OMS C3® (Chronic Care Management)

CMS announced in the 2019 Medicare Physician Fee Schedule Final Rule that it would reimburse three new RPM codes approved by the CPT Editorial Panel in September 2018, effective January 1, 2019:

CPT 99453: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.

CPT 99454: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; each 30 days.

CPT 99457: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.

The OMS C3™ platform supports Remote Physiological Monitoring (RPM) of patients by offering a comprehensive Blue Tooth Enabled devices (BP Monitor, Weight Scale etc.) solution. This service offering provides tremendous power to the practice to be proactive in the management of patients with chronic diseases like Hypertension, Heart Failure and Atrial Fibrillation.

Effective January 1, 2020, CMS reimburses for principal care management (PCM) furnished to beneficiaries with a single chronic condition to stabilize that condition following exacerbation or hospitalization. PCM focuses on disease specific care and is an ideal care management program to be delivered by specialists.

G2065: PCM services furnished by clinical staff under general supervision

G2064: PCM services furnished directly by a practitioner

The OMS C3® platform supports Principal Care Management (PCM) of patients by offering a comprehensive workflow, documentation, and billing solution. The PCM solution can be delivered to patients in conjunction with Remote Patient Monitoring. This combined offering can be a force multiplier in improving patient care and increased practice earnings.

The OMS C3® health monitoring platform empowers physicians to manage patients with chronic diseases remotely. The platform enables the secure remote management of the patient by facilitating physiologic data capture as well as promoting secure online collaboration with the patient.

The OMS C3® health monitoring platform enables the practice to participate in the Chronic Care Management Program

Chronic Care Management (CCM) are services delivered by a physician or non-physician practitioner (Physician Assistant, Nurse Practitioner, Clinical Nurse Specialist and/or Certified Nurse Midwife) and their clinical staff, per calendar month, for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until death, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

CMS established significant rule changes in November 2016 to further address the needs of clinicians and suppliers, including 3 billing codes to ensure practitioners are compensated for time and resources spent providing coordinated care in the delivery of chronic care management services.

Cardiology specialty practices typically manage a large cohort of chronically ill patients (typically 68-70%) and this program provides an opportunity to provide high-quality care for patients and also be reimbursed for the non-face-to-face care.