MEDICAL REIMBURSEMENT
New Medicare Payment Reform for Home Health Solutions
The Most Significant Change In 30 Years
As of January 1, 2020, remote patient monitoring care will no longer require direct supervision by the primary care physician. Remote care facilities will be able to deliver RPM under general supervision, plus patients with only one chronic condition now qualify. ProMedix™ Health has paved the way for physicians to quickly earn predictable recurring revenue between patient visits, streamline their workflow and provide patient centric care with improved outcomes.
CPT CODE 99453
$21.00
Initial set-up, instruction and patient education on furnished medical devices and patient gateway. One-time fee per patient.
CPT CODE 99454
$69.00
Digital medical devices and electronic transmission of daily physiological recordings. Billed every 30-days.
CPT CODE 99457
$52.00
Minimum 20-minutes of remote patient monitoring and interactive patient communication. Billed each month.
CPT CODE 99458
$42.00
Each additional 20-minutes of RPM and interactive patient communication (NTE 60 minutes). Billed each month.
Primary Physician National Averages
Patients
per physician
Patients on medicare
medicare patients w/ chronic Conditions
Patients quality for RPM per Physician
Total Annual Revenue Opportunity
The Number of Medicare Patients Managed by Physicians is Expected to Increase 28% Over the Next Ten Years*
CALCULATE YOUR OWN REVENUE HERE
*The U.S. Census Bureau reports the age 65+ population increasing by 28% from 56.4 million in 2020 to 72.09 million in 2030 (CAGR 2.48%). The 10-year calculator assumes a 2.48% compound annual growth rate in the number of Medicare patients treated by a practicing physician.
*The Centers for Disease Control (CDC) estimates 68.4% of Medicare beneficiaries have two or more chronic conditions and 85.6% of the over 65 population have at least one chronic condition. The American Association for Physician Leadership (AAPL) published research study states the average panel size of a primary care physician to be 1900.
*Revenue opportunity estimates are based upon the number of patients shown qualifying for CPT billing codes 99453, 99454, 99457 & 99458. Does not include the costs of providing RPM service or generating additional revenue from other CPT billing codes.