Reimbursability of Remote Monitoring
Type of financing
Common law
Beneficiary
Buyer / Medical device operator
Context of use
Facility / City
Objective
This system allows access to the market for remote monitoring activities under France's standard healthcare system, i.e. to qualify for reimbursement by the Health Insurance Fund. This is now possible via the list of remote medical monitoring activities (the LATM list). It follows the experiment of the ETAPES program.
Getting started
Remote monitoring is a telemedicine procedure. It is the combination of:
- Medical monitoring performed remotely by a medical professional or a medical team on the basis of data transmitted by the patient.
- The use by the patient of a digital medical device for remote monitoring
Coverage under the standard system allows remote monitoring activities to be eligible to be covered by the French national Health Insurance Fund.
Roadmap
- Since June 2023: it is possible to request the reimbursement on an existing generic telemonitoring activity.
- Since February 2023: brand name and generic solutions can and must be certified on the ANS portal;
- December 30, 2022: Application decree published in the Official Journal;
Type of financing
- Two flat fees are paid per patient :
- one technical fee is paid to the company operating the telemonitoring DMD;
- one medical fee is paid to the care team managing the patient.
- The flat reimbursement values are set in light of the organisational or clinical benefit expected from the medical telemonitoring activity.
The clinical benefit is assessed in light of the impacts on quality of life, morbidity, or mortality. - Medical activities of remote monitoring are evaluated by the Haute Autorité de santé (HAS) according to the demonstrated clinical benefit or a demonstrated organisational impact.
Pricing
The Ministers of Social Security and Health set the reimbursement levels reimbursed by the Health Insurance Fund.
The monthly rates, which cannot be combined, are set for each patient as follows:
- for an organisational benefit: €50, all taxes included
- for a clinical benefit relating to quality of life: €73.33, all taxes included
- for a clinical benefit relating to morbidity: €82.50, all taxes included
- for a clinical benefit relating to mortality: €91.67, all taxes included
These rates can be adjusted in light of the total average monthly active number of patients who have had a remote medical monitoring activity of the same indication (whatever the manufacturer).
For more information, see the government order setting out the flat rates for remote medical monitoring.
Billing
For one patient, in one indication and for every billable period:
- The manufacturer cannot bill the technical fee without the corresponding medical fee billed by the care team.
- Only one technical fee or medical fee can be billed per period
Find out more about how to set up and bill for remote monitoring on the Assurance Maladie website.
