Respiri Limited: AMA's Support for RPM Enhances Growth Prospects
RSH (RSH) Share Update November 2024 Monday 4th
Respiri Limited Gains Boost from AMA's Support for Remote Patient Monitoring
The American Medical Association (AMA) has announced significant changes to reimbursement criteria for Remote Patient Monitoring (RPM), which are set to benefit Respiri Limited (ASX:RSH; OTCQB:RSHUF), an eHealth SaaS company.
Instant Summary:
- AMA proposes changes to RPM reimbursement criteria effective January 2026.
- CPT code 99454 revised from 16 to 2 days of data collection.
- CPT code 99457 revised to 11-20 minutes of communication time.
- CPT code 99458 revised to cover each additional 10 minutes.
- Potential increase in Respiri's RPM program patient reimbursement from 50%-70% to 90%.
Proposed Changes and Impact
The American Medical Association (AMA) has proposed revisions to the reimbursement criteria for Remote Patient Monitoring (RPM) programs, effective January 2026. These changes aim to enhance patient access and simplify the process for healthcare providers to claim reimbursed services.
Key changes include the revision of CPT code 99454, reducing the requirement from 16 days to just 2 days of collected and transmitted data in a 30-day period. Additionally, CPT code 99457 will now include 11-20 minutes of interactive communication, down from the previous minimum of 20 minutes. CPT code 99458 will cover each additional 10 minutes of communication, down from an additional 20 minutes.
Financial Implications
These changes are expected to significantly impact Respiri Limited's financial performance. The revised CPT code 99454 could increase the number of Respiri-managed patients qualifying for monthly reimbursement from 50%-70% to 90%, potentially adding over US$108,000 annually for every 1,000 patients in their RPM program.
Moreover, with changes to CPT codes 99457 and 99458, Respiri projects a 100% increase in monitoring services delivered by their clinical staff. This could raise Respiri's per patient per month (pppm) fees from US$70-US$90 to US$140-US$180, although new reimbursement rates are yet to be finalized by the Centers for Medicare and Medicaid Services (CMS).
Strategic Validation
The AMA's proposed changes further validate Respiri's strategic approach to establishing a comprehensive suite of Connected Care Management programs. These programs aim to reduce hospital readmission rates and emergency department visits, demonstrating the AMA's ongoing commitment to these essential healthcare services.
The AMA's endorsement of RPM and the proposed changes to reimbursement criteria are likely to have a positive impact on Respiri Limited's stock. The potential increase in patient reimbursement and service delivery fees could bolster Respiri's revenue and growth trajectory. This development underscores the growing importance of RPM in the healthcare landscape.
Investor Reaction:
Analysts are expected to react positively to the AMA's announcement, as it aligns with the broader trend of integrating technology into healthcare. The potential for increased revenue and improved patient outcomes makes Respiri an attractive prospect for investors.
Conclusion:
Investors should consider the long-term growth potential of Respiri Limited as RPM becomes an integral part of healthcare delivery. The AMA's support and the expected changes in reimbursement criteria present a promising opportunity for Respiri to expand its market presence and enhance shareholder value.