When developing new medical device and drug products, it is important to understand how the product will be adopted and paid for in the marketplace. The development of new drugs and devices involves countless hours researching, testing, modifying, iterating, and testing some more… In larger companies, whole teams of people also dedicate the same effort into developing a market access plan—meaning careful planning for manufacturing, distribution, and insurance contracting. This strategic planning can be overlooked in start-up biotech companies operating on limited resources and which are squarely focused on innovating new technologies.
On July 29, 2019, the Center for Medicare and Medicaid Services (“CMS”) released its proposed rule for the 2020 Medicare Physician Fee Schedule (the “2020 MPFS”).
The final 2019 Medicare Physician Fee Schedule, released by CMS on November 1, 2018, includes a new code that physicians may use to bill for remote evaluation of images to determine whether or not an in-person office visit is necessary. Learn more about HCPCS Code G2010 and how it can be used in medical practices.
With the July 12, 2018 release of its proposed Medicare Physician Fee Schedule for 2019, CMS further opened the door for use and reimbursement of Remote Patient Monitoring (or Remote Physiologic Monitoring, "RPM") services. In doing so, CMS recognizes the role that new communications technologies play in increasing patient engagement and reducing unnecessary costs.
The Bipartisan Budget Act of 2018 contains important changes to federal law related to reimbursement for and use of telemedicine, signaling Congress's continuing confidence in telemedicine's potential to improve care and reduce costs.
Two Final Rules issued by CMS in November 2017 opened up entirely new avenues for reimbursement of Remote Patient Monitoring services in 2018, creating the potential for better patient outcomes and a boost to a medical practice's bottom line.