How the proposed rule will support alternative care models

In the 2019 Proposed Rule, CMS expands coverage of telehealth-based services including remote patient monitoring programs. They plan to expand coverage by reimbursing virtual check-in services, reimbursing remote evaluation of recorded images and videos submitted by patients, and enhancing the reimbursement opportunities for prolonged preventive services. By reimbursing virtual check-in services, providers will be compensated for a phone or video chat with the patient. The hope is that this type of check in will resolve any immediate patient concerns and help the patient navigate to the appropriate site for the care that they need. Another benefit of this virtual visit is the ease of which the patient can access the care of their provider especially when the patient faces transportation difficulties.

These new codes include coverage for remote patient monitoring services. These codes (codes 990X0, 990X1, and 994X9) will reimburse for chronic care remote physiologic monitoring. CMS also proposed updates to the Home Health Prospective Payment System which would allow for inclusion of the cost of remote patient monitoring on the cost report form. These proposed changes open the door for new technologies, innovations, and care models to continue to bridge the gap between patient need and technologic capability.

References:

https://mhealthintelligence.com/news/cms-proposes-more-medicare-reimbursement-for-telehealth-rpm

https://www.federalregister.gov/documents/2018/08/17/2018-16766/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the