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Remote monitoring: Separate payment may be 'more viable' now

Remote monitoring: Separate payment may be 'more viable' now

HME providers should use CMS’s openness to telehealth during the public health emergency as an opportunity to highlight the remote patient monitoring they’re doing and to lobby for separate reimbursement, Andrea Stark and Jeff Baird say.
 
“That may have more viability as an area we can get traction on, with the evolution of telehealth and remote patient monitoring,” said Stark, a reimbursement consultant at MiraVista, during a webcast in February.
 
CMS has significantly expanded the use of telehealth during the COVID-19 pandemic, waiving numerous restrictions for reimbursement, including that it must be conducted at an originating site and that it must be conducted using video and audio.
 
During the webcast, an attendee asked Stark and Baird, chairman of the Health Care Group at Brown & Fortunato, why HME providers don’t get paid for remotely monitoring patients using “connected” ventilators.
 
“I think the question is, why is this not separately reimbursable,” said Baird. “The supplier is spending money on hardware and software to monitor and stay connected with patients. Why can’t they get paid?”
 
The simple answer: There is no Medicare code to pay HME providers separately for remote patient monitoring. There is, however, coverage for these services when they’re provided by physicians and clinicians.
 
“So I see this as a fair ask (for HME providers),” Baird said. “It’s not something that’s going to happen any time soon, but I’d sure put it (on the priority list).”
 
It behooves HME providers, Stark and Baird say, to advocate for themselves and the services they provide while the iron is hot.
 
“Telehealth is a game changer,” Baird said. “We’ve seen over the years, health care, particularly the commercial insurance space, gravitate toward telehealth. Medicare not so much. But COVID has taken the slow process of conversion and shoved it forward 10 years over the course of nine months.”

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