Frequently Asked Questions

Physicians can collect range of patient health data with RPM, including blood pressure, heart rate, respiratory rate, blood oxygen saturation, weight, blood sugar levels, and physical activity.

The most common devices are blood pressure monitors, weight scales, blood glucose meters, and pulse oximeters. 

RPM codes are considered evaluation and management (E/M) services and so they must be ordered, or prescribed, to patients by practitioners who are eligible to bill Medicare E/M services. Typically, these are clinicians such as physicians and nurse practitioners. Clinical staff can furnish and manage RPM under the general supervision of the billing provider.

Any patient with more than 1 (one) chronic condition,... With that said, a provider should only order/prescribe RPM if captured data is directly relevant to managing a patient's condition(s) (i.e., medical necessity), with such justification documented in the medical record.

Within 24 hours for a new clinic, but with training and EHR integration, the typical onboarding period is 3 to 5 business days

You need to book an appointment with our client specialists/sales team by scheduling here. If you have any questions, our client specialist will be there to help make sure you understand the program and get onboarded with the necessary information to get started quickly.

Schedule a Demo here.

You may call us at 855.932.5273 and email us at support@karevitals.com. You can also chat with us on our Chat Support feature on this page.

KAREVitals™ offers a team of nurses and MAs who provide first-line clinical monitoring for all vital sign data captured by patients 24/7. When an individual’s biometric readings exceed critical thresholds, our nursing professionals will call them on the recorded line to make sure they are safe before taking any actions necessary as it pertains specifically to their needs at this moment in time. The nurse will determine if the case needs to be escalated and contact a physician. This sort of screening can help significantly reduce "noise" so that ordering physicians have less stress when using RPM, which is good for them because it takes up their time!

KAREVitals™ can offer physicians the ability to set both custom default thresholds for each vital sign (such as blood pressure, heart rate, or glucose), as well as individual patient-tailored settings. Some vendors are not able to provide this level of customization.

We provide the first device for each patient. And don't worry, you won't have to purchase a large number of them upfront. Most patients only need one device, and we provide it for you.

KAREVitals™ pays for all consumables because it's essential in maintaining compliance with treatment plans as we're committed to providing you high-quality healthcare services that meet your expectations!

The most accessible and most reliable devices are those with built-in cellular chips that allow for wireless data transmission to our platform. This system removes the need for patient interaction and sends the data wirelessly and reliably. Many vendors still use Bluetooth devices because they are inexpensive. But, patients will inevitably have issues connecting to them from time to time. These problems can make it difficult for patients to stay compliant with RPM.

Doctors no longer need to spend time and money managing devices in their offices. We handle the distribution and storage of medical equipment, which frees up their time for patient care.

KAREVitals™ logs all phone calls, messages, and other interactions with patients. This is done automatically, and it’s time-stamped. The recording of interactions is part of the audit record, and it is also integrated with the patient’s medical history in the ordering provider’s EHR.

Yes, your clinical team can login to our web-based RPM platform, at any time and review live patient readings.

KAREVitals™ logs all phone calls, messages, and other interactions with patients. This is done automatically, and it’s time-stamped. The recording of interactions is part of the audit record, and it is also integrated with the patient’s medical history in the ordering provider’s EHR.

Medicare, Medicare Advantage plans, and some private payers. For Medicare, RPM is a Part B service.

99453, 99454, 99457, 99458
‍
99453 - Initiating visit with the patient to describe the program and get patient acceptance to participate. Typically, this is when the patient is provided an KAREVitals™  brochure. This is a one-time billable code, and the Date of Service is equal to the first successfully recorded reading that comes into Evelyn for the respective patient. This code reimburses typically between $15 and $20 depending on the locality.
‍
99454 - This is for providing the monitoring device(s) to the patient, the software to ingest readings from the patient, and ensuring that both are functioning on an ongoing basis. This code is billed once every 30-days. The patient must record at least one successful reading in the 30-day period. The first date of service for 99454 is equal to the first successfully recorded reading in Evelyn, and is billed every 30-day calendar days subsequently. This code typically reimburses $55 to $62 depending on locality.
‍
99457 - This is for providing between a minimum of 20 minutes of interactive telemonitoring services with the patient and/or patient caregiver over the calendar month. This time can be provided incident to and under the clinics general supervision, meaning KAREVitals™  can provide 100% of this time. It’s encouraged that clinics work within our platform, as any time spent by the clinic also goes towards this cumulative time. This code reimburses ~$49 across most localities.
‍
99458 - This is for providing additional units of 20 minutes of cumulative interactive time spent providing telemonitoring services to the patient and/or patient caregivers. There is no limit to how many units of 99458 a clinic can bill; however, it’s legally recommended NOT to exceed more than 2 units of 99458. In other words, if a clinic records 40 to 59 minutes of time with a patient in a calendar month, they would submit a claim for 99457 and one unit of 99458. If a clinic spends 60 or more minutes, they would submit a claim for 99457 and two units of 99458. This code reimburses typically about $49 for each unit across most localities.

Refer to the CMS tool: https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx

No. 99453 is a one-time code. 99454 is an every-30-day code, not to be confused with 99457 and 99458 which are calendar month codes.

99453 can only be billed after 16 days of monitoring.
‍
99454 should be billed only once each 30 days, regardless of the number of parameters monitored

Do not report any RPM codes in conjunction with 99091 (legacy remote patient monitoring code)

RPM can be billed in the same months as CCM, TCM, and BHI (but time spent doing one service, e.g., CCM, can not also count towards time for another service (RPM)).
Do not count any time on a day when the physician or qualified health care provider reports an evaluation/management service
Do not count any time related to other reported services (e.g., 93290)

May be billed as an "incident to" service
Billing provider must have at least one face-to-face visit with the patient in the preceding 12 months (this rule was relaxed during the COVID-19 PHE to allow for the face-to-face to be done via telemedicine). Face-to-face visits can include levels 2-5 E/M visits, Annual Wellness Visit, Initial Preventive Physical Exams, or the face-to-face from a Transitional Care Management encounter.

RPM codes are considered evaluation and management (E/M) services and so they must be ordered, or prescribed, to patients by practitioners who are eligible to bill Medicare E/M services. Typically, these are clinicians such as physicians and nurse practitioners.

No. If there is a more specific code, you must use the more specific code.

No, you can not round time up.

If you want to participate in the ordering program, make sure your customer consents. The patient must give a verbal consent and the ordering provider must document this consent. This is important because patients on Straight Medicare will be responsible for 20% of the claim that the provider generates (unless their secondary insurance covers it).

Once the device has been shipped, we automatically contact our patients with tips on how to take their first measurements. This way, we can ensure that the device is precise and their data flows accurately into our platform. Some devices require us to train the patients before using the machine.

We have a robust Patient Adherence program that includes the following:
- we pay for all the consumables (for some patients this is a big deal);
- when we call patients, we try to call with the same clinical team member if possible, in order to develop comfort and rapport; and,
- we use automated SMS reminders.

Giving patients the device and expecting them to figure out all their downstream issues themselves is not a good idea. If they stop participating after just one or two months, your program will fail.