Remote Patient Monitoring (RPM) Compliance

Evaluate remote patient monitoring program compliance covering CMS reimbursement, device accuracy, data transmission security, and clinical workflows

HealthcareMedtechBiotech20 minutes18 questions

1. CMS Reimbursement Requirements

Are RPM devices FDA-cleared or meet established medical standards?*

CPT 99453-99458: Devices must be FDA-cleared, FDA-registered, or meet clinical practice standards

Are physiologic data transmitted automatically (not manual entry)?*

CMS requires automatic transmission from device to system (Bluetooth, cellular, WiFi)

Is RPM data monitored by clinical staff for 20+ minutes per month?*

CPT 99457/99458: At least 20 minutes of interactive communication per 30-day period

2. Device Accuracy & Validation

Are RPM devices clinically validated for accuracy?*

Blood pressure monitors (ISO 81060-2), glucometers (ISO 15197), weight scales validated

Are devices calibrated and maintained per manufacturer specifications?*

Regular calibration checks, battery replacement, device replacement schedules

Is patient training provided on proper device use?*

Initial device setup, correct measurement technique, troubleshooting, when to call

3. Data Transmission Security

Is RPM data encrypted during transmission and storage?*

TLS 1.2+ for data in transit, AES-256 for data at rest, HIPAA-compliant cloud storage

Are Business Associate Agreements (BAAs) in place with device vendors?*

BAA with RPM platform, device manufacturer if handling PHI, cloud storage provider

Is access to RPM data role-based with audit logging?*

RBAC for clinical staff, audit trails for data access, patient portal access controls

4. Clinical Workflows

Are alert thresholds evidence-based and customizable per patient?*

Clinical protocols for critical alerts (BP >180/110, glucose <70, weight gain >3 lbs/day)

Is escalation protocol defined for out-of-range values?*

Tiered response: nurse assessment, provider notification, emergency services if needed

Is RPM data integrated into EHR for clinical decision-making?*

Bi-directional HL7/FHIR integration, data flows into problem list, medication reconciliation

5. Patient Engagement

Is patient consent obtained specifically for RPM monitoring?*

Consent covers data collection, transmission frequency, alert procedures, costs/insurance

Do patients have access to their own RPM data (patient portal)?*

Real-time access to vitals, trends, graphs; educational content based on readings

Are engagement metrics tracked (device usage, adherence)?*

Monitor transmission frequency, missed readings, patient responsiveness to outreach

6. Documentation & Billing

Are RPM encounters documented with required data points?*

Document: readings reviewed, time spent, patient communication, clinical actions taken

Are appropriate CPT codes billed per CMS rules (99453-99458)?*

Setup (99453), device supply (99454), data transmission (99454), monitoring time (99457/99458)

Is 16-day minimum data transmission requirement met for billing?*

CMS requires 16 days of data transmission per 30-day period to bill monitoring codes

Please answer all required questions to see your results