Glooko Adds New Enhancements to Billing Export Feature to Streamline Submitting CPT Codes for Remote Patient Monitoring Reimbursement

Glooko Adds New Enhancements to Billing Export Feature to Streamline Submitting CPT Codes for Remote Patient Monitoring Reimbursement
  • 2022-03-30 || WRITTEN BY Glooko
  • Glooko Adds New Enhancements to Billing Export Feature to Streamline Submitting CPT Codes for Remote Patient Monitoring Reimbursement

    Glooko recently introduced new enhancements to the billing export feature in Population Health Analytics for professional users with Glooko Enterprise accounts. The new features provide healthcare providers and care teams supporting patients with diabetes and related chronic conditions the information needed to properly bill CPT codes for remote patient monitoring (RPM) activities.

    This evolution of Population Health Analytics, a tool available in our Glooko platform that creates advanced filters on patient populations, targets at-risk patients and tracks statistics post-intervention, now allows care teams to better serve their patients and helps them easily determine which patients are eligible for RPM reimbursement for a given calendar month.

    These new enhancements provide dates of first in-clinic upload, any in-clinic uploads present during the selected date range and now clearly defined data for the completion of 16 days of remote data uploads required to meet billing requirements. Users will now see two columns added to their billing export CSV file for the information needed to bill for RPM within a calendar month.

    “These enhancements provide healthcare providers and care teams using our digital health platform with the information needed to more efficiently and easily bill for RPM using the proper CPT codes,” said Glooko Chief Commercial Officer Zach Henderson. “We’re proud of Team Glooko’s efforts to create a more streamlined and quicker process for busy care teams seeking reimbursement using billing codes that support RPM efforts aimed at improving care for people with diabetes and related chronic conditions.”

    In the recent 2022 Final Rule, Centers for Medicare and Medicaid Services (CMS) showed support for telehealth and RPM with five updated billing codes.

    • 99543: Initial setup of the device, including patient education on use of equipment for RPM.

    • 99454: Monthly remote monitoring with daily recordings. Billed each calendar month and must have a minimum of 16 days of remotely uploaded data.

    • 99457: Monitoring and treatment management, which requires interactive communication between the patient and caregiver for the first 20 minutes during the calendar month.

    • 99458: Each additional 20 minutes of interactive communication between the patient and caregiver during the calendar month.

    • 99091: The time it takes for qualified clinical staff to gather, interpret and process monitoring data, at least 30 minutes every 30 days.

    For more information on reimbursement payments and to learn how the Glooko digital health platform provides a better economic value to healthcare providers, contact Team Glooko or download a PDF on our new Population Health Billing Export Feature.

    Per CMS policy on reimbursements, patients must agree and opt-in to be enrolled in an RPM program to qualify for the minimum of 16 days of data captured in a 30-day period. Not all payers reimburse for CPT RPM. Reimbursement policies vary by state and payer, please consult your billing specialist on policies for your local area or region.

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