3 Key Questions for CHCs Interested in Remote Patient Monitoring (RPM) Programs

As Community Health Centers (CHCs) navigate the landscape of healthcare innovation, the introduction of reimbursement for Remote Patient Monitoring (RPM) presents new opportunities. However, questions still remain. RPM holds promise for improving patient outcomes and expanding access to care, and to implement a successful, sustainable program, CHCs need a good understanding of the reimbursement landscape, grant opportunities that could be used for RPM, and an understanding of where to start.

RPM Reimbursement:

The 2024 Physician Fee Schedule confirmed Medicare would reimburse CHCs for Remote Patient Monitoring under the G0511 code, separate from the per visit PPS rate. While it is expected state Medicaid plans will follow suit, CHCs should be sure to ask their biller and payer contacts these questions about reimbursement.

• Does my state Medicaid policy cover RPM and are there any restrictions on patient populations or clinical conditions?
• If my state does cover RPM, does it cover Medicaid reimbursement for RPM when a CHC is the originating site?
• Are patients who are dual eligible for Medicare and Medicaid eligible for reimbursement, even if the state’s Medicaid does not provide reimbursement?
• What documentation and coding requirements are necessary to ensure proper reimbursement?
• What metrics are needed for RPM?
  The Center for Connected Health Policy offers a good starting point to review what your state covers.

Grant Opportunities:

• What grant opportunities are available tailored to CHC telehealth initiatives?
• Can grant funding be leveraged to support the upfront costs of purchasing devices and technology infrastructure for the RPM program?
• Are there grants that align with the CHC's mission and objectives, and the RPM program's scalability and sustainability?

Getting Started with RPM:

Understanding what is covered with RPM reimbursement can be daunting, but do not let that deter you from getting started. Think about starting small with a use case that will have the biggest impact on patient outcomes, prove the concept, and expand from there. The following are some questions you might ask to help get started.

• Who are the ideal candidates for the RPM program, considering prevalent chronic conditions in the patient population such as hypertension or diabetes?
• Is there a comprehensive RPM platform that integrates seamlessly with our existing systems and can accommodate future growth and advancements in telehealth?
• What impact can an RPM program have on quality measures we report on?

By addressing these questions, CHCs can navigate the complexities of RPM implementation with greater clarity and confidence. Each question serves as a crucial step towards building a successful RPM program that not only meets the needs of the community but also contributes to the advancement of equitable and accessible healthcare for all.

Rimidi’s Supports CHCs in Building Sustainable RPM Programs

Rimidi supports CHCs in building and sustaining RPM programs with software, services, and easy-to-use connected devices. Our team is happy to answer any questions you have about G0511 and how Rimidi can support your RPM initiatives.