Reimbursement

Reimbursement A. The Division of Medicaid reimburses for remote patient monitoring: 1. Of devices when billed with the appropriate code, and 2. For disease management: a) A daily monitoring rate for days the beneficiary’s information is reviewed. b) Only one (1) unit per day is allowed, not to exceed thirty-one (31) days per month. c) An initial visit to install the equipment and train the beneficiary may be billed as a set-up visit. d) Only one set-up is allowed per episode even if monitoring parameters are added after the initial set-up and installation. e) Only one (1) daily rate will be reimbursed regardless of the number of diseases/chronic conditions being monitored. B. The Division of Medicaid does not reimburse for the duplicate transmission or interpretation of remote patient monitoring data. Source: Miss. Code Ann. § 43-13-121. History: New eff. 07/01/2015. 2.6: Documentation The provider must document the remote patient monitoring service the same as for a comparable in person service which includes, but is not limited to: A. The monitoring equipment meets all of the following requirements: 1. Capable of monitoring any data parameters included in the plan of care, 2. Food and Drug Administration (FDA) Class II hospital-grade medical device, and 3. Capable of accurately measuring and transmitting beneficiary glucose and/or blood pressure data. B. Qualified staff installed the remote patient monitoring equipment necessary to monitor and transmit the data according to the beneficiary’s care plan. C. Clinical data was provided to the beneficiary’s primary care physician or his/her designee. D. Monitoring of the beneficiary’s clinical data was not duplicated by any other provider. E. Beneficiary’s home environment has the necessary space and connections for installation and transmission of data.