American Telemedicine Association Advocacy Initiatives Result in New Medicare Coverage for Chronic Condition Monitoring
Coverage expansion will significantly improve care for patients with chronic health conditions
Washington, DC – Older Americans suffering from chronic disease will soon have significantly expanded options for receiving timely monitoring of their conditions. Starting January 1, 2018, Medicare will begin covering technology-assisted monitoring of patient conditions. The new benefit, called Remote Patient Monitoring, will provide Medicare beneficiaries who have one or more chronic conditions the choice to receive in-home monitoring in addition to traditional check-ups in clinics, doctor’s offices and hospitals.
“Seniors with complex medical conditions will be benefit greatly from Medicare’s decision yesterday to cover remote patient monitoring. As we have seen, frequent medical monitoring appointments can be quite challenging, particularly for those older adults who may be frail and unable to travel long distances,” said Sabrina Smith, DrHA, ATA’s interim Chief Executive Officer. “ATA and its members have been strong, vocal advocates for this critical policy shift, and we are pleased to see Medicare taking this critical step forward.”
Fueled by the aging baby boom generation, the Medicare beneficiary population is projected to increase by 50% over the next 15 years. When coupled with improvements in life expectancy, the growth in beneficiaries with chronic ailments is driving an increased need for chronic disease monitoring and management. The increased needs have, in turn, fueled massive increases in spending on chronic disease care and created bottlenecks to access.
Medicare will pay for CPT code 99091 and the 2018 unadjusted reimbursement rate will be $58.67/month.
ATA has long advocated that Medicare pay for remote patient monitoring and other tech-enabled services in the home, working with states to compile supporting evidence to ensure coverage for RPM in their Medicaid plans.
“This is an important step in what ATA hopes will lead to additional federal action on telemedicine,” continued Sabrina Smith. “We stand with those who are committed to creating an accessible, responsive, and modern healthcare system.”
ATA’s member organizations, including the Department of Veterans Affairs, Good Samaritan Society, University of Pittsburgh Medical Center, University of Mississippi Medical Center, Ontario Telehealth and University of Virginia, along with industry leaders such as VitelNet, Phillips, Ideal Life, Vivify, Qualcomm and Intel, have been dedicated pioneers in building the case for telehealth coverage regardless of a patient’s physical location or ability.
About the American Telemedicine Association
Established in 1993, ATA is a non-profit, membership-based association located in Washington DC. Comprised of a membership network of more than 10,000 industry leaders and healthcare professionals, ATA is the leading telehealth association helping to transform healthcare by improving the quality, equity, and affordability of healthcare throughout the world. To learn more about ATA, visit https://www.americantelemed.org.