Remote Therapeutic Monitoring
What is RTM?
RTM is, essentially, the use of a medical device (as defined by the Food and Drug Administration) to monitor a patient's health or response to treatment using non-physiological data. RTM can be used to monitor things like medication adherence, response to therapy, musculoskeletal activity, and respiratory activity.
Who can bill for Remote Therapeutic Monitoring?
According to CMS, physicians and other “eligible qualified healthcare professionals” are permitted to bill for RTM. In the final rule, CMS says it expects the primary billers of RTM codes to be physiatrists, nurse practitioners, and physical therapists. However, other providers can use the codes as well, including occupational therapists, speech-language pathologists, physician assistants, nurse practitioners, and clinical social workers.
Remote Therapeutic Monitoring: New CPT Codes for 2022
The CPT code changes in 2022 and the inclusion of new RTM codes have increased the use of Medicare coverage for patients signed up for remote monitoring programs that are beyond the scope of Remote Patient Monitoring. This is an essential breakthrough in telehealth and digital health 2022 reimbursement plans.
According to industry experts, healthcare practitioners and providers that were until now unable to bill for Remote Patient Monitoring CPT codes will now have an opportunity to claim reimbursement under the new RTM 2022 CPT codes. The 2022 Remote Therapeutic Monitoring codes include:
CPT Code 98975
Similar to the RPM CPT code 99453, it covers the initial set-up of equipment and patient education regarding the use of the monitoring equipment. The code permits healthcare providers to bill for at least one episode of care. The delivery of care begins with the activation of the Remote Therapeutic Monitoring services and culminates when the specific treatment goals have been accomplished.
CPT Code 98976
Remote Therapeutic Monitoring devices, particularly required for the respiratory system status, require the CPT code to be supplied with scheduled (for example, daily) recordings and/or programmed alerts for transmissions for the monitoring of respiratory systems by appropriate providers, every 30 days.
CPT Code 98977
RTM devices, particularly required for the musculoskeletal system status require the CPT code to be supplied with scheduled (for example, daily) recordings and/or programmed alerts for transmissions for musculoskeletal system monitoring by appropriate providers, every 30 days. The CPT codes 98976 and 98977 are both billable once every 30 days of Remote Therapeutic Monitoring.
CPT Code 98980 and 98981
Remote Therapeutic Monitoring treatment providers or physicians that are well-qualified in healthcare delivery require at least one interactive communication (through phone call or video) in a calendar month with the patient or their caregiver. CPT code 98980 requires at least the first 20 minutes of time dedicated per month to the patient’s Remote Therapeutic Monitoring and management. Each additional 20 minutes of time is billable under CPT code # 98981.
Proven benefits
In addition to significant financial gains, remote therapeutic monitoring can also provide valuable benefits such as:
