Remote Therapeutic Monitoring. What Sets it Apart?
The Centers for Medicare and Medicaid Services (CMS) introduced remote therapeutic monitoring (RTM) in the beginning of 2022.
Remote therapeutic monitoring is a digital health technology solution used to connect patients to their healthcare providers through devices and software.
This technology remotely monitors patients and communicates with care providers between clinical visits. In this way, it is no different from remote patient monitoring, introduced by CMS in 2019.
But RTM is for the monitoring of non-physiological data, while RPM is for the monitoring of physiological data.
Physiological data refers to physiological parameters such as weight, blood pressure, blood glucose, SpO2 and pulse.
Non-physiological data, or therapeutic data, on the other hand, refers to musculoskeletal system status, respiratory system status, therapy adherence and therapy response.
Also, RTM data can be self-reported by the patient. A patient can manually enter the data into a device and upload it. Or like RPM, they can use certain medical devices to collect this non-physiological data and digitally upload it.
An example of RTM is Monitoring COPD patients and recording how frequently the patient is compliant with all prescribed respiratory treatments, such as the use of inhalers.
Another unique RTM characteristic that sets it apart from RPM is its codes. As it currently stands, RTM codes are general medicine codes, whereas RPM codes are evaluation/management codes.
The former is more inclusive in who is allowed to bill for it, as it extends that privilege to therapists, psychologists and pathologists. The latter can only be billed by physicians or other qualified healthcare providers under general supervision.
Remote Therapeutic Monitoring Codes
Humhealth has previously covered all the approved RTM codes that have been newly introduced in its article on remote care return on investment. It’s a must-read for those looking to analyze the returns and costs of the different remote care modalities.
To recap:
CPT 98975 is for initial RTM device set-up and patient education on the use of equipment (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response). The avg. reimbursement rate for this code is $19.38.
CPT 98976 is for supplying the RTM device for daily recording or programmed alert transmissions to monitor the respiratory system for 30 days. The avg. reimbursement rate for this code is $55.72.
CPT 98977 is for supplying the RTM device for daily recording or programmed alert transmissions to monitor the musculoskeletal system for 30 days. The avg. reimbursement rate for this code is $55.72.
CPT 98980 covers the first 20 minutes of RTM treatment, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month. The avg. reimbursement rate for this code is $50.18
CPT 98981 covers each additional 20 minutes of RTM treatment, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month. The avg. reimbursement rate for this code is $40.84.
RTM is evolving quickly, as new applications for this type of remote technology are being developed. In its current iteration, remote therapeutic monitoring is most commonly used for patients with respiratory disorders and musculoskeletal disorders, as defined by CPT codes 98976 and 98977 respectively.
Frequency of Billing in Remote Therapeutic Monitoring
Code 98975 can be billed once per episode of care. An episode of care begins with the initiation of the RTM service and terminates when the targeted treatment goals have been achieved.
Code 98976 and code 98977 can be billed once per 30 days.
Code 98980 and code 98981 can be billed once per calendar month regardless of the number of therapeutic modalities furnished in that month.
Who Can Bill for RTM?
Physicians and other eligible qualified healthcare professionals are allowed to bill RTM.
Other qualified healthcare professionals include:
- Physical Therapists
- Occupational Therapists
- Speech-language Pathologists
- Physicians Assistants
- Nurse Practitioners
- Psychologists
There is no incident to billing under general supervision allowed for RTM as it is a general medicine code and not an E/M code.
RTM services must be directly provided by the billing practitioner, or in the case of a physical therapist or an occupational therapist, by a therapist assistant under the PT’s or OT’s supervision.
Benefits of Remote Therapeutic Monitoring
Captures Behavioral Data To Build a More Complete Picture of The Patient
RTM connects patients with healthcare providers using a device such as a mobile phone, tablet, smartwatch or fitness tracker to transmit non-physiological data. The devices have to be approved by the FDA.
This tool provides powerful insights into patient behavior that would otherwise go unnoticed or unmeasured by traditional healthcare models.
Improves Health Outcomes Cost-efficiently
Using remote therapeutic monitoring has the potential to improve clinical outcomes for patients by identifying potential problems earlier on.
It could also reduce the total costs of care by making it possible for more patients to receive care in the comfort of their own homes, rather than being admitted to the hospital or needing an extra visit to the clinic.
Streamlines Patient-management and Increases Patient Accountability
RTM enables care providers to monitor and assess the efficacy of their therapies remotely, in addition to providing patients with tools for self-management.
Algorithmic decision support is provided to the clinician through a graphical user interface that validates parameters before they are imported into a clinical record.
The data received from RTM also facilitates care planning, documentation and care delivery. Before RTM, the physicians were not incentivized to interact with their patients about their adherence and response to the treatment prescribed. They had one interactive mandatory session with the patient per episode of care, but that interaction was based more on the interpretation of physiologic data.
Patients feel more empowered with RTM as they are given more control over their health outcomes. Instead of only following the medication and regimen prescribed to them, they are able to provide their views on it in real-time, creating a more symbiotic course of care plan.
Keeps up with Patient Expectations
Patients have come to expect remote monitoring of data. 78% of patients say they are very interested in remote patient monitoring and over 95% of them have an interest in sharing wearable device data with physicians.
The patient is ultimately the beneficiary of RTM, and thus their activation and engagement throughout the entire episode of healthcare is crucial to the success of any RTM program. As they wield the power to let their pain levels and functional abilities become known to the care team, it increases their active participation in the process.
RTM with other Remote Care Services
RTM codes were created to support those providers who could not bill for RPM. A patient can be enrolled for either RPM or RTM and chronic care management (CCM) at the same time. CMS says that patients with complex chronic conditions can benefit from remote monitoring services, whether it is RPM or RTM.
It’s of course important to remember, that each code’s time requirements should be separately fulfilled as no double counting is allowed.
What Does The Future Hold for RTM?
Kanter, a member of the CPT editorial panel, says “The future intention is that the CPT code set may be expanded to account for other body systems in monitoring devices beyond just respiratory and musculoskeletal”.
We will have to see the verdict of Final Rules released by CMS in the future. Until that happens, these RTM codes offer a tremendous advantage to any healthcare organizations who are looking to offer a full range of remote care options.
All the usual benefits that are seen in remote care are seen in RTM as well, such as timely interventions, greater patient engagement, and more data-driven decision-making. But RTM boosts each aspect of care with a broader range of data that goes beyond just measuring physiological inputs.
It allows the physician to better understand the condition and progress of the care plan. The patient also has an enhanced understanding of their condition and is better educated, having to observe their adherence and response to the care plan. Such a proactive treatment plan eventually leads to better patient outcomes at a lower cost, where the healthcare organization finds real value in offering RTM.
Remote Therapeutic Monitoring will be available soon on Humhealth! Offerings include both devices and apps through which you can set up an RTM program in no time.
References
https://www.softwareadvice.com/resources/wearable-medical-devices/
https://www.humhealth.com/chronic-care-management/
https://www.humhealth.com/remote-patient-monitoring/
https://www.humhealth.com/blog/remote-patient-monitoring-system/
