Ann: RPM CPT Reimbursement & response to statements made by ADR, page-7

Paddy, perhaps some more careful reading needed? Not sure I agree with you.

"...the Company commissioned an independent expert evaluation [...] to assess its eligibility to qualify for Remote Patient Monitoring (RPM) Current Procedural Terminology (CPT) code reimbursement..."

I have found this online:

7. What type of RPM devices qualify for Medicare purposes?
The RPM device must meet the FDA’s definition of a medical device as described in section 201(h) of the Federal, Food, Drug and Cosmetic Act. CMS confirmed there is no language in the CPT Codebook indicating the RPM device must be FDA-cleared/registered, but such clearance may be appropriate. Nor did CMS hold the RPM device must be prescribed by a physician, although again such a prescription could be necessary depending upon the medical device.The RPM device must digitally (i.e, automatically) upload patient physiologic data (i.e., data cannot be self-recorded or self-reported by the patient). As with any service provided to a Medicare beneficiary, use of an RPM device to digitally collect and transmit a patient’s physiologic data must be reasonable and necessary for the diagnosis or treatment of the patient’s illness or injury or to improve the functioning of a malformed body member. Further, the RPM device must be used to collect and transmit reliable and valid physiologic data that allow understanding of the patient’s health status to develop and manage a plan of treatment.

Source: https://www.foley.com/en/insights/publications/2020/12/2021-remote-patient-monitoring-cms-final-rule

They key part here being "physiologic data". Hence the important part is the expert deemed breath sounds and wheeze met that requirement. It's about eligibility.

Happy to hear the views/understanding of others? I can't remember who, but one of @Richney or @lucasq previously provided me with more information around what was required re: eligibility for RPM CPT.

In the 23rd March 2021 NWR presentation, slide 7/11 notes five (seemingly relevant) CPT codes: 99453, 99454, 99457, 99458, 99091.

Maybe check it out.

Cheers
mondy