The Practice can choose Individual service or a flat rate for the service per active patient per month.
Active patient devine as patient using the service which is billable per medicare guidelines
.
RPM SERVICE FEE
| CPT | Description | Medicare Pays | Description | Paid to Medical Office Force |
|---|---|---|---|---|
| None | HWS safe digital platform | Hws safe will provide digital plate form and training to the practice staff for its use to provide rpm and ccm, rtm service. The cost include only the platform | $10.00 per active patient per service per month , flat rate. Additional training available for purchase | |
| none | cellular devices, blood pressure , weight, glucometer | Single device, shipping cost, replacement cost, replacement of supply, glucose strips, lancets, ect | $100/per device and then $5 /month for bp and weight machine and $20 /month for glucometer ( cellular fee, glucose strips , lancets , replacement of the non functioning device) | |
| 99453 | Initial Patient Setup and education | $19.00 - $21.00 | Hws will provide education material , training to onboard patient for digital services( rpm) | $10.00 per active patient per service per month , plate rate |
| 99454 | 16 days of API Device data transmission | $55.00 - $64.00 | HWS provide device , training to use device , shipment of the device to the patient , replacing the device , complete device management, collect physiological data and create escalation for out of range physiological data and send to supervising physician digitally, using dashboard or care App, on physician’s mobile phone | $ 30.00 per active patient per service per month , plate rate |
| 99457 | 20 minutes of data monitoring and response to alerts | $31.55 - $53.00 | Create reports and communicate with patients and physicians throughout the month on behalf of the supervising physician and present all data collected to the supervising physician for review and approval management . | $ 20.00 per active patient per service per month , plate rate |
| 99458 | Additional 20 minutes of data monitoring and response to alerts | $31.55 | Hws provide data and documentation to supervising physician to document additional 20 minutes or more spent on the remote care of the patient | $ 15.00 per active patient per service per month , plate rate |
| Total Monthly flat fee | HWS provides service included in code 99453, 99454, 99457, 99458, including platform use, cost of devices, providing information for bill or billing on behalf of the practice through third party billing ( medical office force). | $55.00 per active patient per month with single or multiple billable codes |
Disclaimer: These numbers are only for information as per Medicare guidelines. Actual numbers may vary depending
on various factors such as patient compliance, region, & eligibility.
CCM FEE
| CPT | Description | Medicare Pays | Description | HWS Fee |
|---|---|---|---|---|
| G0506 | Initial CCM registration Physician perform extensive assessment and CCM Care planning for the coming 12 months and develop CCM Care plan | $61.00 | HWS assist supervising physician on board the patient, identified by supervising physician as high risk, help to educate patient and provide comprehensive care plan for approval by supervising physician | $20.00 per patient once in lifetime |
| 99490 | 20 minutes or more of Clinical Staff time with Non Complex Pt. | $51.00- $64.00 | Provide CCM through trained staff on monthly basis, document and send documentation to the supervising physician e. | $25.00 |
| 99489 | Each 20 minutes of Clinical staff time | Provide CCM through trained staff on monthly basis, document and send documentation to the supervising physician e. | $20.00 | |
| Total per month | Include G0506, 99490, 99489, including platform use, providing information for bill or billing on behalf of the practice through third party billing ( medical office force). | $22.00 Per month per active patient with single or multiple billable codes |
Disclaimer: These numbers are only for information as per Medicare guidelines. Actual numbers may vary depending
on various factors such as patient compliance, region, & eligibility.
RTM FEE
| CPT | Description | Medicare Pays | Description | HWS Fee |
|---|---|---|---|---|
| none | Use of electronic platform only | use of platform for enrolment and monitoring as well creating report for billing | $10.00 per month /patient | |
| None | Use of Software application Medical device ( SaMD) | Device capture non physiological data as per design of the RTM plan | $5.00 per patient per month | |
| 98975 | Remote Therapeutic Monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on the use of equipment. | $19.32 ( One Time) | HWS provide plate form , assist in enrolment and training to staf | $5.00 Per patient , initial charge |
| 98976 | Remote therapeutic monitoring device(s) supplied with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory systems. | $50.15 every 30 days | HWS provides SaMD for collection and monitoring of the non physiological data for the respiratory system. Create escalation for management by providing qualified healthcare worker | $20.00 per active patient per month served |
| 98977 | Remote therapeutic monitoring device(s) supplied with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal systems. | $50.15 | HWS provides SaMD for collection and monitoring of the non physiological data for the Musculoskeletal system. Create escalation for management by providing qualified healthcare worker | $20.00 per active patient per month served |
| 98980 | Remote Therapeutic Monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes | $49.58 | Provide all data and document all interactive communication and prepare report for the qualified healthcare worker justify billing the first 20 minutes of services | $20.00 per active patient per month served |
| 98981 | Remote therapeutic monitoring treatment management services, physician/other qualified health care | 39.65 | Provide all data and document all interactive communication and prepare report for the | $15.00 per active patient per month |
| professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month. | qualified healthcare worker justify billing the subsequent t 20 minutes of services | served | ||
| Total
per
month RTM | Flat rate for monthly RTM service | Include 98975, 98976, 98977. 98980, 98981, including platform use, cost of devices, providing information for bill or billing on behalf of the practice through third party billing ( medical office force). | $33.00 per month per active patient with single or multiple billable codes |
Appendix A HWS Fee for Telemedicine
| CPT | Description | Medicare Pays | Description | HWS Fee |
|---|---|---|---|---|
| 99213 | Telemedicine with established patients using video or phone to manage escalation during rpm, ccm or rtm services, spent 15 minutes in the episode of care . add modifier 95 | $90.82 | HWS provide plate form , care manager connect patient and physician , document conversation and help carryout supervising physician orders | $20.00 per patient per episode |
| 99214 | Telemedicine with established patients using video or phone to manage escalation during rpm, ccm or rtm services, spent 25 minutes in the episode of care . add modifier 95 | $128.43 | HWS provide plate form , care manager connect patient and physician , document conversation and help carryout supervising physician orders | $20.00 per patient per episode |
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