Is the 16-Day RPM Rule No Longer a Revenue Barrier for OBGYNs?

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The 16-day RPM rule is becoming less of a revenue barrier for OBGYNs due to regulatory clarifications, improved device compliance, and better billing workflows. Previously, the requirement that remote patient monitoring (RPM) devices collect data for at least 16 days per 30-day period limited reimbursement opportunities. For OBGYN practices managing pregnancy-related monitoring and chronic maternal conditions, this rule often restricted consistent RPM reimbursement . Recent operational adjustments and clearer CMS guidance are changing how practices approach RPM billing for OBGYNs . What Is the 16-Day RPM Rule? The 16-day RPM rule requires that patient monitoring devices record and transmit data for at least 16 days within 30 days to qualify for monthly RPM reimbursement. This rule was designed to ensure consistent patient engagement, but it created challenges in: Short-term pregnancy monitoring Intermittent blood pressure tracking Gestational diabetes management Post...
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ASC Coding And Billing: Knowing What’s Important

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The basics of ASC Coding And Billing aren’t hard to master, but they do differ from physician and facility requirements. The following overview will help you know what’s most important in the ASC setting. ASCs use a combination of hospital and physician billing. Although ASCs use CPT and HCPCS Level II codes to bill most of their services (as do physicians), some payers will allow an ASC to bill ICD-10-CM procedure codes (like a hospital). Some payers even base implant reimbursement on revenue code classification.

One of the most fundamental differences between billing for professional services and billing for ambulatory surgery center services is the concept of the global surgical package. The global package applies to the professional component of a surgical service that is performed when using a surgical CPT code. On the professional side, this typically encompasses a 90-day follow-up. In the ASC billing methodology, no such surgical package exists.

Therefore, each time a patient enters the operating room represents a unique and separate encounter and has no historical economic relationship to previous encounters. This is a very important difference and very often leads to the need for qualifying modifiers. Those modifiers tend to clarify a situation such as returning to the operating room on the same day or returning to the operating room by another doctor on a different date.

To know more about ASC Coding And Billing: Knowing What’s Important click here: bit.ly/3EFQc8y Contact us at info@medicalbillersandcoders.com/ 888-357-3226.

Location: United States

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