The Updated 2024 Medicare Physician Fee Schedule Includes Expanded Remote Care Management for RHCs
Providers will like new provisions encouraging the adoption of remote patient monitoring programs while patients will be pleased with greater access to care
- Remote patient monitoring becomes further entrenched in the continuum of care.
- Rural Health Clinics (RHCs) are big winners.
- There is still a requirement of 16 days of connectivity, alerts, and reminders during a 30-day period.
- After years of waiting, RHCs can implement RPM and CCM at the same time with compensation.
- New Patient-First Care rules mean care delivery can be tailored to each patient.
- Vitals monitoring and Health Coaching are now available for patients.
Reimbursement for Remote Patient Monitoring
- CPT 99454: Reimburses for the use of smart-enabled remote patient monitoring systems that transmit biometric readings to a digital platform. The patient must transmit at least 16 days of readings in a 30-day period.
- CPT 99457: Reimburses for 20 minutes of clinical staff time spent monitoring and coordinating care for an RPM patient, including live interaction with the patient.
Reimbursement for Remote Therapeutic Monitoring
Starting Jan. 1, 2024, Medicare will begin reimbursing RHCs for remote therapeutic monitoring (RTM). These codes are also bundled into G0511 and include these services:
- 98976: Supply of the RTM device, collection, and reporting for respiratory.
- 98977: Supply of the RTM device, collection, and reporting for musculoskeletal.
RHCs will be able to bill G0511 multiple times per month for the same patient, provided that the minimum requirements are met for each code.
Enrollment into Services Under General Supervision
During the COVID-19 PHE waiver, Medicare allowed RHCs to enroll patients into care management programs remotely. This waiver helped clinics enroll and provide services for many more patients throughout the pandemic. The initial waiver expired in May of 2023 when an end to the PHE was declared. CMS has made the waiver permanent starting Jan. 1st of 2024. The new rule, along with coverage expansion for RPM services, will increase patient access to remote care programs.
G0511 Reimbursement Rate Reduction Offset by Increased Volume and Access to Care
While CMS has updated the rule to reflect multiple billing for G0511, there is a nominal reduction in the reimbursement rate from $77.24 in 2023 to $71.68 in 2024. However, the overall effect of the rule will produce a net upside for providers and their patients, while also improving access to important services like RPM, RTM, BHI, in addition to CCM.
MD Revolution’s Technology and Services Can Help Providers Transition to RPM and Provide Excellent Patient Care in Accordance with New Rules
- MD Revolution’s hub-based devices enable two-way communication with patients and scale to deliver multiple services with the same care terms and integration.
- MD Revolutions smart alerts, reminders, and text capabilities enable providers to meet care requirements.
MD Revolution is transforming remote care management.
Serving over 150,000 patients and hundreds of providers with multiple solution pathways to choose from, MD Revolution extends your care for RMP, CCM, BHI, AWV, TC and more. MD Revolution is the RHC preferred partner in remote care technology, outreach, and health coaching, all fully integrated with Azalea EHR and RCM. Whether you need best in class technology engagement solutions or a full suite of technology, engagement and clinical health support, MD Revolution meets RHCs where they are, to extend care for the patients they serve.