Frequently asked questions about remote patient monitoring
For decades, remote patient monitoring (RPM) consisted of paper logs to track vital signs and symptoms and phone calls between appointments. While blood pressure logs and weight tracking were useful for individual patients, there was no practical way to design, deploy and scale a remote patient monitoring program for an entire patient population. But rapid hardware and software innovation, coupled with the widespread adoption of desktop and mobile devices, made smart and efficient remote patient monitoring a reality.
Keep reading to learn more about remote patient monitoring and other digital health strategies that are transforming healthcare. Click the links below to automatically navigate to the information you need.
What is remote patient monitoring?
What is remote healthcare? Is that different than remote patient monitoring?
Is remote patient monitoring considered telehealth? Is it the same as remote therapeutic monitoring?
Why hospitals, health systems and private practices are choosing remote monitoring
Implementing remote patient monitoring
Costs, billing, and reimbursement
What is Remote Patient Monitoring (RPM)?
What does RPM stand for in healthcare?
RPM stands for Remote Patient Monitoring.
What is remote patient monitoring in healthcare?
Remote patient monitoring (RPM) is a type of telehealth that utilizes digital technologies to capture patient health data and remotely send it to providers for evaluation. Patients might use connected medical devices, like blood pressure monitors or that automatically transmit data directly to providers, or report physiologic data and other information themselves with digital communication tools. Providers can use this real-time health data to monitor progress, adjust treatment plans and make other recommendations as needed.
Among the most common uses for remote monitoring: chronic disease management, including diabetes, heart failure, high blood pressure and respiratory illnesses. But RPM programs have applications far beyond chronic conditions, and can be used to closely monitor a patient's health status, prevent hospital readmissions, reduce the stress of in-person visits for older and disabled individuals, streamline workload for the care team and improve quality and patient safety. With a large (and growing) aging population that is expected to require more care than ever during the coming years, remote patient monitoring services will be an essential tool to ensure that all patients, regardless of their health conditions, can receive the right care at the right time.
What is remote healthcare? Is that different from remote patient monitoring?
Remote healthcare–also called telehealth or telemedicine–is an umbrella term that describes any medical care delivered when patients and providers are in different locations, and can include any step of the care process, from consultation to treatment plans and follow-ups. Remote patient monitoring refers specifically to capturing and transmitting patient health data to healthcare providers.
What is remote patient monitoring used for?
Remote patient monitoring can be used to care for patients with a wide variety of health conditions, and is often used to manage chronic illnesses like diabetes or cardiovascular disease. Patients can use remote monitoring technologies, such as connected devices or mobile apps, to transmit data to providers, who evaluate information and respond when necessary. RPM technology can be used to improve care and encourage adherence to treatment plans, reduce the number of necessary in-person visits and help clinicians deliver efficient and cost-effective care to larger numbers of patients.
Why is remote patient monitoring important?
Remote patient monitoring can broaden patient access to high-quality care, improve patient outcomes, improve clinical efficiency and create important revenue sources for providers. Unlike the traditional model of episodic care, remote patient monitoring technology offers clinicians real-time information about their patients’ conditions. With more and better data, healthcare providers are equipped to make the best possible treatment decisions and quickly respond to potential issues.
In clinical specialties experiencing provider shortages, such as family medicine or obstetrics and gynecology, remote patient monitoring technology can help alleviate transportation barriers and make it possible for clinicians to accommodate more patients without compromising quality of care.
For patients with complex or chronic conditions, or high-risk patients who require frequent and sometimes costly care, RPM services can reduce the frequency of in-person care and decrease the risk of preventable emergency room visits and hospital readmissions.
In a public health emergency, RPM technology can be used to remotely triage patients and facilitate more efficient care across healthcare organizations and geographic areas. Numerous remote monitoring solutions were deployed during the COVID-19 pandemic to track exposures, enhance disease surveillance and provide automated guidance to COVID-19 patients during their illness.
According to the American Medical Association, remote patient monitoring and other telehealth services are also effective for keeping patients engaged in their care and giving them better access and understanding of their medical needs and treatment plans.
How does remote patient monitoring work?
Typically, patients transmit personal health data to their care team via connected monitoring devices, such as blood pressure cuffs, glucometers or other specialized monitors. Patient data can also be transmitted to health professionals through digital communication and engagement tools, such as mobile apps or automated phone calls, with no remote physiologic monitoring devices necessary.
In many healthcare organizations with RPM programs, the remotely collected patient data is automatically stored in the patient's chart for care teams or monitoring centers to evaluate in a timely manner. AI-powered software can also automatically notify the care team about changes in a patient's condition and facilitate earlier intervention and more effective patient care.
Is remote patient monitoring considered telehealth? Is it the same as remote therapeutic monitoring?
Remote patient monitoring is a telehealth strategy that refers specifically to the remote collection and transmission of physiologic data (such as vital signs) through a connected medical device or digital communication tool. Telehealth is a much broader term that encompasses any health care provided without an in-person visit.
Remote therapeutic monitoring (RTM) is similar to RPM services, but refers to the remote monitoring of non-physiologic patient data, such as musculoskeletal or respiratory system status. Examples of RTM include home oxygen therapy or CPAP machines for sleep apnea. Providers and suppliers can seek RTM reimbursement from the Centers for Medicare and Medicaid Services for equipment set-up, patient education, devices and related supplies, follow-up communications and time spent assessing the data collected.
What is an example of remote patient monitoring?
The clinical benefits of RPM programs are well-established across a variety of use cases, including primary care settings, surgical care, chronic care management and caring for patients in skilled nursing facilities, to name just a few. Diabetes patients could use connected blood glucose meters to automatically transmit their blood glucose levels to providers, or submit readings from a non-connected device using other RPM tools, like mobile apps or automated phone calls. Providers can utilize real-time patient data to observe patients over time and respond to changes in a timely manner.
How is remote patient monitoring changing healthcare?
Healthcare professionals have relied on remote monitoring to enhance patient care for many years, with strategies such as pen-and-paper blood pressure logs and phone calls to report symptoms. But advanced telecommunications technologies, connected RPM devices, artificial intelligence and sophisticated data analysis software have transformed remote monitoring from a tool to supplement in-person care to a new method of care delivery for acute and chronic conditions, an approach to disease control and a strategy to improve health equity. And with greater legislative focus on connected health policy and more payers--including CMS--offering RPM reimbursement, remote patient monitoring investments are critical to ensure financial success for health systems and healthcare providers of any size and scope.
What is the future of remote patient monitoring?
While the Centers for Medicare and Medicaid Services and other payers don't require that healthcare providers offer remote patient monitoring, the vast majority of health systems are either already investing or are planning to invest in RPM technology safeguard their long-term financial health and alleviate the heavy workloads that clinicians and support staff face. As RPM technology continues to advance and be adapted to new use cases, healthcare providers will likely continue to expand its use beyond monitoring patients suffering from acute and chronic conditions, and into prevention and wellness.
Why hospitals, health systems and private practices invest in RPM services
What are the benefits of remote patient monitoring (RPM)?
The new generation of RPM devices can transmit more and better health data than ever before, and user-friendly patient engagement tools, paired with AI-powered data analysis and surveillance and support for providers, can offer significant clinical benefits for patients while saving healthcare organizations and healthcare providers time and money. RPM technology also helps healthcare professionals and health systems expand beyond the traditional episodic model of care--meaning periodic office visits with little or no contact between visits and no exchange of patient health data--to continuous care that can more efficiently treat chronic conditions and acute problems while preventing complications and reducing hospital readmissions.
What conditions qualify for remote patient monitoring?
Healthcare organizations can use RPM technology to facilitate care for an enormous variety of chronic and acute conditions, as well as prevention and general wellness. Chronic diseases such as hypertension, congestive heart failure and obesity are often monitored remotely, but care teams can use RPM tools to provide pregnancy care, monitor post-operative recovery, track adherence to treatment plans and more. RPM technology is also used to provide hospital at home services and tele-ICU care in intensive care units. Even maternity care is going digital, with patient engagement software and specialized RPM devices designed to provide virtual maternity care for even high-risk patients.
Where can remote patient monitoring be used?
Anywhere that health data can be transmitted, including in areas with limited or no access to broadband or cellular service. Digital health vendors offer a wide array of software and hardware solutions to meet the needs of a variety of healthcare organizations and patient populations, including RPM devices that transmit patient data via Bluetooth and tablets or smartphones that are pre-loaded with mobile apps and utilize major cellular networks. For patients who face travel and transportation barriers--including patients who live in rural areas or lack access to personal or public transit options--RPM devices and software can significantly improve access to care.
How does remote patient monitoring reduce costs?
Remote patient monitoring can reduce healthcare costs in a variety of ways. By continuously monitoring vital signs and collecting patient-reported data about their health conditions, RPM can help reduce preventable (and costly) emergency room visits and hospital readmissions. RPM is also useful for the management of chronic diseases, and when used effectively, can improve outcomes and reduce the number of necessary office visits without compromising quality of care.
What is one disadvantage of remote patient monitoring?
Remote patient monitoring frequently relies on technology that is not universally usable, accessible or affordable for all patients, such as smartphones or tablets. Other patients may lack reliable and consistent access to broadband or cellular networks.
Implementing remote patient monitoring
How is remote patient monitoring done?
Remote patient monitoring relies on digital technology, such as remote patient monitoring devices and mobile apps, to collect and send health data to providers. Providers can use a variety of software tools, including AI-powered automation and data analysis functions, to assess the data and respond when necessary.
How do I start remote patient monitoring?
Patients who are interested in remote patient monitoring should talk to their providers, who can offer recommendations or explain the available options in their health system or practice. Some insurance policies and employers also cover digital care programs and tools to promote overall wellness and healthy behaviors.
For healthcare professionals who wish to know more about remote monitoring companies and solutions, the AVIA Marketplace offers accurate and unbiased information about thousands of digital health vendors, which tools like Market Maps and the Match Score to assist hospitals and health systems as they look for their next digital solutions.
What is a remote patient monitoring system?
A remote patient monitoring system utilizes a connected medical device or mobile device to transmit health data to providers, who can remotely review the data and respond when necessary. In addition to connected devices or mobile apps, remote patient monitoring systems can include patient engagement tools to encourage care plan adherence and facilitate communication, data analysis software to help care teams manage and interpret healthcare data, and automated processes to help identify potential issues and escalate as needed.
What are remote patient monitoring devices?
Remote patient monitoring devices are medical devices that capture physiologic data and transmit it to providers. Common RPM devices include blood pressure cuffs, pulse oximeters, glucometers, wearables (including activity trackers and continuous monitoring devices), ECG + stethoscope, thermometers and smart scales.
Most payers, including CMS, will only reimburse for RPM devices that meet the technical definition of medical devices, as outlined in the federal Food, Drug and Cosmetic Act.
Costs, billing and reimbursement
What are RPM and CCM?
RPM refers to Remote Patient Monitoring, while CCM refers to Chronic Care Management.
Remote patient monitoring (RPM) is a type of telehealth that utilizes digital technologies to capture patient health data and remotely send it to providers for evaluation. RPM programs might utilize connected medical devices, mobile apps, automated phone calls or a combination or those things to remotely manage a patient's condition between appointments.
Chronic care management is a care management service to support patients with two or more chronic conditions, and includes detailed care plans, 24/7 patient access to a member of the care team for urgent needs, remote communication between the patient and care team, and assistance with referrals, prescriptions and care transitions. There are two types of CCM: Non-complex and complex, which bill under different CPT codes. Providers can bill for complex CCM when a case requires more complicated and time-consuming medical decision-making.
What is remote patient monitoring according to CMS?
According to the Department of Health and Human Services, which oversees the Centers for Medicare and Medicaid Services (CMS):
Remote patient monitoring consists of transmitting and storing patient data and clinical measurements from in-home devices to patient portals. This data transmission may be either asynchronous or support synchronous provider visits.
For providers seeking reimbursement for RPM services, CMS requires at least 16 days of monitoring in the first 30-day period. CMS will also only reimburse for remote patient monitoring devices that can digitally upload physiologic data.
How much does RPM cost?
The cost to implement a remote patient monitoring program can vary widely, and an enormous number of hardware and software solutions are available to meet the needs and budgets of most healthcare organizations. Some associated costs may include:
• Software subscriptions and tech support
• Hardware purchasing and maintenance
• Labor costs (including training) for clinical and support staff and/or third-party support services
For many healthcare professionals, the long-term financial benefits of RPM services far outweigh the costs. Taxpayer-funded and private insurers save money with fewer emergency room visits and hospital readmissions and reduced length-of-stay. Patients may also save money on their out-of-pocket costs, with fewer office visits and emergency room trips, along with potentially shorter inpatient hospital stays.
Who pays for remote patient monitoring?
Remote patient monitoring is commonly paid for with patient insurance coverage and government health plans such as Medicare or Medicaid.
Is RPM covered by insurance?
Many private insurance plans cover RPM, along with Medicare and a number of state Medicaid plans. In some states, such as Louisiana, state law mandates that private insurance plans must cover remote patient monitoring.
Is RPM covered by Medicare?
Yes, Medicare covers RPM. The five primary Medicare RPM codes are CPT codes 99091, 99453, 99454, 99457 and 99458.
What are the requirements for RPM?
The Centers for Medicare and Medicaid Services permits RPM reimbursement if certain requirements are met. These requirements include, but are not limited to:
• RPM services can only be ordered and billed by physicians and practitioners who are eligible to bill Medicare for Evaluation/Management services.
• Only "established patients" are eligible for RPM coverage.
• Monitoring must occur for at least 16 days over a 30-day period to bill for initial set-up and continued monitoring.
• RPM services can be billed once per patient during each 30-day period, and cannot be billed by more than one practitioner, even when multiple medical devices are provided to the patient.
• Medical devices must be reasonable and necessary for diagnosis and treatment of the patient's illness or injury, and must be able to digitally upload physiologic data.
• RPM devices must meet the definition of "medical device" as outlined in the Federal Food, Drug and Cosmetic Act to be eligible for reimbursement.
• Devices must capable of capturing and transmitting physiologic data or generating an alert with readings fall outside pre-determined parameters.
Requirements continue to evolve, along with health policy and available technology. Visit cms.gov for complete and up-to-date information about RPM requirements.
Does Medicare cover CCM?
Medicare Part B and Medicare Advantage both cover chronic care management for patients with two or more chronic conditions. CMS classifies CCM into two groups: non-complex and complex. Both share common required service elements, which include (but are not limited to):
• Two or more chronic conditions lasting at least 12 months
• Patient consent
• Personalized care plans in the EHR with a copy provided to patients
• Round-the-clock access to a member of the care team for urgent needs
• Enhanced communication between patients and their care team
How much does Medicare pay for CCM?
As of 2022, Medicare offers the following non-facility national average reimbursement rates for CCM CPT codes:
• 99490: $64
• 99491: $86
• 99439: $48
• 99487: $134
• 99484: $71
• 99484 (behavioral health): $45
• 99489: $71
• G0506: $62
CMS updates the Medicare fee schedule annually, and rates vary by location. For additional information, visit cms.gov.
What place of service is used for RPM?
The place of service is the location at which the billing practitioner maintains his or her practice.
Can CCM and RPM be billed in the same month?
CCM and RPM can both be billed in the same month. In addition, two or more providers who prescribe RPM to the same patient are eligible for reimbursement--for example, one provider might prescribe remote blood pressure monitoring for a patient, while another provider prescribes a smart scale to track weight. Both providers are eligible for the standard monthly reimbursement.
Unlike RPM reimbursement, only one physician can report CCM services for a patient per calendar month.
What is the maximum amount of time remote monitoring can be billed each month?
Medicare reimburses providers for 20 minutes of case management per month under code 99457, and providers can bill under code 99548 for each additional 20 minutes. There are currently no limitations on the frequency with which providers can bill under 99548, but those additional 20 minutes must meet service requirements.
How often can you bill CCM?
Claims for chronic care management under code 99490 can be submitted once per month. Two providers may not bill for CCM for the same patient in the same month.
How do I code RPM?
• Initial device setup: 99543
• Daily device use: 99454
• Provider service (first 20 minutes): 99457
• Provider service (plus each additional 20 minutes): 99457 + 99458
Initial device setup and patient education can only be billed once. Providers can bill for additional 20-minute service increments as many times as necessary. When patients use their RPM devices daily, providers are eligible for additional payments.
Contact a billing expert or visit cms.gov for additional information about RPM guidelines.
How do I code CCM?
Non-complex chronic care management can be billed under the following codes:
• First 20 minutes: 99490
• First 20 minutes and additional 20 minutes: 99490 + 99439
• First 20 minutes and additional 40 minutes: 99490 + 99439 (billed twice)
Physician-driven non-complex chronic care management reimbursement compensates physicians and practitioners who utilize a more hands-on approach. These services are billed under the following codes:
• First 30 minutes: 99491
• First 30 minutes and additional 30 minutes: 99491 + 99437
For complex chronic care management, the following codes apply:
• First 60 minutes: 99487
• First 60 minutes and additional 30 minutes: 99487 + 99489
Does Medicare cover remote pacemaker monitoring?
Remote pacemaker monitoring is covered by Medicare, as well as many private insurance companies, but are billed under different CPT codes than other remote physiologic monitoring services. Unlike RPM and CCM services that can be billed monthly, remote pacemaker monitoring (CPT 93294 and 93296) are billed every 90 days, or four times annually.
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