The 2021 Medicare Physician Fee Schedule for Remote Physiologic Monitoring
What you should know
During the COVID-19 public health emergency (PHE), CMS loosened regulations on remote physiologic monitoring (RPM) and telehealth in order to increase access to healthcare services.
In August, CMS released its proposed rule to update the Medicare Physician Fee Schedule (PFS) for calendar year 2021. The proposed rule is one of several proposed rules that reflect a broader Administration-wide strategy to create a healthcare system that results in better accessibility, quality, affordability, empowerment, and innovation.1
Proposed Clarifications for RPM
Proposed New Interpretations
The new clarification mandates at least 20 minutes per month of direct patient communication, as opposed to 20 minutes of total RPM service, such as reviewing and analyzing RPM data.
using multiple devices
CMS stated the CPT language suggests that even when multiple medical devices are provided to a patient, the services associated with all the medical devices can be billed only once per patient per 30-day period and only when at least 16 days of data have been collected.
CMS also noted that CPT 99453 can be billed only once per episode of care where an episode of care is defined as “beginning when the remote physiologic monitoring service is initiated and ends with attainment of targeted treatment goals.”2