New CPT Codes Highlight Connected Health

Connected health promises to improve healthcare services, delivering benefits to providers and patients. From increased access to care to more efficient use of physicians’ time, and associated cost benefits, telehealth, remote patient monitoring, and other elements of connected health solutions can play a major role in relieving the burden the U.S. healthcare systems is facing.

But, while hospitals have seen significant adoption of connected health technologies, physicians in smaller practices haven’t been as quick to start using them.  In fact, the AMA reported only a few years ago that only 15% of physicians were using telemedicine in their practices.  It’s not that patients aren’t open to the idea of virtual care and related services – in fact, almost two-thirds of people with primary care providers say they are open to virtual care.  Despite that, about two-thirds have never used any telehealth services.

There are several factors that are likely contributing to the low adoption rate by physicians, including awareness and perception, reporting, reimbursement and the technology itself. Reimbursement, however, is outside providers’ control largely.

The good news is, as the industry continues to evolve, the AMA regularly revises its definitions and CPT codes. A year ago, the AMA created and CMS later implemented several new codes related to RPM services.  As technologies continue to evolve and as demand and adoption for connected health services grows, further adjustments are necessary in order to make it easier for providers and payers to accurately account for and bill for new services.

Understanding that, AMA has announced a set of CPT code changes that will go into effect January 2, 2020, which can help drive connected health models and help overcome geographic and socioeconomic barriers to care.

They include several key changes that impact telehealth and RPM.

*Six new codes to report online digital evaluation services (e-visits). These codes describe patient-initiated digital communications provided by physician or other qualified health care professional or a non-physician health care professional.  As the use of portals and other digital engagement methods grows and makes it easier for patients and doctors to interact and exchange information, these codes will allow providers to more accurately report these patient encounters.

*Two new codes were added to support home-based self-measured blood pressure monitoring. This increases physicians’ ability to treat and monitor a broader set of patients by overcoming distance and time challenges with traditional care models.

*Nine new codes have been defined to recognize health and behavior assessment and intervention services. These will replace six existing codes to more accurately reflect current practices and place greater focus on care coordination and collaboration between providers, particularly between PCPs and specialists.  Considering the gap between instances of behavioral health issues and treatment, this can help ensure more patients have access to and receive appropriate care.

These changes reflect a continued trend towards new healthcare models using connected health technologies to supplement or even replace in-person care.  By making it easier for physicians to report connected health services delivered with these new CPT codes, the hope is adoption will increase.  As a result, they will be able to offer more patients access to healthcare services conveniently and cost effectively, and more effectively manage a growing number of patients with chronic conditions.

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Meredith leads strategy and execution of Trapollo's comprehensive marketing strategy including events, digital, content, campaigns and social media. She has a passion for bringing awareness to innovative, digital healthcare solutions through marketing programs enabling organizations to fully engage patients and improve patient experiences.