Real-Time Monitoring
Achieve Perfection When you Refer Your Hypertension Patients to Real-Time Monitoring's
Remote Patient Monitoring Program (RPM)
About Us
For over 20 years, our philosophy has been to provide a clinically driven, value based platform that addresses the problems, conditions and challenges that impact the end result for all chronic conditions through remote patient monitoring. Our platform and clinical approach is recognized as industry leading and has been embraced by healthcare professionals, hospitals, and varying health plans; enabling us to become one of the largest diabetes and PT/INR management companies in the country. Real-Time Monitoring’s Hypertension Management Program was built with this same health philosophy and foundation, which has made this a perfect expansion to our current service portfolio.
Our experience utilizing our PharmD led clinical team to provide patient education, drive engagement and participation with the patient to improve compliance, has been a game changer for us. Our clinical team addresses the conditions and challenges that impact the result by placing clinical guardrails around the process to ensure optimum compliance and safe transition of your patients.
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As we enter into a time where Telehealth and the ability to communicate with patients and manage chronic conditions from outside the traditional office setting is imperative, the timing for the CMS introduction of 4 new billable Remote Patient Monitoring CPT codes in 2019/2020 couldn’t have come at a more opportune time. These recently released CPT codes (99453, 99454, 99457/99458) are specific to Remote Patient Monitoring for physiologic parameters (i.e hypertension, weight management, diabetes) and now provides physicians substantial reimbursement for management of these chronic conditions that are costly to the practice, patient and payer.
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Our unique Integrated Condition Management Philosophy for remote patient monitoring is an ideal platform to introduce the new CMS opportunity into your clinical setting. Rather than simply providing the patient with a device and recording results, our partners recognize our Hypertension Management Program as an opportunity to centralize their operational challenges (time and resources) and off-load them to our expanded clinical services. We will streamline your operational and financial costs while elevating/optimizing reoccurring billable revenue streams to increase profitability for the practice.
What is RPM?
The Opportunity
As an investment in prevention, in November of 2018, Centers for Medicare and Medicaid Services (CMS) released a final announcement for 3 new Remote Patient Monitoring (RPM) billing codes that became active on January 1, 2019. These codes pay for wireless collection of data for “physiologic parameters” (e.g. blood pressure, weight management, diabetes). In 2019, CMS began reimbursing healthcare providers for Remote Patient Monitoring. The results of RPM were favorable and has shown to prevent hospital readmissions by 62%. Therefore, in 2020 CMS expanded the program to include an additional code.
CPT Code 99453
CPT Code 99454
CPT Code 99457/99458
"Initial; set-up and patient education on use of equipment."
"Initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days."
"Initial; Treatment management services, initial 20 minutes (99457) and
additional 20 minutes (99458) of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month."
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Once per "episode of care"
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Must monitor for more than 16 days
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Must monitor for more than 16 days
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Once every 30 days, regardless of parameters monitored
$20*
$62*
$50*
* Average reimbursement rates may vary state to state or by region
The Requirements
The 4 CPT codes used for Remote Patient Monitoring are covered by Medicare, Medicaid and many private insurances. Patients are responsible for co-pays & deductibles.
1. The patient must consent
2. Devices must be registered with the FDA
3. Must be ordered by qualified medical professionals
4. Data must be wirelessly synced
5. The data monitoring services must be performed by the physician, a qualified healthcare professional, or clinical staff (RNs/medical assistants), subject to state law
How Much Revenue Could I Generate?
All patient interactions are documented and tracked and will ensure your practice is 100% compliant and in accordance with CMS and HEDIS guidelines as well as assisting your practice in achieving performance measures and requirements which will ultimately lead to revenue production for the practice.
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CMS reimburses healthcare providers approximately $1400 per patient/per year for remote patient monitoring. Through our Remote Patient Monitoring Program a primary care physician with an average number of 200 Medicare/Medicaid patients with hypertension could generate over $280,000 per year for remote patient monitoring. With the NEW code released in 2020, physicians can NOW generate a minimum of $100,000, in additional revenue per year which could yield approximately $380,000 in revenue annually.
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It is also worth mentioning, these new CPT codes for Remote Patient Monitoring can be combined with other non face-to-face codes (CCM, Transitional Care, BHI, etc.).
Easy Setup
Your patients will receive the device and training through Real-Time Monitoring. Our cellular blood pressure device has a large, easy to read number display with LED backlight and will work for any patient, no technical skills required. All devices provide real-time tracking of blood pressure results.
Service and Support
Our Clinical Care Coordinators are available M-F 8am to 5pm, to assist patients and providers.
Simplified Billing to Help You Stay Compliant
Our system makes it easy to bill. Each month, we will provide your practice with a detailed report of all patients and CPT codes that are ready to be billed for that time period.
Patient Engagement & Communication Tools
Our platform helps remind patients to test through automated reminders such as text and phone. Our system also provides useful SMS messaging, click-to-call and click-to-video for communication with patients.
Q & A
Q: When Did the RPM Reimbursement First Go into Effect?
​​​​​The original 3 CPT codes became available on January 1, 2019. One additional CPT code, 99458 was added effective January 1, 2020
Q: How Much Time is Required to Seek Reimbursement for CPT 99457?
At least 20 minutes per calendar month.
Q: How Does CPT 99457 Compare with CPT 99458?
CPT 99458 will be used in conjunction with CPT 99457. This code (99458) represents an add on of each additional 20 minutes of RPM treatment management services.
Q: Can RPM (CPT 99457/99458) be Billed "Incident to" ? What Supervision Level is Required?
Yes, these codes may be furnished by auxiliary personnel, "incident to" the billing practitioner's professional services. An "incident to" service is one that is performed under the supervision of a physician (broadly defined), and billed to Medicare in the name of the physician, subject to certain requirements. As of January 1, 2020, Medicare is allowing general supervision - i.e. the physician and auxiliary personnel are NOT required to be in the same building at the same time.
Q: What Type of Technology Qualifies under the New RPM Codes?
Many advocates asked CMS to clarify the kinds of technology covered under CPT codes 99453, 99454, 99457, and 99458. Some groups gave examples of the kinds of technology they believe these codes should cover, such as software applications that could be integrated into a beneficiary’s smartphone, Holter-Monitors, Fitbits, or artificial intelligence messaging. Other examples included behavioral health data and data from wellness applications, or results of patients’ self-care tasks. Unfortunately, CMS did not offer any specifics in the final rule on what technology qualifies, but CMS does plan to issue forthcoming guidance to help inform practitioners and stakeholders on these issues.
Q: Will Medicare Pay for Setting Up the RPM Device and Patient Education?
Yes. CPT 99453 offers separate reimbursement for the initial work associated with onboarding a new patient, setting up the device and patient education on the use of the equipment.
Q: Must the Patient Give Consent for RPM Services?
Yes. The patient must agree to the service and sign a consent form.
Clinical Services
Patients receive a BP device with integrated cellular connectivity and are trained and instructed to monitor their BP as often as the Rx indicates and the results are submitted into our company. We have the ability to identify early detections of daily BP fluctuations and can take action. All noncompliance & out of range results received are immediately communicated to the physician.
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Through our Triple A Condition Management Program™ your patients will have a greater AWARENESS of your prescribed care plan, ACCESS to ongoing education and interaction with our clinical team, and be motivated to take ACTION and actively participate in their care.
Patients referred to Real-Time Monitoring will be more educated, confident and motivated to engage in their care, therefore improving compliance and producing better outcomes. Real-Time Monitoring can actively engage with patients through our software via SMS messaging, click to call, click to video (coming soon) and email. Patients will receive daily SMS testing reminders/calls as well as weekly health tips with links for ongoing educational opportunities and preset clinical questions will be emailed to your patients to identify underlying compliance issues & further condition management opportunities for outreach.
There are 2 levels of clinical care within our Triple A Condition Management Model™ for a practice to choose from:
Level 1 Care:
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Our team will reinforce the physicians care plan and testing frequency through daily testing reminders
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Preset clinical questions will be ​sent to patients to help identify potential compliance issues and/or uncover further condition management opportunities for the physician or practice to address with the patient
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Through our state of the art software system, all results received as well as patient interactions and responses will be available to physicians/staff to review and provide follow-up with the patient, as necessary
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Patients receive printed educational materials and weekly SMS heath tips on specific health related topics
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Level 2 Care:​
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​Our PharmD led team is available to maintain clinical connectivity and monitoring of patients to ensure safe transition and compliance outside of the “traditional” office setting. Our Pharmacists and RN’s who specialize in hypertension are available to assist with management and oversight to ensure patients achieve their set targeted BP range and are adherent to the prescribed care plan as determined by the physician
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All patients will receive ongoing clinical interaction with our hypertension specialists through phone, text, video and email
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Preset clinical questions will be sent to patients to identify underlying compliance issues and further condition management opportunities. Our clinical team will review and access information received by the patient and provide consultation
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​​​All non-compliance and out of range results received are immediately communicated to the physican within the portal
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All conversations and interactions are timed and documented within our HCP portal for review and billing
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Patients receive printed educational materials and weekly SMS health tips on specific health related topics
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Software & Reporting
Our state of the art software in conjunction with BP device technology, inclusive of integrated cellular connectivity without a plan or monthly bill, allows for reoccurring communication with the patient, continuous oversight and follow-up. Our system allows us to send preset clinical questions to the patient via SMS text to identify underlying compliance issues, encourage healthy habits & lifestyle and uncover further condition management opportunities requiring follow-up. We can apply algorithms to transform a patient’s physiological parameters into a novel index or alarm that may aid a healthcare professional in the diagnosis of a particular condition or disease state/severity.
Comprehensive data and reporting tools give physicians “Real-Time” visibility and immediate notification of all patient results and data through our on-line portal, fax, phone and email, as requested. Above all, the uniqueness of our system allows for all communication with the patient to be documented & tracked to ensure your practice is 100% compliant and in accordance with CMS and HEDIS guidelines as well as assisting your practice in achieving performance measures and requirements resulting in revenue production for the practice.
State of the Art Software System Provides our Referring HCP's With:
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Customized Screen View to Easily Identify/Flag At-Risk Patients
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Auto Time Tracker to document billable minutes spent with patients
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Detailed Reports for Billing Purposes
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Real-Time Data Sync
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HIPPA Complaint/Secure Portal
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Simple Communication Options With Patients
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SMS Messaging
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Click to Call
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Click to Video (coming soon)
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Email
Training & Education
Included in Initial Patient Shipment:
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3 Step Patient Training Card
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Printed American Heart Association Educational Materials
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