Skip to main content
x

Remote Patient Monitoring Vermont

Vermont Medicaid is required to cover home remote patient monitoring services performed by home health agencies or other qualified providers for beneficiaries who have serious or chronic medical conditions. 


Source: VT Statutes Annotated Title 33 Sec. 1901g(a). (Accessed Sept. 2019).


Home telemonitoring is a Medicaid benefit.


Source: Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 141-142 (Feb. 2019). (Accessed Sept. 2019).


Conditions


Individuals receiving Medicaid telemonitoring services must have Congestive Heart Failure (any diagnosis; 428.xx).


Source: Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 141 (Feb. 2019). (Accessed Sept. 2019). 


Provider Limitations


Qualified providers are home health agencies enrolled with Vermont Medicaid.


The following healthcare professionals can review data:


• Registered nurse
• Nurse practitioner
• Clinical nurse specialist
• Licensed practice nurse under supervision of RN
• Physician assistant


Source: Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 141-142 (Feb. 2019). (Accessed Sept. 2019).


Other Restrictions


Individuals receiving Medicaid telemonitoring must:


• Have Medicaid as primary insurance or be dually eligible with non-home bound status; and
• Have congestive heart failure; and
• Be clinically eligible for home health services; and
• Have a physician’s plan of care with an order for telemonitoring services


Source: Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 141-142 (Feb. 2019). (Accessed Sept. 2019). 


Must be provided by a provider who is working within the scope of his or her practice and enrolled in Vermont Medicaid.


Source: VT Agency of Human Services. Health Care Administrative Rules. 3.101.2(b) (Jan. 2019) & Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 141 (Feb. 2019). (Accessed Sept. 2019).


Qualified providers may bill once in every 30 days, including all necessary equipment; computer system, connections, and software; maintenance; patient education and support; per month. CPT 98969 may be billed once every 7 days for ongoing assessment and management of telemonitoring data. 


Source: Dept. of VT Health Access, Green Mountain Care Provider Manual, p. 142 (Feb. 2019). (Accessed Sept. 2019).