F Potential for early interventions for emerging
issues, which can improve patient outcomes,
decrease costs, and improve value-based care
metrics such as re-hospitalizations.
An observed byproduct of mobile-enabled
RPM is that participating patients often become
more engaged in their own care, which leads to
greater adherence to treatment plans. Patients
report feeling “like I’m actively doing something
to improve my health”—which leads to activities
such as taking an extra walk or making informed
food choices, further supporting management of
their chronic condition(s).
Wait … It’s Reimbursable, Too?
A growing number of group practices are
already using or considering adopting RPM for
chronic care management (CCM). The Centers
for Medicare & Medicaid Services (CMS) and
private insurers have crossed the tipping point to
recognize the value of CCM, including the use of
mobile-enabled RPM—and reimburse for it.
Specifically, CMS now recognizes CCM “as a
critical component of primary care that contributes to better health and care for individuals.” 1
In 2015, Medicare began paying separately for
CCM services under the Medicare Physician Fee
Schedule furnished to Medicare patients with
multiple chronic conditions.
The related CPT codes—99490 (and 99487
and 99489, which extend the periods)—are now
well established. CMS’ guidance on covered CCM
services refers to the use of technologies such as
RPM as “enhanced opportunities for the patient
and any caregiver to communicate with the practitioner regarding the patient’s care through not
only telephone access, but also through the use
of secure messaging, Internet, or other asynchronous non-face-to-face consultation methods.” 2
Mobile-enabled RPM is a non-face-to-face,
asynchronous communication. This is a world
of difference from telephone-based synchronous interaction with all its limitations, such as
calls needing to be made during certain hours,
playing “phone tag” with patients, and the
revenue-versus-cost problem of paying a staff
member to talk with one patient at a time to
gather “one-off” data.
Mobile-enabled RPM is convenient for both
physicians and patients and uses few resources
to reach a large population and gather their
data consistently and efficiently. An automated
schedule prompts the patient to send in specific
information at a convenient time and place.
Once the data have been received, a clini-
cian assesses the information and, only when
necessary, escalates to a face-to-face visit or
In addition, just this year, CMS took a first step
toward recognizing RPM services for separate
payment by unbundling CPT code 99091.3 This
development means there may be an opportunity
to bill separately “for time spent on collection
and interpretation of health data that is generated by a patient remotely, digitally stored,
and transmitted to the provider, at a minimum
of 30 minutes of time.” 4 Clarification of 99091 is
expected in 2019, so stay tuned.
Achieving the Triple Aim—Remotely
When used in conjunction with other CCM strategies, mobile-enabled RPM enables providers
to achieve the Institute for Healthcare Improvement’s (IHI’s) Triple Aim, which includes improving
the patient experience of care (including quality
and satisfaction), improving the health of populations, and reducing the per capita cost of
health care. 5
Even better, this allows you to improve care
in a way that is efficient and convenient, both
for your practice and your patients. Not only
do you and your patients benefit—but so do
payers and employers.
Harry Soza is CEO of CAREMINDr, a health IT company focused on creating mobile technology to enable
effective remote patient monitoring that gives doctors
the ability to check in on patients between office visits. Irina Yermilov, M.D., M.P.H., M.S., CAREMINDr’s
chief medical officer, is a healthcare executive with
more than 10 years of experience measuring cost
and quality related to chronic conditions using varied
1. Centers for Medicare & Medicaid Services. 2016. Chronic Care Management
Services, December 2016. Accessed June 22, 2018 at cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/
3. J.G. Daniel and M. Uppaluru. 2017. New Reimbursement for Remote
Patient Monitoring and Telemedicine. C&M Health: Law, November 3, 2017.
Crowell Moring, LLP. Accessed June 22, 2018 at cmhealthlaw.com/2017/11/
5. Institute for Healthcare Improvement. 2018. Triple Aim for Populations.
Accessed June 24, 2018 at ihi.org/Topics/ TripleAim/Pages/default.