The Future of CMS and Remote Patient Monitoring

One major change outlined in the 2024 Proposed Rule pertains to the reimbursement for remote monitoring services provided to new versus established patients. Currently, CMS provides a higher reimbursement rate for remote monitoring services delivered to new patients as compared to established patients. However, in the 2024 Proposed Rule, CMS is opting to eliminate this distinction and provide equal reimbursement rates for both new and established patients. This change aims to encourage providers to continue offering remote monitoring services to all patients, regardless of their status as new or established.

This change is in line with CMS's goal of expanding access and utilization of remote monitoring services, as they recognize the value and benefits of these services in improving patient care and outcomes. By removing the reimbursement disparity between new and established patients, CMS hopes to incentivize more providers to adopt and use remote monitoring technologies.

RPM Frequency Monitoring Changes

Another notable change in the 2024 Proposed Rule concerns the frequency of monitoring for Remote Patient Monitoring (RPM) services. Under the current regulations, providers must monitor patients at least once every 30 days to qualify for reimbursement. However, CMS is proposing to increase the frequency of required monitoring to at least once every 20 days.

This proposed change reflects CMS's emphasis on ensuring more timely and proactive monitoring of patients receiving remote care. By increasing the monitoring frequency to once every 20 days, CMS aims to enhance patient safety and improve the effectiveness of remote monitoring services. Providers and Remote Therapeutic Monitoring (RTM)/RPM companies should take note of this change and ensure that their monitoring protocols align with the new requirement to remain eligible for reimbursement.

Expanded Coverage for Remote Therapeutic Monitoring

The 2024 Proposed Rule also includes expanded coverage for Remote Therapeutic Monitoring (RTM) services. Currently, CMS covers RTM for certain chronic conditions such as hypertension, diabetes, and heart failure. However, under the proposed changes, CMS plans to expand the coverage to include conditions such as chronic obstructive pulmonary disease (COPD), cancer, and mental health disorders.

This expansion of coverage for RTM services reflects CMS's recognition of the growing need to monitor and manage a wider range of chronic conditions remotely. It also presents an opportunity for providers and RTM/RPM companies to enhance their service offerings and cater to a larger patient population that needs care.

Increased Reimbursement Rates for Remote Monitoring Services

In addition to the aforementioned changes, the 2024 Proposed Rule also includes an increase in reimbursement rates for certain remote monitoring services. CMS recognizes the value and impact of remote monitoring in facilitating patient care and reducing healthcare costs. Increasing the reimbursement rates incentivizes providers to offer and invest in these services, ultimately promoting the widespread adoption of remote monitoring technologies.

The Future of RPM

The 2024 Proposed Medicare Physician Fee Schedule brings significant changes and clarifications to remote monitoring services. Providers and RTM/RPM companies should stay informed about these changes and adjust their protocols and offerings accordingly. The elimination of the reimbursement distinction between new and established patients, increased frequency of monitoring, expanded coverage for RTM services, and higher reimbursement rates all contribute to the future expansion and utilization of remote patient monitoring.