Remote Patient Monitoring Documentation Requirements

Remote patient monitoring (RPM) allows a patient to collect their own health data using a connected medical device that automatically transmits the data to their provider. This data should then be used to treat or manage the patient’s condition. Medicare broadly covers remote patient monitoring of health data for any chronic or acute condition. An Office of Inspector General (OIG) audit found that the use of these services for Medicare patients has the potential to greatly expand in the future and that additional oversight of remote patient monitoring is needed.

The Centers for Medicare & Medicaid Services (CMS) requires that medical practices have a prior relationship with the patient to bill for remote patient monitoring. This means that before billing, one of the practice providers must have an in-person or telehealth visit with the patient. During this visit, the provider can collect information about the patient’s medical status and determine whether remote patient monitoring could be a benefit and obtain patient consent. An acute or chronic condition must be monitored and data collected for at least 16 days out of 30 days.

RPM includes both remote physiological monitoring and remote therapeutic monitoring (RTM). Remote physiological monitoring involves using non-face-to-face technology to monitor and analyze a patient’s physiological metrics. Examples of physiological metrics include: 

• Oxygen saturation or blood oxygen levels
• Blood sugar 
• Weight loss or gain 
• Blood pressure 

RPM consists of three main components, each building off the step before it. 

1. Patient education and device setup: How to use the device; how to accurately collect data 
2. Device supply: Device examples; connecting the device so you can read results; how often patients should use devices 
3. Treatment management: Reviewing patient data to improve patient health outcome

RTM captures non-physiological data, often self-reported, related to a therapeutic treatment. This includes data on a patient’s musculoskeletal or respiratory system. RTM can also monitor treatment adherence and treatment response. A connected medical device is necessary to transmit the patient’s information. These services do not require an established patient relationship.

Resources

• CMS Medicare Learning Network® (MLN®) Booklet, MLN901705: Telehealth & Remote Patient Monitoring (PDF)
• CMS Remote Patient Monitoring
• OIG Additional Oversight of Remote Patient Monitoring in Medicare Is Needed (PDF)
• OIG Investigates Remote Patient Monitoring in Medicare