I’m sure you also read article after article about how remote patient monitoring (RPM) is going to help “bend the cost curve”.
We still believe in its promise as there’s no other way for healthcare to become more affordable without good technology.
While saving money is important, it’s way MORE FUN to help healthcare organizations MAKE MONEY.
New CPT Codes for Remote Patient Monitoring
On January 1, 2019, the Center for Medicaid and Medicare Services (CMS) added three new CPT codes for remote patient monitoring. to reflect some of the changes in how patients and providers are using digital health tools to manage disease. These three new codes are designed for remote patient monitoring programs — like Overlap’s. They include:
- CPT Code 99453 for the initial set-up and patient education on the use of remote monitoring tools.
- CPT Code 99454 for patient monitoring over a 30-day period; and
- CPT Code 99457 for 20 minutes or more per month of clinical staff time interacting with a patient.
These new CPT codes are a boon for healthcare providers as they not only make it possible to improve patient satisfaction, but also add incremental revenue to an organization’s already slim bottom line.
We will be writing some use cases about these new codes as some of Overlap’s customers are already beginning to enjoy them.
How does the new Overlap billing feature work?
As far as we know, Overlap is one of the only RPM companies pairing the activities of RPM with the new CPT codes. Which means healthcare organizations using Overlap make money (we’ll be writing more on the economics of remote monitoring soon).
Say a patient is enrolled into RPM, is given an Omron blood pressure cuff, and is tracking for 30 days.
A clinician and her support team communicates with the patient, and responds to alerts (via Overlap) for 30 minutes over the month.
With the new Overlap billing tool, a health administrator (or whoever handles billing) goes into the Overlap clinical dashboard, selects a date range and each code is paired with each patient with a justification. Whether that’s 20+ minutes of time spent or the patient was recently enrolled, Overlap records this and makes it actionable for providers to bill for the new codes.
Not only does Overlap track time and RPM activities, but it also knows how much time each clinician spent with each patient.
There’s also a CPT lookup finder for filtering by only those patients under a specific code.
We support three sets of CPT codes
These are remote patient monitoring, chronic care management and continuous glucose monitoring:
- Remote Patient Monitoring
- CPT 99453
- CPT 99454
- CPT 99457
- Chronic Care Management
- CPT 99490
- CPT 99491
- Continuous Glucose Monitoring
- CPT 95249
- CPT 95250
- CPT 95251
How much revenue is available under these new codes?
We’ll be writing more about the revenue opportunities, but you could expect anywhere between $1,500 to $2,000 per patient per year under these new codes.
What’s next on the Overlap billing roadmap?
- Making the billing dashboard smarter with optimizations for codes to maximize revenue. For example, it might be better to bill for CCM codes versus the RPM codes given revenue maximization.
- Supporting more codes
- Integrating with a practice’s billing software to help with optimizations
- Creating workflow tools around billing so a provider can follow-up with the patient given the reporting
Hope you enjoy the new product update and if you’d like a demo of the new tool, let’s talk.