Remote Patient Monitoring

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‘This type of service allows a provider to continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates.’

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Expy Surgery serves as an extension of the care team by guiding patients to the best outcome with proven protocols. Providers can now view real-time patient reported outcomes, keep patients engaged, and identify high-risk patients early on.

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The Office of the Inspector General (within the Department of Health and Human Services), is allowing physicians and other healthcare providers to waive patient cost-sharing payments for telehealth services and other non-face-to-face services like monthly remote care management and remote patient monitoring for the duration of the public health emergency.

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A temporary safe harbor is allowing high-deductible health plans (HDHP) to cover telehealth services and other remote care without cost to plan members before plan members’ deductibles are met. This applies to all HDHPs, including those with plan members using HSAs.

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The Federal Communications Commission has implemented a $200 million program to fund telehealth services and some end user devices for healthcare providers and to cover the costs associated with some services and personnel.

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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

Who:

Must be ordered by physician or qualified health care professional (QHCP)**

Auxiliary personnel (including those “not clinical staff” but employees or leased or contracted employees) are allowed to furnish services under the general supervision of the billing physician or practitioner.

How Often:

Should be reported only once during a 30-day period (even when multiple medical devices are provided to a patient), can be billed by only one practitioner, only once per patient per 30-day period and only when at least 16 days of data have been collected

Medicare Rate:

$19.19 (Both non-Facility and Facility)
Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days

Who:

Must be ordered by physician or QHCP**

Auxiliary personnel (including those “not clinical staff” but employees or leased or contracted employees) are allowed to furnish services under the general supervision of the billing physician or practitioner.

How Often:

Should be reported only once during a 30-day period (even when multiple medical devices are provided to a patient), can be billed by only one practitioner, only once per patient per 30-day period and only when at least 16 days of data have been collected

Medicare Rate:

$63.16 (Both non-Facility and Facility)
Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes

Who:

Performed by physicians and non-physician providers (NPP) who are eligible to furnish evaluation and management, or auxiliary personnel/clinical staff under the general supervision of the billing provider

How Often:

Per calendar month

Medicare Rate:

$50.94 (Non-Facility Rate)
$31.75 (Facility Rate)

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes

Who:

Performed by physicians and non-physician providers (NPP) who are eligible to furnish evaluation and management, or auxiliary personnel/clinical staff under the general supervision of the billing provider

How Often:

Per calendar month

Medicare Rate:

$41.17 (Non-Facility Rate)
$31.75 (Facility Rate)
Collection and interpretation of physiologic data (e.g. ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days

Who:

Performed by physician or other QHCP, not clinical staff

How Often:

Reported each 30 days

Medicare Rate:

$56.88 (Both non-Facility and Facility)
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Expy Health

Welcome to Expy Health! We're here to help you manage your joint pain through personalized physical therapy. To match you with the best physical therapist for your needs, please take a moment to complete the questions below.

Your therapy preferences:

Self-pay / Commercial insurance rules

In California, Direct Access rules allow patients to be seen for physical therapy for up to 12 visits with no prescription. After 12 visits or 45 days (whichever is first), the Expy team will work with your doctor to obtain a prescription if more visits or time is needed.

Medicare rules

Medicare requires a signed plan of care for physical therapy. Your therapist will create a plan of care during your first visit, and the team will work with your doctor to get it approved. You will need a new plan of care established every 90 days or 10 visits whichever is sooner.

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