Health IT stakeholders urge CMS to adopt 3 new remote monitoring reimbursement codes

AMA, ATA and several large providers want CMS to expand physician reimbursement for remote monitoring. (Getty/metamorworks)

Nearly 50 health IT stakeholders are calling Centers for Medicare & Medicaid Services (CMS) to expand reimbursement for remote monitoring services in its next physician payment rule.

In a letter (PDF) to CMS Administrator Seema Verma, several major healthcare associations, along with dozens of health IT and mHealth companies, pushed the agency to consider three Current Procedural Terminology (CPT) remote monitoring codes approved by the American Medical Association’s CPT Editorial Panel last year.

The request comes less than a year after, CMS finalized a separate CPT code, effective Jan. 1, 2018, to reimburse physicians for collecting and interpreting patient-generated data. AMAs new CPT codes, however, distinguish payments for educating patients to use remote monitoring technology, using devices with daily recordings or programmable alerts, and at least 20 minutes of staff time each month devoted to interacting with patients about remote monitoring data.

RELATED: MACRA final rule includes financial incentives for remote monitoring, flexibility on EHR certification

The groups argued that unbundling the three services would “increase value and improve patient health,” particularly for those with chronic conditions. The organizations also called on CMS to release and study claims data to determine how the services are being used. 

“While CMS has taken this commendable step forward in unbundling CPT 99091, we believe CMS must continue the commitment carefully articulated in the 2018 PFS Final Rule: to consider new digital health CPT codes created by the American Medical Association CPT Editorial Panel,” the groups wrote. “We stand in agreement with CMS that RM are paid under the same conditions as in-person physician services and can be a significant part of ongoing medical care.”

RELATED: Study shows wearables lack clinical impact, but researchers haven’t lost hope

The letter was signed by the American Medical Association, the American Telemedicine Association, HIMSS, and dozens of vendors. Several health systems, including the Center for Telehealth at the University of Mississippi Medical Center, Mount Sinai Health System, the University of Pittsburgh Medical Center and the University of Virginia Health System.

The proposed Physician Fee Schedule is typically released by CMS in late summer and finalized in November.