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BALTIMORE, September 20, 2021 — In the most recent proposed Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) recognized for the first time a set of CPT codes that will allow healthcare providers to be reimbursed for Remote Therapeutic Monitoring (RTM). On September 13, emocha Health, a Johns Hopkins-backed digital health company that radically improves medication adherence, added its support to this proposal. The company also encouraged CMS to clarify and expand the types of healthcare professionals that can participate in the monitoring of any RTM programs as part of its final Medicare Physician Fee Schedule for 2022.
According to the CMS proposal, the RTM codes are intended to be used to monitor medication adherence and to understand the effectiveness of patients’ responses to their prescribed therapy. RTM represents one of the latest advancements to reimburse providers for providing remote treatment modalities. The addition of RTM codes signals that payment policies are beginning to address consumer demand for the effective use of digital healthcare programs and services to improve health outcomes and lower costs.
“I want to thank CMS for the recognition of the importance of remote therapeutic monitoring with the addition of new codes, and for specifically stating that these codes are intended to monitor medication adherence,” said Sebastian Seiger, CEO of emocha. “We encourage CMS to continue expansion and support for medication adherence monitoring, remote patient monitoring, telehealth, and other virtual care services to benefit Medicare patients long past the end of the COVID-19 public health emergency.”
With the introduction of these codes, CMS recognized a new category of patient data: therapeutic data. This includes measurements like medication adherence, therapeutic response, pain levels, and therapy adherence, parameters that are not typically captured by a hardware device that automatically transmits healthcare data. The newly proposed RTM codes would enhance clinicians’ abilities to provide quality care and offer more convenient ways for patients to engage with the healthcare system.
Medication non-adherence costs the US healthcare system hundreds of billions of dollars each year in preventable hospitalizations. It also results in poor health outcomes, including death, for millions of people with chronic and infectious diseases. The reasons for non-adherence are varied and often complicated, and support in-between visits are critical to understanding and addressing an individual’s challenges.
emocha has developed a novel, technology-enabled service that scales the gold standard for medication adherence, Directly Observed Therapy. emocha’s frequent, asynchronous video messaging paired with human engagement changes the medication challenge into a medication engagement opportunity. emocha’s software and services are exactly the types of patient support tools that are encouraged by the introduction of RTM.
CMS will review comments about proposed RTM codes for the next several months and final policies will likely be published in December of 2021. Use of any new RTM codes will begin in 2022 for patients covered by Medicare. Adoption of final Medicare RTM codes by other payers would be at the discretion of each commercial and Medicaid health plan and their related governing bodies.
About emocha Health: emocha is tackling one of the biggest unsolved problems in healthcare: medication non-adherence. emocha’s Digital Medication Adherence Program empowers patients to take every dose of medication properly using video technology and scalable human engagement. emocha partners with health plans, health systems, employers, and health departments across the country to radically improve adherence for patients with diabetes, asthma, tuberculosis, and other chronic and infectious diseases.