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Remote Patient Monitoring Maryland

Maryland Medicaid department may provide reimbursement for services delivered through remote patient monitoring technology.


Source: Health General Code 15-105.2. (Accessed Sept. 2019). 


MD Medicaid reimburses for remote patient monitoring for certain chronic conditions. 
Preauthorization requirements apply.


Source: Remote Patient Monitoring. MD Department of Health. (Accessed Sept. 2019). 


No reimbursement for home health monitoring services under telehealth manual.


Source: MD Medicaid Telehealth Program. Telehealth Provider Manual. Updated May 2, 2018. p. 5, (Accessed Sept. 2019). 


Conditions


Medicaid recipients diagnosed with one of the following conditions qualify:


• Chronic Obstructive Pulmonary Disease
• Congestive Heart Failure
• Diabetes (Type 1 or 2)


The participant must be enrolled in Medicaid, consent to RPM, have an internet connect and capability to use monitoring tools and have one of the following scenarios within the most recent 12-month period:Two hospital admissions with the same qualifying medical 
condition as the primary diagnosis


• Two hospital admissions with the same qualifying medical condition as the primary diagnosis
• Two emergency room department visits with the same qualifying medical condition as the primary diagnosis
• One hospital admission and one emergency department visit with the same qualifying medical condition as the primary diagnosis.


Source: MD Home Health Transmittal No. 64. Jan. 10, 2018. (Accessed Sept. 2019). 


Provider Limitations


Eligible Providers:


• Home Health Agencies
• Hospitals
• Clinics
• Federally Qualified Health Centers
• Managed Care Organizations
• Health Professionals (Physicians, Nurses, Physician Assistants)


Source: Remote Patient Monitoring. MD Department of Health. (Accessed Sept. 2019). 

Preauthorization required.


RPM reimbursement rate covers equipment installation, participant education for using the equipment, and daily monitoring of the information transmitted for abnormal data measurements. 
Reimbursement does not include RPM equipment, upgrades to RPM equipment or internet service for participants.


Source: MD Home Health Transmittal No. 64. Jan. 10, 2018. (Accessed Sept. 2019).