Remote Physiological Monitoring in Telemedicine and Concierge Medicine for 2019

Remote patient monitoring is increasing in momentum as doctors and hospitals look for ways to serve their patients effectively in a quickly aging population with complex chronic healthcare needs. However, up until now, the Centers for Medicare & Medicaid Services (CMS) caused a major hindrance by not making it simple for providers to manage remote monitoring and be reimbursed for it. Fortunately, new CMS rules and reimbursement codes for patient remote health monitoring is quickly changing this. 

Remote Patient Monitoring Reimbursement History and Changes

Beginning in 2019, remote physiological monitoring as taken effect.

In most states, remote patient monitoring reimbursement was an ill-defined situation for healthcare providers, up until recently. Some reimbursement is offered by 20 states, but for all others, CMS categorized remote monitoring into a broad-ranging telehealth category applying only to those in remote or rural areas.

Then, CMS published a two-year study in 2017 on its Chronic Care Management (CCM) program, demonstrating how it:

• Saved millions of dollars for Medicare
• Increased patient awareness around managing disease
• Reduced hospital readmissions

Beginning to recognize how valuable remote monitoring could be for the CCM program, CMS made the decision to make the service more obtainable.

On November 1, 2018, CMS amended the 2019 Medicare Physician Fee Schedule (PFS)for remote patient monitoring reimbursement to include three new CPT codes following reimbursement requirements. 

The new codes became effective on January 1, 2019. These codes include:

1. CPT Code 99453: “Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up; and patient education on use of equipment.”
2. CPT Code 99454: “Remote monitoring … device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.”
3. CPT Code 99457: “Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.”

Other applicable reimbursable codes are:

1. CPT Code 99495:  Covers communication with the patient or caregivers within 48 hours of discharge and prepare the patient for a moderate complexity 14 day face-to-face visit (work RVR 2.11).
2. CPT Code 99496 -Covers communication with the patient or caregivers within 48 hours of discharge and prepare the patient for a high complexity 7 day face-to-face visit (work RVR 3.05)

Under the new codes, Medicare pays for the initial setup, the device and the continuing management of remote monitoring programs in accordance with adherence to reimbursement requirements. Because remote monitoring and CCM can be billed separately, health care providers may be able to increase revenue without increasing patient numbers.

Advancing Telemedicine and Steth IO Health

Telemedicine should be much more than a simple video call between you and your patients. At present, accessible telemedicine tools don’t provide examination functions. However, Steth IO® Health’s distinctive form factor makes it perfect for home use and an efficient telemedicine platform. It enables remote patient exams and monitoring, providing patients at home with true telemedicine. Patient exams also provide you with valuable information that could affect your clinical decision making and improve your patients’ satisfaction and experience.

About the Steth IO Device

Steth IO builds technology to improve your patients’ outcomes and experience. The Steth IO device is a smartphone stethoscope using the pervasiveness of mobile phones with the power of device learning for more objective lung and heart exams.

As a physician, you can visualize, hear, analyze and share lung and heart sounds for improved diagnosis with many advantages over the traditional stethoscope.

The latest Steth IO application release, which you can download from the App Store, offers an AI capability for analyzing the heart sounds the Steth IO’s smartphone stethoscope captured in real-time.

It contains a few pieces of technology enabling an array of features designed for improving the data you have to diagnose and monitor your patients, including:

1. Phonocardiogram: Sounds are broken down into separate frequency elements and displayed live on the smartphone screen. The sound’s frequency and amplitude spectrogram is shown across a time scale. You can identify the timing of the sounds with a moving cursor for a better diagnosis.
2. Listening to Auscultation: The Steth IO application comes with outstanding Sony wireless headphones that come with earbuds with cups that seal the ear canal. These tend to work best. Of course, you can still use your own wireless or wired Bluetooth earbuds or headphones to hear lungs and heart sounds. But, keep in mind, you’re listening to extremely low-frequency sounds.
3. Digital Filters: The microphone receives recorded sounds in which the digital filters process to improve the naturally low-frequency lung and heart sounds.
4. Replay for Analysis: You can replay the recorded sounds for analysis for helping with your clinical decision. The screen displays sound loops which you can replay for review and you can change the loop size by zooming the content on the screen in and out.
5. Ability to Save Files: Like you would a regular stethoscope, you could simply listen to auscultation, come up with a clinical decision and then move forward. However, you can now save the stethoscope exam for future consultation, review or teaching. You save the exams under date of birth and name.

Benefits of Steth IO for Remote Physiological Monitoring 

There are several benefits of Steth IO, including:

1. Helps with Clinical Trial Follow-Up

Clinical trials are becoming increasingly global and complex. It’s both expensive and difficult to follow a large number of participants for obtaining accurate clinical data.

Steth IO’s remote exam and efficient documentation helps with more efficient and cost-effective clinical trial follow-up visits. This digital health technology is convenient for patients, improving enrollment and participation. You can:

• Recruit patients remotely
• Provide digital consent
• Monitor at the source, electronic data capture, including medicine treatment adherence

The Steth IO stethoscope can offer a secure, all-in-one, integrated tool and you can easily customize the platform to deploy forms that are specific to each clinical trial.

2. Assists with Chronic Care Management (CCM)

Steth IO makes chronic care almost effortless. CCM improves patient satisfaction and outcomes. Steth IO enables you to provide continuous chronic care efficiently to your patients. CCM coordination is considered outside normal office visits and applies to patients with a couple or more chronic care disorders at risk of decompensation, exacerbations, functional decline or death. 

Steth IO helps with the management of:

• Asthma
• Cardiovascular diseases (i.e. Angina, CHF, CAD)
• Hypertension
• Chronic Obstructive Pulmonary Disease (COPD)

3. Assists with Transition Care Management (TCM)

TCM allows you to:

• Communicate with ancillary healthcare services
• Communicate with patients within 48 hours of discharge
• Review discharge information and medications
• Increase treatment adherence and provide clinical assessment
• Documentation for appropriate reimbursement
• Interact with other healthcare providers

4. Helps With Reimbursements

Under the new rules and codes, Medicare will pay for the device, the initial setup and the ongoing remote monitoring program management. Instead of you having to be responsible for the management of these programs, the new rules and codes allow nursing assistants, RNs and other clinical staff to pick up the slack. Also, since remote monitoring and CCM can be billed separately, you can increase your revenue without having to increase your patient workload.

This is good news for doctors, hospitals and home health centers. 

Embrace the Future of Concierge Medicine and Remote Healthcare with Steth IO Health and the Steth IO Device

CMS’s digital transformation came just in time for overwhelmed home care agencies and hospitals trying to reduce the number of patients in the emergency rooms. Now, you can stay connected, you can involve your clinical staff more, and you can be paid or reimbursed for using new technology, like Steth IO, to solve old issues and keep your patients healthier at home.

Buy the Steth IO and move your healthcare practice into the future today.