AMA CPT Panel Meeting to Discuss Redesign of Remote Patient Monitoring Codes

The American Medical Affiliation (AMA) has introduced the agenda for its first quarter 2024 CPT Editorial Panel assembly in February, and it features a stunning proposed full redesign of all distant affected person monitoring (RPM) CPT codes. 

Key takeaways embody the next: 

1. Deleting most RPM and RTM codes. AMA is contemplating deleting most CPT codes at the moment related to distant affected person monitoring and distant therapeutic monitoring (RTM): CPT 99453, 99454, 99457, 99458, 98976, 98977, and 98978.
2. Creating a mix CPT codeset for RPM/RTM administration time. AMA is contemplating consolidating RPM and RTM providers into one household of distant monitoring codes — in different phrases, a single CPT codeset.
3. Combining measurement codes for RPM and RTM, together with variations for fewer than 16 measurement days. AMA is contemplating simplifying the codes describing the provision of apparatus by not utilizing codes to explain particular medical units for particular physique methods. Slightly, there could be two codes: one for 48 hours to fifteen days of distant monitoring and one for 16 to 30 days of distant monitoring. If established, this could create a brand new code that may allow suppliers to code for fewer than 16 measurement days, assuming Medicare adopts the brand new code. AMA notes, “The 16-day requirement is a barrier, limiting entry to take care of sufferers that may profit from shorter durations of RPM or RTM monitoring.”
4. Probability of implementation. Whereas Medicare just isn’t required to replace its coding guidelines as per AMA’s CPT code revisions and additions, the federal company typically does so when the affiliation implements modifications. Non-public payers and well being plans technically have the choice of not updating to new codesets, however not often do they deviate from AMA’s guidelines. Even when the AMA makes the modifications, it is vitally unlikely that any protection modifications would go into impact till no less than 2025. 

What This Means 

If AMA implements the modifications into account, and Medicare follows swimsuit, suppliers of distant affected person monitoring and distant therapeutic monitoring might want to revise how they’re coding and billing for RPM and RTM to make sure compliance with the brand new codesets and guidelines. The identical is true for any non-public payers and well being plans that modify their coding guidelines to align with AMA’s modifications. Suppliers that use distant care administration expertise to help coding and billing will wish to guarantee the seller is conserving present with the evolving guidelines and making any needed modifications to the software program to take care of compliant coding. 

As well as, distant affected person monitoring and distant therapeutic monitoring suppliers will wish to start coding and billing for sufferers who report RPM or RTM providers for durations of fewer than 16 days however at least two days (i.e., 48 hours to fifteen days). This new coding and billing alternative could additional improve the monetary worth and efficiency of a distant care administration program. 

Becoming a member of the Dialog 

If you’re considering attending the assembly and/or sharing your ideas with AMA on their RPM and RTM concerns, this is what you must do: 

• To register for the assembly, go here, then click on “Register now.” 
• To submit feedback, you have to be recognized as an ” celebration.” To use to take part as an celebration, submit your request via the “Interested Party Portal” by Jan. 11, 2024. The deadline to submit written feedback is midday CST on Jan. 18, 2024. events could have a possibility to remark reside in the course of the assembly. 

Prevounce can have representatives attending the CPT Editorial Panel assembly and can share any information that comes out of the assembly on social media.

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