CMS posts national reimbursement rate for wireless heart monitoring

By Brian Dolan
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CardioNet patient monitorBig news for anyone concerned about reimbursement issues for wireless health: CardioNet, which leverages wireless technology to diagnose and monitor cardiac arrhythmias, announced this week that the Centers for Medicare and Medicaid Services (CMS) has established a national rate for the technical component of mobile cardiovascular telemetry (MCOT). CardioNet said that the rate is approximately $800 and is expected to become effective on the first of the year. The new price will replace the current carrier price of $754, which CMS contractor Highmark Medicare Services established last year.

"We are pleased that our ongoing dialogue with CMS over the last two years culminated in a national price," Joseph Capper, president and CEO of CardioNet stated in a company press release. "We believe that this sends a clear message that MCOT is an established, accepted technology that is critical to providing better patient care to Medicare beneficiaries nationwide."

CardioNet's prospects stumbled a bit last year when Highmark announced that it would reduce its reimbursement rate for CardioNet and other MCOT solution providers (i.e. LifeWatch, eCardio, Corventis) from more than $1,100 to $754. (Highmark is a CMS contractor for Delaware, New Jersey, Pennsylvania, Maryland and the Washington DC area.) The national rate of $800 announced by CMS this week is welcome news but it still does not come close to restoring the original reimbursement rate. Of course, this new national rate is only for the technical component of MCOT solutions.

"It is good news that the CPT code is finally resolved," CardioNet founder and former president and CEO James Sweeney (current CEO of PatientSafe Solutions) told MobiHealthNews in an email. "Now physician reimbursement needs to be dramatically improved to reflect the increased work load involved in caring for MCOT patients."

As Sweeney implies, better reimbursement for the service component of these wireless remote patient monitoring services will help drive adoption.

Read on below for a recap of the reimbursement saga that CardioNet has battled these past few years.

CardioNet founder Jim Sweeney explains importance of CPT codes
New billing codes for cardiac telemetry, Cardionet
CardioNet tries to quash reimbursement rate cut rumors
Report: CMS to cut CardioNet's reimbursement rate?
Sequoia Capital invests in CardioNet competitor, eCardio
CMS slashes CardioNet's reimbursement rate
CardioNet cancels Biotel acquisition agreement
Reimbursement rate cut takes effect in September

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