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By Mihir Thatte
The Centers for Medicare and Medicaid Services continued their push to advance healthcare in the digital age with their 2019 Physician Fee Schedule and Qualified Payment Program updates. CMS has furthered their encouragement of remote patient monitoring, created new opportunities in telemedicine, and improved documentation requirements for existing programs.
"Today is a huge win for patients and providers as CMS is proposing historic changes to modernize Medicare and restore the doctor-patient relationship," said CMS administrator Seema Verma "This proposal alone is one of the most significant reductions in provider burden undertaken by any administration." Verma has been a strong proponent of telehealth as the next step in the healthcare industry, most recently on July 2nd when she announced a plan to pay home health agencies for remote monitoring.
If officially enacted, the 2019 proposal will mean doctors can be reimbursed for check-ups using remote communication rather than an in-person visit. Not only that, but these check-ups can be reimbursed with no prior in-person visit, and don’t require a follow-up in-person visit either, making them completely independent.
Verma outlined how this new reimbursement could play out in real-life and said "There are going to be many situations where a physician might say 'I’m going to need to see you in my office' but it could be a check-in where they come in for a visit and they want to talk to their doctor about the medication that they’re taking and how it’s impacting them, and [this gives] the ability for them to not have to come in physically to have that conversation with the doctor, but to be able to have that remotely,"
Remote patient monitoring is also poised to expand from his new proposal, which calls for activation of three new remote patient monitoring reimbursement codes. CPT codes 990X0, 990X1, and 994X9, which would reimburse doctors for setting up and educating patients on monitoring devices, providing patients with daily recordings and alerts, and physiologic monitoring treatment management services, respectively.
The CMS also acted to make remote patient monitoring a more efficient and rewarding process. The new proposal aims to make documentation of remote monitoring much easier, according to CMS "Doctors should not be spending time typing information into a computer simply in order to bill a certain level of code. They should focus on documenting the material that’s needed to capture the patient’s health data. Therefore we are proposing to move from a system with four kinds of documentation requirements to a system with one set of documentation requirements. There will still be four distinct code levels, but the differences will be meaningless. There will be one set of documentation requirements." The goal of the new documentation system is to allow developers to focus on patient care rather than satisfying billing loopholes when creating new products. These changes are expected to save time and money for practitioners, at an estimated 29,305 hours and $2.6 million dollars in reduced costs. The proposal also seeks to improve the MIPS payment system which is currently in place for remote patient monitoring by changing their “Promoting Interoperability” section to encourage patients to access their health information.