Remote Patient Monitoring & Chronic Care Management
The healthcare landscape is evolving and there is an increasing focus on the value of non-face-to-face care. In recognition of these changes and to improve outcomes, reduce costs, and support the efforts of patients and physicians, The Centers for Medicare & Medicaid Services established new billing codes to increase reimbursement for the additional time and resources spent managing the care of patients outside of the usual face-to-face encounters. These codes are reflected in two initiatives: Remote Patient Monitoring (RPM) and Chronic Care Management (CCM).
Join the future of medical care while increasing your annual revenue with Mydayda!
Using Mydayda’s platform and services you will...
- receive reimbursement for the services you are already providing
- have use of devices with a seamless software interface needed to perform services effectively and efficiently
- use the included robust billing dashboard, detailed analytics and reports to meet your financial goals
- have access to a built-in timer that automatically records the time spent in patient care to meet the requirements for full reimbursement
- receive the training needed for you and your staff
- have the option to customize the software to meet your needs and use Mydayda’s Onboarding Specialist to enroll patients
Three Easy Steps
Remote Patient Monitoring
RPM is remote monitoring of physiologic parameters (e.g., temperature, blood pressure, weight, pulse oximetry) that are transmitted electronically to the patient’s healthcare provider. The monitoring devices must provide daily recordings or programmed alerts.
Minimum Potential RPM Annual Revenue*
*Based on Reimbursement of $115.69/patient/month (CPT codes 99454+99457)
Chronic Care Management
Chronic care management is a critical component of primary care that contributes to better health and care for individuals with multiple conditions. The Centers for Medicare & Medicaid Services (CMS) data shows that two thirds of people on Medicare have two or more chronic conditions, which means many of your patients may benefit from a CCM program.
CCM is divided into two categories: non-complex care and complex care. Both require the following :
- The patient must have two or more chronic conditions expected to last 12 months and place the patient at significant risk of death, acute exacerbation / decompensation, or functional decline
- Advanced consent must be obtained from the patient before initiating CCM
- New patients or patients not seen within 1 year prior to the commencement of CCM, require initiation of CCM services during a face-to-face visit with the billing practitioner
- The patient must have 24-hour-a-day, 7-days-a-week access to address urgent needs
- The CCM practitioner must establish, implement, revise, or monitor a comprehensive care plan
The differences between the two categories is that complex care requires moderate to high complexity decision making with additional time requirements per month. The billing codes and details are indicated below.
Minimum Potential Annual Complex CCM Revenue*
*Based on Reimbursement of $158.83/patient/month (CPT codes 99487+99454)
Medical decision making of moderate to high complexity with at least 60 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month.
Each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional. Use with 99487.
At least 20 minutes of clinical staff time, directed by a physician or other qualified health care professional, per calendar month.
Each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month. Limit: 2x during service period. Use with 99490.
At least 30 minutes of care provided personally by the billing physician or other qualified health care professional, per calendar month.
1 All reimbursement rates and potential revenue are estimates and subject to change. For full details of Medicare requirements and reimbursement of RPM & CCM go to the Centers for Medicare and Medicaid Services website