Automation, Analytics and AI- the next for RPM program that can result in 6 figure additional revenue for HCPs!
Avakash Dekavadiya
RPM Program- the New Normal for Chronic Disease Management and a Potential to generate an additional 6 figures revenue for HCPs!
Post COVID-19, the need for Remote Patient Monitoring (RPM) has increased exponentially in the US and the RPM program has been adopted by both patients and providers. With the growing sophistication of the RPM solutions and greater clarity from CMS on RPM reimbursements, it is evident Remote Patient Monitoring will become the new normal of managing chronic conditions.
Along with its clinical decision making, continuous monitoring and remote telemedicine capabilities the program also brings the potential to generate 6 figures additional revenue to the HCPs!
CMS RPM Reimbursement Rules 2024:
- One Device reimbursement bill per month
- One practitioner reimbursement per month
- Patients with Established patient relationship status eligible for RPM programs
- Minimum 16 days of data records essential using RPM devices and platform
If you RPM program adheres to the above rules, below are the latest reimbursement rates with CPT Code:
- 99453: Initial setup and education, with an average reimbursement rate of $19.65
- 99454: Data transmission, with an average reimbursement rate of $46.50
- 99457: Management services for the initial 20 minutes, with an average reimbursement rate of $48.14
- 99458: Management services for each additional 20 minutes, with an average reimbursement rate of $38.64
- 99091: Collecting and analyzing physiologic data, with an average reimbursement rate of $52.71
RPM and 6 Figures Additional Revenue Generation:
There are majorly 3 different parties involved in the RPM program that can benefit from RPM reimbursements that are RPM device manufacturers, RPM solution providers and Physicians/Hospitals.
If we roughly calculate the reimbursement amount considering the 16-day rule, each RPM patient who gets enrolled in the program can generate an additional reimbursement revenue of $1374.5 per annum!
If a hospital manages to enroll 100 patients in the RPM program, it can effectively generate 6 figures of additional revenue per annum from the program.
Also, these are not just hypothetical scenarios. Many such Hospitals and RPM solutions providers have a successful RPM program. But to generate this additional revenue with stability, there are certain essential functionalities and digital experiences that RPM solution providers must integrate into their platform to make it successful and future proof.
