APPENDIX A

The Practice can choose Individual service or a flat rate for the service per active patient per month.
Active patient devine as patient using the service which is billable per medicare guidelines

RPM SERVICE FEE

CPT	Description	Medicare Pays	Description	Paid to Medical Office Force
None	HWS safe digital platform		Hws safe will provide digital plate form and training to the practice staff for its use to provide rpm and ccm, rtm service. The cost include only the platform	$10.00 per active patient per service per month , flat rate. Additional training available for purchase
none	cellular devices, blood pressure , weight, glucometer		Single device, shipping cost, replacement cost, replacement of supply, glucose strips, lancets, ect	$100/per device and then $5 /month for bp and weight machine and $20 /month for glucometer ( cellular fee, glucose strips , lancets , replacement of the non functioning device)
99453	Initial Patient Setup and education	$19.00 - $21.00	Hws will provide education material , training to onboard patient for digital services( rpm)	$10.00 per active patient per service per month , plate rate
99454	16 days of API Device data transmission	$55.00 - $64.00	HWS provide device , training to use device , shipment of the device to the patient , replacing the device , complete device management, collect physiological data and create escalation for out of range physiological data and send to supervising physician digitally, using dashboard or care App, on physician’s mobile phone	$ 30.00 per active patient per service per month , plate rate
99457	20 minutes of data monitoring and response to alerts	$31.55 - $53.00	Create reports and communicate with patients and physicians throughout the month on behalf of the supervising physician and present all data collected to the supervising physician for review and approval management .	$ 20.00 per active patient per service per month , plate rate
99458	Additional 20 minutes of data monitoring and response to alerts	$31.55	Hws provide data and documentation to supervising physician to document additional 20 minutes or more spent on the remote care of the patient	$ 15.00 per active patient per service per month , plate rate
Total Monthly flat fee			HWS provides service included in code 99453, 99454, 99457, 99458, including platform use, cost of devices, providing information for bill or billing on behalf of the practice through third party billing ( medical office force).	$55.00 per active patient per month with single or multiple billable codes

Disclaimer: These numbers are only for information as per Medicare guidelines. Actual numbers may vary depending
on various factors such as patient compliance, region, & eligibility.

CCM FEE

CPT	Description	Medicare Pays	Description	HWS Fee
G0506	Initial CCM registration Physician perform extensive assessment and CCM Care planning for the coming 12 months and develop CCM Care plan	$61.00	HWS assist supervising physician on board the patient, identified by supervising physician as high risk, help to educate patient and provide comprehensive care plan for approval by supervising physician	$20.00 per patient once in lifetime
99490	20 minutes or more of Clinical Staff time with Non Complex Pt.	$51.00- $64.00	Provide CCM through trained staff on monthly basis, document and send documentation to the supervising physician e.	$25.00
99489	Each 20 minutes of Clinical staff time		Provide CCM through trained staff on monthly basis, document and send documentation to the supervising physician e.	$20.00
Total per month			Include G0506, 99490, 99489, including platform use, providing information for bill or billing on behalf of the practice through third party billing ( medical office force).	$22.00 Per month per active patient with single or multiple billable codes

Disclaimer: These numbers are only for information as per Medicare guidelines. Actual numbers may vary depending
on various factors such as patient compliance, region, & eligibility.

RTM FEE

CPT	Description	Medicare Pays	Description	HWS Fee
none	Use of electronic platform only		use of platform for enrolment and monitoring as well creating report for billing	$10.00 per month /patient
None	Use of Software application Medical device ( SaMD)		Device capture non physiological data as per design of the RTM plan	$5.00 per patient per month
98975	Remote Therapeutic Monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on the use of equipment.	$19.32 ( One Time)	HWS provide plate form , assist in enrolment and training to staf	$5.00 Per patient , initial charge
98976	Remote therapeutic monitoring device(s) supplied with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory systems.	$50.15 every 30 days	HWS provides SaMD for collection and monitoring of the non physiological data for the respiratory system. Create escalation for management by providing qualified healthcare worker	$20.00 per active patient per month served
98977	Remote therapeutic monitoring device(s) supplied with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal systems.	$50.15	HWS provides SaMD for collection and monitoring of the non physiological data for the Musculoskeletal system. Create escalation for management by providing qualified healthcare worker	$20.00 per active patient per month served
98980	Remote Therapeutic Monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes	$49.58	Provide all data and document all interactive communication and prepare report for the qualified healthcare worker justify billing the first 20 minutes of services	$20.00 per active patient per month served
98981	Remote therapeutic monitoring treatment management services, physician/other qualified health care	39.65	Provide all data and document all interactive communication and prepare report for the	$15.00 per active patient per month
	professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month.		qualified healthcare worker justify billing the subsequent t 20 minutes of services	served
Total per month RTM	Flat rate for monthly RTM service		Include 98975, 98976, 98977. 98980, 98981, including platform use, cost of devices, providing information for bill or billing on behalf of the practice through third party billing ( medical office force).	$33.00 per month per active patient with single or multiple billable codes

Appendix A HWS Fee for Telemedicine

CPT	Description	Medicare Pays	Description	HWS Fee
99213	Telemedicine with established patients using video or phone to manage escalation during rpm, ccm or rtm services, spent 15 minutes in the episode of care . add modifier 95	$90.82	HWS provide plate form , care manager connect patient and physician , document conversation and help carryout supervising physician orders	$20.00 per patient per episode
99214	Telemedicine with established patients using video or phone to manage escalation during rpm, ccm or rtm services, spent 25 minutes in the episode of care . add modifier 95	$128.43	HWS provide plate form , care manager connect patient and physician , document conversation and help carryout supervising physician orders	$20.00 per patient per episode

APPENDIX A

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