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In 2018, CMS unbundled CPT code 99091, allowing clinicians to be reimbursed for time spent collecting and interpreting digitally stored physiologic data. Although code usage was minimal in its first year, it proved a pivotal moment for remote patient monitoring reimbursement. Since then, CMS has implemented four other remote physiologic monitoring (RPM) codes, including 99453, 99454, 99457, and 99458 for patient education and setup, device supply, and additional time spent reviewing data.
From 2018 to 2023, the number of billed remote physiologic monitoring claims has skyrocketed, growing from ~120,000 in 2018 to nearly 11 million in 2023. The COVID-19 pandemic and Congress’ emergency authorization to encourage the use of RPM undoubtedly helped to facilitate this growth, with claims volumes more than doubling from 2020 to 2021. Even after the height of the pandemic, progress remains strong.
Which specialties are driving this growth? How does this compare to the claims volumes for remote therapeutic monitoring (RTM) codes, which were implemented more recently? Follow the rest of our four-part RPM/RTM Data Series to find out more.
Health Advances is a strategy consulting firm that helps management teams and investors in digital health, health IT, biopharma, medtech, and diagnostics make more confident strategic business decisions and capitalize on their growth potential. The firm leverages proprietary data assets and its robust advanced analytics skills to provide clients with innovative perspectives and actionable insights based on real-world data.
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