InstaMD
Enterprise connected-care solutions

Programs built around clinical need, patient eligibility and provider workflow.

Deploy one focused program or combine multiple services through a coordinated operating model designed to support medical necessity, patient engagement, documented care and claim readiness.

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RPMKidney CareCardiometabolicPulmonaryPost-AcuteCare ManagementEnterprise
Program portfolio

Patient and provider eligibility by solution

Eligibility is a clinical and payer-specific determination. The criteria below are practical program-screening guidelines, not a guarantee of coverage or payment.

RPM

Remote Physiologic Monitoring

Connected devices, onboarding, daily data flow, exception-based review, patient communication and documentation support.

Patient eligibility

  • Acute or chronic condition where physiologic data can inform treatment.
  • Examples include hypertension, heart failure, CKD, diabetes, COPD, obesity and post-discharge risk.
  • Patient or caregiver can use a connected medical device with support.
  • Ordering practitioner documents medical necessity and a monitoring plan.
  • Patient consents and understands expected measurement frequency and communication.

Provider eligibility

  • Physician or other qualified health care professional permitted to order and bill under applicable rules.
  • Established treatment relationship and responsibility for the monitored condition.
  • Clinical staff may support treatment management under required supervision.
  • Practice maintains protocols for alerts, escalation, documentation and emergency redirection.
  • Billing entity verifies Medicare and payer-specific enrollment, place-of-service and coverage rules.

InstaMD operating model

  • Cellular blood pressure, weight, pulse oximetry and glucose workflows.
  • Patient setup, education, logistics and adherence outreach.
  • Configurable thresholds with clinical review queues and escalation records.
  • Interactive communication and cumulative treatment-management time capture.
  • Device-day and code-readiness reporting for 99445, 99454, 99470, 99457 and 99458.
99453Initial setup and patient education
99445Device supply with 2–15 days of transmitted readings in 30 days
99454Device supply with 16–30 days of transmitted readings in 30 days
99470First 10 minutes; used for 10–19 total treatment-management minutes
99457First 20 minutes of treatment management
99458Each additional 20 minutes
CKD

Kidney Disease, Dialysis and Transplant Readiness

Longitudinal support for CKD progression, blood-pressure and weight trends, missed-treatment prevention, medication adherence and transplant pathway coordination.

Patient eligibility

  • CKD stages 3–5, ESRD, home dialysis or high-risk nephrology population.
  • Uncontrolled blood pressure, fluid-management risk, repeated missed dialysis or recent utilization.
  • CKD stage 4–5 patient who may benefit from transplant education and referral screening.
  • Clinical need for weight, blood pressure, glucose or oxygen monitoring.
  • Patient agrees to coordinated outreach and specialty care-plan participation.

Provider eligibility

  • Nephrologists, transplant clinicians, primary care practitioners and qualified care teams.
  • Dialysis and specialty organizations operating under appropriate practitioner oversight.
  • Documented responsibility for treatment decisions and referral follow-through.
  • Defined escalation plan for fluid gain, severe blood pressure, symptoms and missed treatment.
  • Separate documentation when RPM is combined with CCM, PCM or other services.

Program capabilities

  • Interdialytic weight and blood-pressure surveillance.
  • Missed-treatment outreach and care-team notification.
  • Medication reconciliation and education support.
  • Transplant eligibility screening, referral tracking and center coordination.
  • Enterprise dashboards by practice, provider, location and risk cohort.
Cardiometabolic

Hypertension, Heart Failure and Diabetes

Patient eligibility

Patients with uncontrolled blood pressure, heart-failure fluid risk, diabetes requiring trend visibility, medication changes, recent hospitalization or elevated utilization risk.

Provider eligibility

Primary care, cardiology, endocrinology, nephrology and qualified practitioners responsible for active treatment and escalation decisions.

  • Blood pressure, weight, glucose and pulse-ox trends
  • Medication and symptom outreach
  • Post-discharge surveillance
  • Risk-based clinical queues
Pulmonary

COPD and Respiratory Monitoring

Patient eligibility

Patients with COPD or other chronic respiratory disease, oxygen use, recurrent exacerbation, recent discharge or a need for pulse-ox and symptom monitoring.

Provider eligibility

Pulmonology, primary care, hospitalist and post-acute practitioners with authority to evaluate trends and modify the care plan.

  • Pulse oximetry and symptom checks
  • Exacerbation-risk escalation
  • Medication adherence support
  • Emergency symptom redirection
Transitions

Post-Discharge and High-Risk Recovery

Patient eligibility

Patients leaving a hospital, ED, SNF or other care setting who need short-interval monitoring, medication reconciliation, follow-up coordination or deterioration surveillance.

Provider eligibility

Discharging or community practitioners who assume ongoing responsibility and can meet applicable transition, monitoring and follow-up requirements.

  • Rapid device deployment
  • Discharge-plan reinforcement
  • Appointment and medication follow-up
  • Escalation closure tracking
Longitudinal care

CCM and Principal Care Management Support

Patient eligibility

CCM generally serves patients with multiple chronic conditions expected to last at least 12 months or until death and that place the patient at significant risk. PCM focuses on one serious, high-risk chronic condition requiring condition-specific management.

Provider eligibility

Eligible physicians and qualified health care professionals with an established care relationship, comprehensive or condition-specific care plan, consent and required access and continuity processes.

  • Care-plan development and maintenance
  • Structured monthly outreach
  • Medication and referral coordination
  • Distinct time and activity records
ENT

Enterprise Population Health and Revenue Operations

One operating layer for multispecialty groups, IPAs, ACOs, health systems and value-based organizations.

Organization fit

  • Multi-location or multispecialty provider groups.
  • Organizations managing Medicare, Medicare Advantage or commercial populations.
  • Teams seeking standardized enrollment, monitoring, documentation and billing workflows.
  • Risk-bearing entities focused on engagement, utilization and quality.

Implementation eligibility

  • Executive and clinical sponsorship.
  • Identified eligible population and ordering-practitioner workflow.
  • EHR, roster or claims-data access appropriate to the deployment.
  • Defined clinical ownership, escalation coverage and billing responsibility.

Enterprise capabilities

  • EHR and data integration.
  • Eligibility, consent and enrollment operations.
  • Device logistics and support.
  • Centralized clinical work queues.
  • Claims, denial and reconciliation support.
  • Executive clinical and financial reporting.
CMS-aligned operations

Multiple-program enrollment without duplicate billing

Patients may qualify for more than one service when each program is medically necessary and payer rules permit concurrent billing.

1

Separate clinical purpose

Document why each service addresses a distinct monitoring or care-management need.

2

Separate activities and time

Do not count the same minute, communication or staff activity toward two time-based services.

3

Code-specific requirements

Meet the consent, device, data-day, interactive communication, care-plan and supervision requirements for every billed service.

4

Payer verification

Confirm current NCCI edits, Medicare guidance, local coverage and commercial payer policy before claim submission.

Compliance notice: Program descriptions and abbreviated code references are for general operational planning. Coverage and payment depend on the beneficiary, practitioner, services actually furnished, documentation, applicable CPT instructions, CMS rules, NCCI edits and payer policy. InstaMD does not guarantee reimbursement.