Remote Patient Monitoring (RPM) is a new revenue stream for your Urology practice.
This page will provide you with a brief overview of how RPM works and how it can benefit you. We include a revenue estimation calculator you can use to see how much revenue this model can add to your office.
The RPM model enables you to take advantage of new CPT billing codes to increase your office revenue while also providing your patients with a higher quality of care.
What is Remote Patient Monitoring (RPM)?
RPM is a new protocol of medical care in which a patient performs a simple medical test such as a uroflow in the comfort of their home. The patient is guided every step of the way via phone support from trained medical personnel. The approach of Remote Patient Monitoring and Telemedicine has been growing in popularity since the COVID pandemic.
With Remote Patient Monitoring, once the medical home test is complete, the results are transmitted wirelessly to the doctor. Last, everything is billed for using specialized RPM billing codes. (Codes 99453; 99454; 99457; 99458). Read on to understand how these billing codes work.
The infographic below provides an overview of how Remote Patient Monitoring serves as a new revenue stream for your Urology practice with no additional work when you partner with UroGenie. We work as an extension of your medical practice to manage the RPM program for your patients. At no extra cost or work from you, you can use the RPM model to increase your practice revenues.
One of the most common questions from Urologists is how will this work? The process might seem complicated but it is actually very simple.
As a Urologist using the RPM model for your uroflows, you only need to focus on treating patients and prescribing their uroflows. We at UroGenie handle everything else.
The model and flow works this way:
Prescription of Uroflow
First a urologist will prescribe a uroflow test to their patient. Instead of coming in to the office and dealing with the hassle of doing it there, with Remote Patient Monitoring, the patient can do the test in the comfort of their own home.
Urogenie Device
Alongside CHOP and their patented technology, we have created a lightweight easy-to-use Uroflowmeter that patients can use in the comfort of their own home. We handle the distribution of this device to your patients.
Once patients use the device, the data from the uroflow test is sent securely and wirelessly over the cloud to each patient’s individual EMR.
Medical Phone Support
Our trained nurses provide medical support over the phone as telemedicine to your patients. We take care of any questions they have. This is compensated for by unique billing codes designed for telehealth and remote patient monitoring.
Compliant Billing
Once all uroflow procedures are done, we assist you with our billing expertise to bill for medical care which was provided to your patients remotely.
Please take a look at our infographic below which describes the Remote Patient Monitoring flow.
RPM Billing: Codes 99453 ; 99454 ; 99457 ; 99458
Remote Patient Monitoring has specialized CPT codes so that providers can be reimbursed for the home services they are providing. These codes are specific to telemedicine health services. Below we provide a description of each code and what it covers. Remember that the reimbursement rates are subject to change and is based on national averages.
CPT Code 99453
This code covers the initial set up and education (the onboarding) of a new patient for Remote Patient Monitoring. It can be billed for once per treatment duration for the patient.
The average reimbursement rate for this code is $21.
For this code, you do not need your staff to do the onboarding. We at UroGenie have trained clinical staff who handle this for you.
CPT Code 99454
Code 99454 covers the management of the Remote Patient Monitoring medical device. In this case it is the UroGenie Uroflowmeter which transmits uroflow results wirelessly to the patient’s EMR. Code 99454 reimburses the distribution and management of transmission of data from the device.
Code 99454 can be billed for monthly and has an average reimbursement rate of $60. (Once/month)
As your trusted RPM partner, UroGenie will handle the distribution of the UroGenie Uroflowmeter device to your patients. No extra work needed on your part.
CPT Code 99457
This code covers 20 minutes of monthly remote patient consultation over phone or video call. The reimbursement average is $50.
Our trained in-house clinicians handle these consultations for your patients. You don’t have to worry about your patients as our main focus is on increasing the quality of patient care.
CPT Code 99458
Code 99458 covers two additional 20 minute consultations pre month for your patients by our clinical staff. The maximum is two per month. The reimbursement average is $41.
Codes 99457 and 99458 are associated codes (they go together). For example if our nurse consults your patient for 3 times each month for 20 minutes each session, we will help you bill for one unit of code 99457 and two units of code 99458.
CPT Code 51741-26
In addition to the RPM specific codes above, you will also bill for the usual Uroflow code 51741. The exception is that you will add a modifier (26) that is specialized for a test that took place in the patient’s home.
If you have any questions regarding compliant billing, we have a team of medical billing experts on our staff that will help you should that need arise.
Now that you have some more familiarity with what Remote Patient Monitoring is and how it works, please use our calculator below to estimate your potential earnings from this new revenue stream.
Use our Calculator below to estimate your potential earnings by adding Remote Patient Monitoring to your practice