Thanks to the campaigning of several prominent medical groups, the Centers for Medicare and Medicaid Services (CMS) will hopefully soon reimburse several additional remote monitoring codes instead of simply 99091 (Physician/healthcare professional collection and interpretation of physiologic data stored/transmitted by patient/caregiver). These CPT codes are as follows:

  • 990X0: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment
  • 990X1: device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
  • 994X9: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month

In early June, several organizations, including the American Medical Association (AMA) and the American Heart Association (AHA), sent a letter asking CMS administrator Seema Verma asking her to consider allowing reimbursement for the additional codes. According to the letter, the groups “believe CMS must continue the commitment carefully articulated in the 2018 PFS Final Rule: to consider new digital health CPT codes created by the American Medical Association CPT Editorial Panel. We stand in agreement with CMS that RM are paid under the same conditions as in-person physician services and can be a significant part of ongoing medical care.”

Though these remote monitoring codes were only introduced in September of last year, the groups argue that they have already become commonplace enough that they deserve reimbursement. Only time will tell whether or not Administrator Verma and the rest of CMS decide to implement the changes for the 2019 coding year. In the meantime, stay tuned to see what other information is released regarding this and other new coding topics.