Effective October 1st 2013 Texas Medicaid approved procedure code 99090 for deploying vital sign monitors into the home for a reimbursement of $50. Use this same code along with modifier GQ and receive $9.45 a day to monitor the patient. For a typical 60 day episode the total reimbursement would be $617 per qualifying diabetic and/or hypertensive patient.
This new reimbursement is a no brainer. Medicaid is genuinely trying to help agencies watch the patients every day while helping the patient to be more involved in their health management. This will result in fewer hospitalizations for those patients being monitored.
To incentivize the adoption by doctors, they too receive a new reimbursement. The code is 99444. This new code pays $57.20, to review the patient’s vitals once every seven days.