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BALTIMORE, MD (September 8, 2022) – In July, the Centers for Medicare and Medicaid Services (CMS) proposed new changes to Remote Therapeutic Monitoring (RTM) services as part of the proposed 2023 Medicare Physician Fee Schedule rule. On September 6th, 2022, emocha health the leading digital medication adherence company, provided feedback on the proposed revisions.
When CMS first introduced the RTM codes in 2022, it provided the healthcare system with a payment mechanism for managing medication adherence beyond a hospital’s walls. However, adoption was low as the code set did not allow for a provider’s clinical staff time to be counted towards billing, as allowed by the Remote Physiological Monitoring (RPM). In this year’s proposed rule, CMS fixes the problem with four new RTM HCPCS G codes and adds one new RTM CPT code to increase patient access to RTM services and reduce the supervisory burden on physicians and non-physician practitioners.
“The proposed changes from CMS are a step towards improving healthcare delivery and bolstering medication adherence monitoring, remote patient monitoring, telehealth, and other virtual care services to benefit Medicare patients,” said Sebastian Seiguer, CEO of emocha. “Now, we encourage CMS to continue expanding these services by allowing RTM to be used for all chronic and acute conditions.”
Currently, the condition-specific limitations of RTM billing to respiratory and musculoskeletal conditions prevent the use of RTM for populations who could benefit from medication adherence support. Patients with heart failure, hypertension, diabetes, thyroid conditions, gastrointestinal diseases, sickle cell disease, substance use disorder, and solid organ transplant recipients depend on medication to help control their chronic conditions. While the CMS proposes the expansion of RTM to cognitive behavioral therapy, emocha urges CMS to create an additional condition/system agnostic RTM device code to allow for the provision of critical services to patients with other chronic, infectious, or acute conditions.
To further expand how RTM can be used, emocha also encourages CMS to change the proposed requirement of 16 days of data per month. emocha applauds CMS’ efforts to ensure that patients use RTM services in a meaningful manner, but some conditions do not require medication monitoring for 16 days per month. Instead, emocha suggests CMS revise the proposed language to require at least 50% adherence to daily usage. This change would allow therapeutic monitoring reimbursement for conditions where the recommended treatment regimen requires fewer “days” of monitoring but where therapeutic monitoring remains important, such as latent tuberculosis infection and asthma.
About emocha Health
emocha Health’s 360° model of care builds on Directly Observed Therapy by combining technology and personalized video coaching to engage and improve medication adherence in patients with diabetes, opioid use disorder, asthma, COPD, hepatitis C, and other chronic and infectious conditions. emocha Health has partnered with health plans, hospitals, health centers, and managed care organizations to improve adherence rates for vulnerable populations across the globe. Learn more at emocha health.
5W Public Relations