CMS will be separating the current CPT code (99091) for patient monitoring into 3 codes in 2019. New in 2018, 99091 was reimbursed $58 a month.
The new codes essentially cover initial training on the device (99453 $21 one time); monthly for the device (99454 $69); and a 20-minute monthly call (99457 $54). Managing these codes should produce $123 for Medicare patients. We do not know what the charges will be for insurance patients.
Reading the 3 codes as they are worded, it is my opinion that a practice cannot install a manual BP device, then charge CMS for a remote patient monitoring device. It appears the intent is clearly for the device to transmit patient data.
A practice may choose to use SensoSCAN (measures BP, pulse oximetry, and respiration rate) to monitor the patient’s signs remotely. They can bill 99453 ($21) for calibrating the SensoSCAN to the office BP cuff on the first visit and instructing the patient to use it. SensoSCAN’ s accuracy has been well documented. Since it is cuff less and just slipped onto the finger, is convenient, painless and easy to use.
The practice can use a qualified professional to contact the patient or caregiver once a month for a 20 minute or longer chat about the patient and readings under 99457 ($54). As an alternative, the practice can engage Telemedical Partners strategic partner to manage this and many other codes.
SensoSCAN as a wellness monitoring device transmits data to a smartphone via Bluetooth and then to a computer, typically monitored by a caregive or healthcare professional. It also meets the requirement for programmed alerts which are transmitted as well to the caregiver and/or physician office. It is billed under new CPT code $69 monthly.
Telemedical Partners provides a patient monitoring service and the SensoSCAN to practices on a turn key basis. Give us a call to ask how we might help your practice at 800-940-7113 or email us. (Updated November 5, 2018)