Medicare Administrative Contractors Decline Issuing New Coverage Restrictions for Remote Physiologic Monitoring (RPM) Services
May 30, 2023 - On February 28th, Medicare Administrative Contractors (MACs) held a "Multi-Jurisdictional Contractor Advisory Committee" to discuss clinical use scenarios, available data, and potential new local coverage determinations (LCDs) for remote physiologic monitoring and remote therapeutic monitoring for non-implantable devices.
On February 28th, Medicare Administrative Contractors (MACs) held a "Multi-Jurisdictional Contractor Advisory Committee" to discuss clinical use scenarios, available data, and potential new local coverage determinations (LCDs) for remote physiologic monitoring and remote therapeutic monitoring for non-implantable devices.
- The discussion questions that served as the framework for the discussion can be found here.
- A link to the transcript of the call is available here.
- A link to a recording of the discussion can be found here.
After input provided on the call, including that of several electrophysiologists and cardiologists, , Novitas, one of the MACs that hosted the event, announced in its "LCD Center" that there will be no coverage changes or new LCDs developed that could have potentially restricted coverage or utilization of these services. As posted on Novitas' website:
Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) comment update
"We greatly appreciate the comments and evidence we received as a result of the multi-jurisdictional Contractor Advisory Committee (CAC) meeting that was held on February 28, 2023, regarding Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) for Non-implantable Devices. After careful consideration, Novitas Solutions and First Coast Service Options will not develop a Local Coverage Determination (LCD) for RPM and RTM for Non-implantable Devices. All the information and feedback received, along with any new evidence that becomes available, will be carefully considered if we decide to develop an LCD in the future.
Please keep in mind that we do not have a policy to match every procedure code, diagnosis code, or service reportable to Medicare. In some instances, we may have an LCD that is not applicable to all providers or services. In the absence of an LCD, NCD, or CMS Manual Instruction; reasonable and necessary guidelines still apply to any service reported to Medicare."