Remain Compliant with Your RPM Billing Requirements

How to remain in compliance with medical billing codes with remote monitoring of clinical patients.

While deploying an accuRPM program can be an exciting opportunity for clinics to expand their offerings, many providers experience anxiety regarding the seeming complexities of billing for RPM.

One of the most common areas of confusion related to RPM is how to remain in compliance with billing codes while providing remote monitoring, and how third-party providers fit into this revenue model.

While these are important and legitimate concerns, telehealth providers are leading the way in eliminating the ambiguity surrounding RPM billing and are automating processes to be in full compliance with current and proposed changes to physician fee schedules.

Fears Regarding Billing Compliance

A growing concern amongst providers considering remote monitoring for their clinics is the potential for error in properly billing for RPM services.

These anxieties, and the ambiguity surrounding how to properly bill for RPM, lead to many clinics missing out on the real and immediate increase in revenue they could benefit from by implementing RPM.

While these fears are understandable, the reality is that RPM program implementation is risk-free with the right third-party provider.

The best service providers—like Tellihealth—offer full-service, turnkey solutions for remote patient monitoring that remove all liabilities and potential for errors through effective program and platform design.

Automatically Reducing Risk

Effective RPM providers design their platforms to be auto-timed so that services perfectly fit into the time-based coding requirements of RPM.

This creates a system that makes it impossible to incorrectly bill service provision, as the attestation of time spent on care is completely automatic.

In this capacity, these platforms actively reduce audit risk and make implementing and scaling remote patient monitoring programs simple and secure.

With providers like Tellihealth, doctors don’t have to stress about learning yet another program or be inundated with a complicated new system. Instead, these third-party services guide clinics through the whole process and manage remote patient monitoring programs in their entirety, leaving no room for compliance errors.

Anticipating Regulatory Changes

Not only do the best third-party providers ensure compliance with all current coding for remote patient monitoring, but they also anticipate future changes to coding and billing requirements—ensuring that clinics aren’t left scrambling when regulations change.

The current proposed changes to the Medicare Physician Fee Schedule are a great example of how providers like Tellihealth future-proof their services.

RPM has gained new attention due to the global pandemic and the necessity it created for remote care. These developments have led to regulations surrounding RPM billing being reassessed at the federal level, such as for Medicare and Medicaid billing.

The newly released 2021 Proposed Medicare Physician Fee Schedule seeks to define which providers can bill for RPM services and what conditions must be met to maintain compliance.

Within the proposed changes, several key shifts have occurred in how clinics must manage their RPM billing codes.

New Developments in Medical Billing

One major change in the new MPFS is that RPM has now been defined as falling under Evaluation and Management (E/M) services. This means only practitioners qualified to provide E/M services are permitted to bill for RPM.

This is especially good news for primary and specialty care doctors, who are the most likely to benefit from implementing their own RPM programs.

These changes also state that RPM services are officially available and billable for patients with acute and chronic conditions, expanding the pool of eligible patients.

Other changes address device allowance, required data collection, patient consent, and interactive communication—requirements that must all be met to bill compliantly.

Future-Proofing Changes in Billing Codes

Effective RPM providers like Tellihealth already address these shifts, as accuRPM was designed from the ground up to anticipate evolving standards for remote care.

These providers use FDA-approved devices that are accessible to patients of all ages and enable high-quality interactivity between patients and providers.

In fact, the most reliable suppliers of RPM programming not only meet these regulations but often exceed minimum requirements for quality and effectiveness.

Features like Tellihealth’s proprietary calling feature—which allows unlimited audio and/or video interaction with patients—demonstrate how the best providers go beyond compliance to improve patient engagement.

The Bottom Line of RPM Billing

Clinics hoping to implement RPM can do so without the anxiety of billing compliance. By choosing the right telehealth provider, clinics can safely orchestrate their RPM services while staying compliant with coding requirements—even as they evolve.

accuRPM is designed to support providers through the ever-changing landscape of regulatory billing requirements for remote patient monitoring.

The platform automatically tracks the 30-day billing cadence, eliminating manual tracking and reducing errors. This, along with other features, gives clinics peace of mind knowing their RPM programs are always in compliance with CMS rules.

Remote Patient Monitoring is a major step in scaling clinics. While there are many considerations, providers like Tellihealth take the risk out of the process so clinics can focus on reaping the benefits of RPM instead of stressing over billing.