News: Medicare payments for remote monitoring spiked during COVID, data shows

CDI Strategies - Volume 18, Issue 12

Medicare coverage for remote monitoring was limited up until 2019, when Medicare allowed doctors to bill for monitoring more routine vital signs than those with a pacemaker, such as blood pressure, weight, and blood sugar. They also allowed monitoring to be done by clinical staff who work in different places than the physician. In the two years following these changes, remote monitoring services billed to Medicare grew from fewer than 134,000 to 2.4 million in 2021, according to federal records analyzed by KFF Health News.

For the four most common billing codes for remote monitoring, total Medicare payments rose from $5.5 million in 2019 to $101.4 million in 2021, which is the latest year for which data is available. About 400 doctors and other providers billed more than 10 patients for at least one type of remote monitoring in 2019, compared to about 3,700 providers, KFF Health News reported upon analyzing Medicare data. Medicare enrollees may share 20% of the cost for the devices and monthly monitoring, depending on the health plan they’ve enrolled in. During the pandemic, however, the government allowed insurers to waive this cost.

“Part of the allure is that Medicare will pay for remote monitoring indefinitely regardless of patients' health conditions as long as their doctors believe it will help,” KFF Health News stated in the article. “For doctors with 2,000 to 3,000 patients, the money can add up quickly, with Medicare paying an average of about $100 a month per patient for the monitoring.”

Now, after a surge in complaints about some remote patient monitoring companies, federal law enforcement officials say they have begun conducting investigations. The Department of Health and Human Services' Office of Inspector General in November also issued a consumer alert about companies signing up Medicare enrollees without their doctors' knowledge, regardless of medical necessity, and billing them even when no monitoring occurs.

Editor’s note: To read KFF Health News’ coverage of this story, click here.

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