What is Remote Patient Monitoring (RPM)?

One of the most interesting trends of today’s healthcare climate is the increased adoption of virtual healthcare services and delivery systems. This includes remote patient monitoring (RPM), also described as remote physiologic monitoring. RPM was a concept foreign to most individuals before 2020, but that is changing as providers increasingly adopt the service and prescribe it to their patients.

Still, many people still lack a firm understanding of remote patient monitoring. This guide provides a definition of RPM and contrasts the concept of remote patient monitoring with other terms often associated with it.

For a better understanding of an appropriate RPM definition, let’s review how three medical organizations and associations describe remote patient monitoring:

U.S. Government Accountability Office states, "Remote patient monitoring refers. to a coordinated system that uses one or more home-based or mobile monitoring devices that transmit vital sign data or information on activities of daily living that are subsequently reviewed by a healthcare professional.”	Medical Group Management Association (MGMA) states, “In simple terms, RPM is a device that collects patient data and transmits it via the internet to a physician. The collected data allows a physician to monitor changes in patient vital signs and act accordingly.”	CCHP states, “Remote patient monitoring (RPM) is the collection of a wide range of health data from the point of care, such as vital signs, weight, and blood pressure. The data is transmitted to health professionals in facilities such as monitoring centers in primary care settings, hospitals and intensive care units, and skilled nursing facilities.”

Based on these definitions and research we conducted as part of the development of the Prevounce remote patient monitoring software and Pylo connected patient device program, we came up with our own definition. The following is shared on our FAQs resource page “RPM is the use of digital technologies to monitor and capture medical and other health data from patients and electronically transmit this information to healthcare providers for assessment and, when necessary, recommendations and instructions. RPM allows providers to continue tracking health care data for patients once they are discharged. It also encourages patients to take more control of their health.” Though many people use the terms remote patient monitoring and telehealth interchangeably, doing so is incorrect.

Remote Patient Monitoring vs Telehealth

To be clear, remote patient monitoring is a subset of telehealth. RPM is also not part of telemedicine, which is a different subset of telehealth.

This must be clarified because while the definition of remote patient monitoring may seem straightforward, there is some confusion about the concept, including how it differs from telehealth. Distinguishing between RPM and telehealth is important for several reasons, including coding and billing purposes.

First, let’s investigate this question: “How is remote patient monitoring different from telehealth?” A Medicaid resource states, “Telehealth includes such technologies as telephones, facsimile machines, electronic mail systems, and remote patient monitoring devices, which are used to collect and transmit patient data for monitoring and interpretation. While they do not meet the Medicaid definition of telemedicine, they are often considered under the broad umbrella of
telehealth services."

We distinguish between the terms as such:

You can further appreciate the difference between remote patient monitoring and telehealth by briefly reviewing Medicare coding and billing guidelines. As of January 2022, there are five CPT codes covering RPM: CPT 99453, CPT 99454, CPT 99457, CPT 99458, and CPT 99091. None of these codes are included in the lengthy list of 2019 calendar year Medicare telehealth services codes, which cover everything from individual and group kidney disease education services, psychiatric diagnostic interview exams, advance care planning, smoking cessation services, psychoanalysis, and the annual wellness visit (AWV).

Providers delivering remote physiologic monitoring services will want to ensure they use the proper RPM CPT codes when submitting claims. (Note: If you are interested in learning more about coding and billing for RPM, download our free RPM Billing Guide.) In addition to making these distinctions, it’s also important to delineate between RPM and patient monitoring to obtain a clearer understanding.

Remote Patient Monitoring vs. Patient Monitoring

While remote patient monitoring is sometimes confused with patient monitoring as the concepts do overlap in some regards, their difference is important. The National Cybersecurity Center of Excellence (NCCoE), part of the National Institute of Standards and Technology, does a nice job of simplifying RPM vs. patient monitoring when it states the following: “Traditionally, patient monitoring systems have been deployed in healthcare facilities, in controlled environments. Remote patient monitoring (RPM), however, is different in that monitoring equipment is deployed in the patient’s home. These new capabilities, which can involve third-party platform providers utilizing video conferencing capabilities, and leveraging cloud and internet technologies coupled with RPM devices, are used to treat numerous conditions, such as patients battling chronic illness or requiring post-operative monitoring.

Note: RPM is also different from remote therapeutic monitoring (RTM), which is a series of five treatment management service codes. Learn more about RTM here. Now that we have defined RPM, let’s gain a better understanding of the service.

How Does Remote Patient Monitoring Work?

Even after understanding the definition of RPM, you still may experience a bit of confusion about how RPM works. On the surface, it’s relatively straightforward, but a closer examination is necessary. Let’s look at some common facts about the RPM process:

1. A provider identifies the condition(s) to manage remotely and launches a remote patient monitoring program to offer an RPM service to patients. Providers can use remote patient monitoring to collect a wide range of patient health data. This includes blood pressure, heart rate, vital signs, weight, and blood sugar levels.
2. A provider determines that a patient would benefit from remote physiologic monitoring of one or more of the types of health data that can be captured via RPM. With the patient’s consent, the provider orders or prescribes RPM.
   
   
3. The patient is provided with a device to collect the health data. Remote patient monitoring devices must be electronically connected, which is most often accomplished via cellular networking or Bluetooth. The most common RPM devices are blood pressure monitors, weight scales, blood glucose meters, and spirometers. Other device types that are seeing increased RPM use include pulse oximeters and ECG machines.
   
   
4. Once the device is set up appropriately, health data is captured by the device and transmitted from patient to provider, usually electronically.
   
   
5. The provider analyzes this data and gives the patient health and wellness guidance and directions based upon the results.

To deliver remote patient monitoring services, providers will need to complete other steps, including determining coverage (if considering providing RPM to non-Medicare beneficiaries), establishing a patient base, choosing a device(s), setting up a patient intake program, developing policies and procedures, and training staff. Note: By partnering with a good RPM program vendor, providers will not need to complete some of these steps and will receive assistance with others.

For patients, the ease of their receiving remote patient monitoring will primarily depend upon the design and/or complexity of the devices provided to them. Patients may require assistance (in-person or virtual) to use the technology.

Understanding what RPM is and how it works is only the first step. Providers are increasingly considering the many benefits that it will provide to their organizations.