College of Healthcare Information Management Executives, the Healthcare Information and Management Systems Society, among others.

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The letter asks the federal agency to approve three new remote monitoring codes developed last year by the American Medical Association’s Digital Medical Payment Advisory Group, comprising experts in digital medicine services as well as coding, valuation and coverage. Their work was approved by the Current Procedural Terminology panel last year, and the coalition urges CMS to formalize adoption of the codes.

The group notes that the physician fee schedule for 2018 from CMS permits separate payment for remote physiological data monitoring, “allowing reimbursement to physicians and qualified healthcare professional who rely on (patient generated health data) to monitor patients from wherever they may be.”

The group asks CMS to designate the three new CPT codes for reimbursement by Medicare. “We stand in agreement with CMS that (remote monitoring efforts) are paid under the same conditions as in-person physician services and can be a significant part of ongoing medical care.”

The new codes cover the initial setup of digital devices, ongoing expenses for the devices, and services to remotely monitor physiological parameters.

“There is an existing body of evidence demonstrating that these services will increase value and improve patient health outcomes, particularly for patients with multiple co-morbidities, chronic conditions, and those facing access barriers due to geography, limited mobility (and) medical fragility,” said the letter, addressed to CMS Administrator Seema Verma.

“As a community in support of connected health innovations in the Medicare system, we eagerly await the release of the next proposed and final Medicare Physician Fee Schedule, and plan to provide further input to promote the use of remote monitoring innovations in the delivery of care,” the letter concludes.

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