Financial Impact of MACRA

Looking at the 2018 calendar and working on a couple of presentations for the EPI Conference I decided to shift gears and calculate the financial impact of MACRA.

This decision to look into the MACRA’s financial impact was not a sudden impulse but the consequence of a concern I have. After analyzing last year’s findings from the HIPAA Security Risk Analysis, I was worried that eligible clinicians and support personnel are still not ready for MACRA. Perhaps it is because they don’t think is necessary to do them every year. Potentially they don’t know that this is a legal requirement…

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Written by: Dr. Jose I. Delgado, CEO/Founder of Taino Consultants, Inc.

Remote Monitoring

Introduction
The genie is out of the bottle! What we mean with this statement is that telemedicine is here to stay and with telemedicine and the current advances in technology the need for remote monitoring shows an untapped potential.

Description
One of the results of the COVID 19 pandemic has been the evolution and implementation of remote services. The Centers for Medicare & Medicaid Services (CMS) has been looking at this “opportunity” and agreed to make changes in their fee schedule to accommodate these services. One of CMS major changes has been the incorporation of “remote therapeutic monitoring (RTM).” The CPT codes proposed by CMS for RTM are:

CPT code 989X1: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response), initial set-up and patient education on use of equipment;

CPT code 989X2: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response), device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days;

CPT code 989X3: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response), device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days;

CPT code 989X4: Remote therapeutic monitoring treatment management services, physician/ other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes; and

CPT code 989X5: Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month, each additional 20 minutes (List separately in addition to code for primary procedure).

The key of this presentation and the important point to focus on is that remote monitoring provides healthcare providers opportunities to improve patient care while simultaneously increase their income opportunities.

Target Audience
Physicians, Chiropractors, Physical Therapists, Rehab specialists, healthcare administrators, office managers, billing specialists, Practice consultants.

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Financial Impact of MACRA

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