News: CMS boosting telehealth with new CPT codes

CDI Strategies - Volume 15, Issue 45

The Medicare 2022 Physician Fee Schedule includes CPT codes for remote therapeutic monitoring, suggesting that telehealth policies implemented in response to COVID-19 may be here to stay. According to the proposal, the codes are intended to understand the effectiveness of a patient’s response to prescribed therapies, specifically medication adherence.

Because preventable hospitalizations and emergency room visits related to medication non-adherence hold a huge cost in the U.S., the addition of medication adherence programs in CMS’ proposed CPT codes not only is a major step towards solving a major healthcare challenge, but also shows the continued advancement to modernize digital health.

The new remote therapeutic monitoring codes are similar to those of remote physiological monitoring that reimburses providers based on the review of physiological data that is automatically transmitted from a device (for example, heart rate). The difference with the new codes is the inclusion of medication adherence monitoring which does not rely on automatically transmitted information and instead can include cases where patients self-report health information.

Editor’s note: The 2022 Physician Fee Schedule can be found here.

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