Heart-failure patients whose weight or blood-pressure trends can guide care
Talk with us FOR YOUR PRACTICE · CARDIOLOGY
Turn home signals into timely clinical follow-through.
For appropriate cardiac patients, PrimeVital can support clinician-selected monitoring and follow-up after discharge while your cardiology team directs treatment and escalation.
PATIENT FIT & PROGRAM CHOICES
Start with the patient and the work that needs doing.
Clinical need, an accountable billing practitioner, payer coverage and actual service requirements determine the pathway. A diagnosis alone is not enough.
A complex high-risk cardiac condition needing focused management
Patients returning after a qualifying cardiac hospitalization
01 · CORE MONITORING OPTION
RPM · Home physiologic readings
Use a qualifying connected device when blood pressure or weight trends will inform care. Device transmission and treatment-management time have separate requirements.
Read RPM requirements 02 · DISCHARGE-TRIGGERED OPTIONTCM · Transition after discharge
For a qualifying discharge with contact within two business days, moderate-complexity decision-making and a visit within 14 days for code 99495.
Read TCM requirementsOther pathways to assess separatelyPCM for one complex cardiac condition CCM if this practice owns whole-person care management
Behavioral health can be part of the care plan.
Explore BHI and CoCM General BHI may fit when the treating practitioner and care team provide the required ongoing behavioral-health work. Psychiatric CoCM needs a separate consultant, care manager and registry; it is not assumed in our service example.
Coordinate with primary care and other monitoring services. A diagnosis alone does not establish RPM or TCM eligibility, and discharge follow-up is an episode, not monthly recurring care.
SANTA CLARA COUNTY, CALIFORNIA · ORIGINAL MEDICARE · OCT–DEC 2026
A 100-patient panel: two possible service pathways.
This is one hypothetical period using non-facility Medicare allowed amounts. It is a service-level illustration, not a forecast of eligibility, collections or profit.
$74.79 device supply (99454) + $66.49 first 20 minutes of management (99457) per qualifying patient, each only when its requirements are met.
$279.94 per qualifying 99495 episode. This requires timely contact, moderate-complexity decision-making and a face-to-face visit within 14 days; it is not recurring monthly revenue.
Before cost share, sequestration, denials, payer contracts, PrimeVital fees, device costs and practice oversight. This is neither expected collections nor practice profit.
The 60 RPM months and 3 TCM episodes are independent assumptions within a 100-person panel. TCM is limited to eligible discharges, not every patient every month. PCM or CCM may fit other patients, but is not included in this total.
Before we quote your practice: we check payer mix, who already bills each service, eligibility, documentation, place of service, cost share and actual operating fees. Behavioral health integration is a separate clinical pathway and is not assumed in these figures.
Sources: CMS RVU26D and the 2026 carrier file for amounts; CMS remote monitoring, care management FAQ, TCM and BHI for requirements.
HOW WE WORK WITH YOUR PRACTICE
We can run the operational work without adding a new in-house coordinator.
Scope, access and escalation responsibilities are set in the agreement. Your practice retains clinical authority and billing accountability.
PrimeVital can operate
- Patient list preparation, onboarding and permitted outreach
- Device and transmission support where RPM fits
- Care-team follow-up, task routing and documented handoffs
- Exception review, evidence tracking and RCM handoff
Your clinical team directs
Your cardiologist selects patients, defines clinical thresholds, makes treatment decisions, reviews escalations and remains responsible for claims.
No new dedicated coordinator is assumed in the illustration; clinician oversight and responses remain necessary.
Patient at homePrimeVital care operationsTreating specialistDocumented service & claim review
DESIGN A PRACTICAL STARTING POINT
Tell us where the workflow is breaking. We’ll show you where to begin.
Send us a message
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