Common use of RPM Clause in Contracts

RPM. As of July 1, 2024, as further specified by EOHHS, certain services, provided by a physician, community health center, or hospital, to facilitate close, in-home monitoring of Enrollees who are pregnant, postpartum, have congestive heart failure, chronic obstructive pulmonary disease, or other conditions specified by EOHHS. 2) COVID-19 RPM - bundled services to facilitate home monitoring of Enrollees with confirmed or suspected COVID-19 who do not require emergency department or hospital level of care but require continued close monitoring. The COVID-19 RPM bundle includes all medically necessary clinical services required to facilitate seven days of close, in-home, monitoring of members with confirmed or suspected COVID- 19. Details around MassHealth’s coverage of the RPM bundle can be found in All Provider Bulletin 294, as may be updated from time to time. The Contractor must cover the RPM bundle of services in the method and manner specified in All Provider Bulletin 294, as may be updated from time to time, when such services are delivered as Medicaid services. The Contractor may determine their own rate of payment for the RPM bundle of services. ✓ ✓ ✓ Coverage Types Service MassHealth Standard & CommonHealth Enrollees MassHealth Family Assistance Enrollees CarePlus School Based Health Center Services – all ACO Covered Services set forth in this Appendix C delivered in School Based Health Centers (SBHCs). ✓ ✓ 1) Physical: evaluation, treatment, and restoration to normal or best possible functioning of neuromuscular, musculoskeletal, cardiovascular, and respiratory systems. 2) Occupational: evaluation and treatment designed to improve, develop, correct, rehabilitate, or prevent the worsening of functions that affect the activities of daily living that have been lost, impaired, or reduced as a result of acute or chronic medical conditions, congenital anomalies, or injuries. 3)

RPM. As of July 1, 2024, as further specified by EOHHS, certain services, provided by a physician, community health center, or hospital, to facilitate close, in-home monitoring of Enrollees who are pregnant, postpartum, have congestive heart failure, chronic obstructive pulmonary disease, or other conditions specified by EOHHS. 2) COVID-19 RPM - bundled services to facilitate home monitoring of Enrollees with confirmed or suspected COVID-19 who do not require emergency department or hospital level of care but require continued close monitoring. The COVID-19 RPM bundle includes all medically necessary clinical services required to facilitate seven days of close, in-home, monitoring of members with confirmed or suspected COVID- 19. Details around MassHealth’s coverage of the RPM bundle can be found in All Provider Bulletin 294, as may be updated from time to time. The Contractor must cover the RPM bundle of services in the method and manner specified in All Provider Bulletin 294, as may be updated from time to time, when such services are delivered as Medicaid services. The Contractor may determine their own rate of payment for the RPM bundle of services. ✓ ✓ ✓    Coverage Types Service MassHealth Standard & CommonHealth Enrollees MassHealth Family Assistance Enrollees CarePlus School Based Health Center Services – all ACO Covered Services set forth in this Appendix C delivered in School Based Health Centers (SBHCs). ✓ ✓  1) Physical: evaluation, treatment, and restoration to normal or best possible functioning of neuromuscular, musculoskeletal, cardiovascular, and respiratory systems. 2) Occupational: evaluation and treatment designed to improve, develop, correct, rehabilitate, or prevent the worsening of functions that affect the activities of daily living that have been lost, impaired, or reduced as a result of acute or chronic medical conditions, congenital anomalies, or injuries. 3)

RPM. As of July 1, 2024, as further specified by EOHHS, certain services, provided by a physician, community health center, or hospital, to facilitate close, in-home monitoring of Enrollees who are pregnant, postpartum, have congestive heart failure, chronic obstructive pulmonary disease, or other conditions specified by EOHHS. 2) COVID-19 RPM - bundled services to facilitate home monitoring of Enrollees with confirmed or suspected COVID-19 who do not require emergency department or hospital level of care but require continued close monitoring. The COVID-19 RPM bundle includes all medically necessary clinical services required to facilitate seven days of close, in-home, monitoring of members with confirmed or suspected COVID- 19. Details around MassHealth’s coverage of the RPM bundle can be found in All Provider Bulletin 294, as may be updated from time to time. The Contractor must cover the RPM bundle of services in the method and manner specified in All Provider Bulletin 294, as may be updated from time to time, when such services are delivered as Medicaid services. The Contractor may determine their own rate of payment for the RPM bundle of services. ✓ ✓ ✓ Coverage Types Service MassHealth Standard & CommonHealth Enrollees MassHealth Family Assistance Enrollees CarePlus School Based Health Center Services – all ACO MCO Covered Services set forth in this Appendix C delivered in School Based Health Centers (SBHCs). ✓ ✓ 1) Physical: evaluation, treatment, and restoration to normal or best possible functioning of neuromuscular, musculoskeletal, cardiovascular, and respiratory systems. 2) Occupational: evaluation and treatment designed to improve, develop, correct, rehabilitate, or prevent the worsening of functions that affect the activities of daily living that have been lost, impaired, or reduced as a result of acute or chronic medical conditions, congenital anomalies, or injuries. 3)