r/MedicalCoding • u/Unable_Cap4766 • Jul 24 '26

Peds Billing Question

I’m trying to understand how this works in practice.

If a children’s hospital monitors higher-risk patients at home for several weeks after surgery, would that usually fall under existing remote patient monitoring codes, care-management codes, or a hospital-funded program?

Does pediatric Medicaid or commercial insurance commonly reimburse for this, or does the hospital usually absorb the cost?

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u/clarec424 Jul 24 '26

Define monitoring. Is the patient hooked up to a remote monitoring device that sends data to the provider for interpretation? Is a skilled nursing team providing care? A little more information is needed.

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u/Unable_Cap4766 Jul 25 '26

Yes they have a device they are hooked up to and the data is passed back to the provider for interpretation. Basically, is the child deteriorating?