We are making an improvement to how RPM and RTM active day billing works to ensure billing is more accurate and aligned with actual patient usage.
What’s changing?
Active day billing for RPM and RTM is moving from a calendar-month model to a rolling 30-day billing cycle.
The update will go live on January 29
Patient activity starting January 1 will be calculated using this new 30-day billing logic
This means billing will be based on a patient’s actual activity period rather than resetting at the end of each calendar month.
How will this work?
For existing patients
All existing patients will be aligned to a rolling 30-day billing cycle based on activity starting January 1
Each subsequent cycle will continue in rolling 30-day periods
For new patients
The 30-day billing cycle will begin from the date of the patient’s first successful reading
The onboarding date does not determine the billing cycle
Example
Patient onboarded: February 5
First reading taken: February 10
Billing cycles:
February 10 – March 11
March 12 – April 10
And so on
What is not changing?
There is no change to:
Time-based RPM or RTM codes
Clinical workflows
Device usage requirements
How this appears in reports and the platform
Billing reports will show an Active Day Billing Cycle (e.g., Feb 10 – Mar 11), Compliance, and Active days for that billing period, and the DOS of the active days' codes
Example: DOS for active days:
Example: Billing Cycle, Compliance, and Active days
Patient listings will show CPT codes with the DOS on mouse over
Example: 99454*
PDF will display the active day billing cycle on the top right, underneath the reporting period
Why does this change help you
More accurate billing tied to real patient activity
Clearer visibility into compliance and active days
Fewer edge cases caused by calendar month cutoffs
Better alignment with payer expectations around Date of Service
What you need to do
Nothing. This update is fully handled within the platform, and your workflows can continue as usual.
If you have questions or would like to review how this looks for your patients, your Account Manager is happy to walk you through it.