Reimbursement Scenarios

CMS has released its final rule for the 2020 Physician’s Fee Schedule.

We have previously covered how one can set up a chronic care management program in 5 steps. We have also covered the available CPT codes that can be used to bill for chronic care management, which also includes remote patient monitoring. If you want a condensed version of all that, 


(Summary of What CCM and RPM Entails)

If you want to see the changes enacted for 2020 and the exact reimbursement amounts you can expect, 


(Actual Reimbursement Amounts Going Forward)

The great news is none of the existing CPT codes have been modified for 2020! So a provider organization or practice can use those codes to finance their CCM and RPM programs. Especially those who have not gotten into the habit of using those CPT codes, now would be the time, as they have remained the same for the next year. So this 2019 Reimbursement Guide is still applicable, that covers both Chronic Care Management (CCM) and Remote Patient Monitoring (RPM). It will allow you to better understand the nature of those two programs. But to see exactly what changes have been made, and what it means for the reimbursement amounts for 2020, see this guide

For a more detailed breakdown of that guide, keep on reading.

The only changes that have happened for 2020 are the inclusion of other codes to bill extra periods of time worked on a patient, and making the RPM codes furnishable via general supervision. It was only possible to furnish them via direct supervision prior.

Both changes are extremely beneficial. First, they do not displace any existing codes, thus organizations and clinicians alike do not need to relearn anything. The only thing they need to do is start familiarizing themselves with the existing CPT codes(as found on the reimbursement guide), and begin using them.  

Second, the new changes make it easier to implement the codes because of a more relaxed stance on supervision. They also allow more options when providing care as far as the time allotted to patient goes. We cover the changes below. Going forward in 2020, one can bookmark this page to see all CPT codes that are available to them (existing ones and new ones included). 

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September 14, 2020 At 2:02 am

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I truly appreciate people like you! Take care!!

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