Brick-and Mortar still today?
- Elite Accreditation Consultants
- 16 hours ago
- 2 min read
Home-deployed diagnostics (sleep testing, cardiac rhythm patches, ABPM, some ambulatory EEG, remote vitals) can slash costs and speed access. So why do some payers/partners still insist on a “full-blown center”? A few big reasons:
Why a brick-and-mortar site is still requested
Modality limits & safety: A lot of imaging/tests (x-ray/fluoro, CT/MRI, stress testing with monitoring, full PFT labs, contrast studies) simply can’t be done at home due to radiation, magnet safety, crash-readiness, or technician support.
Medicare/IDTF standards: IDTF enrollment expects defined supervision, QC/calibration, secure records, and frequently a fixed operational base. Home distribution is fine for some tests, but the IDTF still needs policies, chain-of-custody, asset control, and a physical “anchor.”
Supervision rules vary by code: Some tests require direct/personal supervision; others allow general supervision. That drives where/how you can perform them.
Accreditation & QA: For many payers, accreditation (and periodic audits) is easier to verify when there’s a controlled site with logs, device maintenance, and competency files.
Coverage policy & billing edits: Many plans hard-code place-of-service or tie reimbursement to an IDTF or facility setting for certain CPT families.
A practical path that keeps costs down
Hybrid model: Maintain a lean fixed site (meets IDTF standards/QC) + deploy home devices for eligible studies. Reserve the site for set-ups, returns, calibrations, higher-acuity tests, and audits.
Code-by-code crosswalk: Map your intended services to setting (home vs. site) and supervision level. That becomes your payer-ready rationale.
Tight logistics for home use: Written patient instructions, device tracking, tamper seals, cleaning/turnaround SOPs, data encryption, and a rapid fail-safe (patient can come to the site if home test fails).
Outcomes & cost story: Track turnaround time, diagnostic yield, and no-show reductions to demonstrate the savings of home deployment.
Starter crosswalk (illustrative)
Good home candidates: sleep apnea screening/HSAT, ambulatory ECG patches (Holter/MCT), ambulatory BP monitoring, some long-term EEG (with proper set-up), remote physiologic monitoring bundles.
Usually site-based: echo and most ultrasound labs (quality/technician requirements), stress tests, full PFT labs, x-ray/fluoro, CT/MRI, contrast studies, DEXA (varies), procedures needing immediate clinical oversight.
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