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CPT 99091
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Generating Recurring Revenue through Remote Patient Monitoring

As of Jan 1, 2018 physicians can be reimbursed $59* per month per patient for remote patient monitoring by CMS using the billing code CPT 99091 
   *National average

How does it work?

  1. You provide patients with remote patient monitoring (RPM) devices
  2. Patient data is automatically uploaded to a portal for review and followup
  3. CMS reimburses you $59* per-patient per-month for reviewing this information

RPM Revenue Generator 

Medicare patient population per physican
Patients enrolled in RPM program (75%)
​CMS reimbursement per month (national average)
                                                                                                     
​Potential Annual Revenue Opportunity                          
2,500
1,875
$59
                                    
           $1.32 Million​
​

RPM Devices

RPM encompasses a wide range of chronic care needs through blood pressure monitors, pulse oximeters, weight scales, glucometers, and more
see the devices

Practitioner Requirements

CMS requirements for billing CPT Code 99091:
  • Providers can initiate services immediately for established patients. For new patients or those not seen within one year, services can be initiated through a face-to-face visit
  • ​Service must be provided by a physician or a qualified healthcare professional*. 
  • Providers must obtain beneficiary consent for the service and document it in the patient’s medical record.
  • No restrictions on originating sites or technology that Telehealth services are subject to by statute.
  • Providers may bill for time spent accessing, reviewing or interpreting the electronically transmitted patient-generated health data, as well as communication with the patient and/or caregiver. Also includes time spent directing clinical staff on modifications to the patient's care plan.
  • This separate reimbursement code requires a minimum of 30 minutes of time each month and can be billed no more than once in a 30-day period per patient.
  • Unlike CCM, there is no chronic condition or care planning requirement.
* As per AMA, a qualified individual is an individual who is qualified by education, training, licensure/regulation (when applicable) and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.

Improved Outcomes

For patients with chronic conditions, monitoring and tracking their health data is crucial to managing their care. Cutting-edge RPM technology ensures that this is done as efficiently as possible. ​
Reduced ER Visits
​Reduced 30-Day Readmission Rates
​Increased Pharmacy Refills
        
​
%
 
​
%
 
​
%

The Carematix Solution

Every Carematix offering, including our portal, which is FDA 510(k) cleared, CE marked, HIPAA and 21 CFR Part 11 compliant. ​
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Wireless Monitoring

Our award-winning devices are designed to maximize ease-of-use and efficiency
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Electronic Transmission

Data is automatically sent to you through our interactive portal
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Practitioner Review

You review patient data through the portal to receive CMS reimbursement ​

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Frequently Asked Questions

Is an rpm program cost effective?
In short, yes. The Centers for Medicare and Medicaid Services reimbursements will break even for the cost of our program within two months. Not only that, but the program is easily scalable, meaning that you can start at any size you want, and then continue to enroll more patients as profits increase.
Will i need to hire more staff?
You will need to hire or retrain staff if you wish to employ the program on a large scale, however the recurring revenue generated by the program far outweighs the labor required.
Which patients should i focus on?
Remote patient monitoring, and subsequent CMS reimbursement, is focused on chronic Medicare patients. Our program has proven effective with patients suffering from hypertension, heart disease, diabetes, and COPD.
is patient health data secure?
Patient generated health data is always protected in the Carematix program. Only the patient and the healthcare provider/ care team will have access to the data.

Location

209 W. Jackson Blvd.
​Suite 401
Chicago, IL
​60606

About us

Carematix, a leader in remote patient monitoring programs, develops innovative and affordable teleheatlh solutions to help reduce readmissions and decrease total cost of care. 
CONTACT US
Phone: (312)-627-9300
E-Mail: info@carematix.com
​Website: www.carematix.com

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