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Remote therapeutic monitoring (RTM) is a hot topic in healthcare. It’s exciting, it’s new – but there are many factors to consider before you can offer and bill for RTM services. Luckily, we’ve broken it down for you in this blog that covers everything from the benefits of RTM to the definition of each code.
What is remote therapeutic monitoring (RTM)?
Remote therapeutic monitoring refers to the use of technology to monitor non-physiological data remotely, including data pertaining to both the musculoskeletal and respiratory systems. Remote therapeutic monitoring data can be objective and subjective, meaning that data can be collected, recorded, and transmitted digitally and the patient can self-report data to their providers. RTM must utilize a medical device that meets all necessary criteria to support the delivery and billing of RTM.
The Benefits of RTM For Patients and Providers
RTM is an extension of telehealth that provides clinicians with the ability to monitor a patient’s progress outside of clinic walls. It captures a patient’s functional abilities for real-life circumstances and is a valuable tool to ensure patients are progressing towards their individual goals. Likewise, RTM boosts patient engagement by extending connectivity to care, personalizing their experience, and allowing them to have an active role in ongoing treatment to ensure safety and optimal outcomes.
Healthcare is shifting to incorporate advancing technology, and patients are looking for convenient, digital options. While telehealth and virtual services were not new, the impact of COVID resulted in many organizations expediting their transition to digital offerings. Today with specific remote therapeutic monitoring codes, implementing efficient RTM can provide clinics with ancillary revenue streams and improve profit margins without sacrificing the quality of patient care. Remote therapeutic monitoring options also provides therapists with increased flexibility, more treatment options, and the ability for clinics to reach more patients while still providing personalized physical therapy treatments.
What are the CPT codes for RTM?1,2
In January 2022, five remote therapeutic monitoring codes were introduced that allow therapists to bill for services pertaining to the musculoskeletal and respiratory systems. The four codes that can be utilized for the musculoskeletal system when billed by a physician or a qualified healthcare provider (QHP), such as a physical therapist, are:
98975
This code is used to bill for the initial setup and patient education on the use of equipment for RTM. Data must be recorded and monitored for at least 16 days after the first measurement is recorded. Providers can submit this code for a one-time reimbursement per episode of care. The reimbursement rate is approximately $20 based on the 2022 Physician Fee Schedule.2
Note: According to the 2022 Physician Fee Schedule final ruling, when code 98975 is used a modifier must be added in accordance with the de minimis policy as an untimed code. This means that if more than 10% of the service or unit of service is provided by a physical therapist assistant or occupational therapist assistant, the appropriate modifier must be added.
98977
This code is used to bill for supplying the patient with the device that enables scheduled recording(s) and/or programmed alert(s) transmission to monitor the musculoskeletal system. Data must be recorded and transmitted via a medical device. The data can be automatically transmitted or patient-recorded. Additionally, monitoring must occur for at least 16 days. Providers can submit this code once per calendar month. The reimbursement rate is approximately $55 based on the 2022 Physician Fee Schedule.2
98980
This code is used to bill for the initial RTM treatment management services in which the physician or QHP interacts with the patient in a calendar month. Other activities described within this code include provider time spent reviewing patient data, modifying patient care plans, progressing patient exercise programs, and responding to patient feedback, including feedback received via chat. In order to bill using this code, one interactive communication between the provider and the patient must occur and the total amount of time of all activities described within this code must be at least a full 20 minutes (this can include the interactive communication and the additional activities as long as the total duration is at least a full 20 minutes). Providers can submit this code once per calendar month for the first 20 minutes of interaction and monitoring. The reimbursement rate is approximately $55 based on the 2022 Physician Fee Schedule.2
98981
This code is used to bill for each additional 20 minutes of interactive communication and time spent reviewing and monitoring patient data. Providers can submit this code per each additional full 20 minutes of patient interaction and monitoring of patient data. The reimbursement rate is approximately $40 per each full 20-minute interaction based on the 2022 Physician Fee Schedule.2
Billing for RTM With OneStep
OneStep is an app-based platform that enables convenient and exceptional digital physical therapy – and meets all the necessary requirements to support the billing of RTM codes. OneStep’s first-of-its-kind technology turns any smartphone into a 24/7 motion analysis lab that provides immediate, easy-to-understand, around-the-clock feedback directly to patients and their providers. With OneStep, physical therapy extends beyond clinic walls as therapists can treat and monitor patients remotely between sessions, enhancing clinical decision making and outcomes. The best part? Absolutely no wearables are required.
OneStep offers providers insight into both objective and subjective outcome measures, as well as enhanced communication through virtual sessions and the platform’s chat feature. Furthermore, all interactions and patient data monitored by OneStep are maintained within HIPAA compliance and treated with the utmost caution to respect patient privacy.
What sets OneStep apart from other digital physical therapy solutions? OneStep’s ability to capture background gait analysis data directly from a patient’s smartphone allows clinicians to observe functional mobility during real-life circumstances. Additionally, OneStep’s technology detects changes in gait parameters over time that are indicative of potential fall risk and will notify providers so they can intervene proactively, preventing injuries and complications.
Ready to go digital?
With OneStep, your practice can gain valuable patient insight, optimize clinical decision-making, and reach more patients by complementing traditional physical therapy with a digital solution customized to meet your specific requirements. Schedule a demo today to explore the many features of both the OneStep patient app and clinic portal that will extend your practice digitally – taking it to the next level!
Learn more about remote therapeutic monitoring (RTM) with OneStep.
References:
Current Procedural Terminology (CPT) Copyright 2022 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.
2022 payment rates are based on national average 2022 Medicare rates to physicians. Source: 2022 Physician Fee Schedule (PFS) Look-Up Tool. Actual payment rates will vary based on geographic location, may differ based on policies and fee schedules in health plan and/or payer contracts, and are subject to change without notice.
DISCLAIMER: Reimbursement information is provided for informational purposes only and is not an instruction as to which codes to use for a particular service, supply, procedure or treatment. It is the provider’s sole responsibility to determine and submit the appropriate codes and modifiers for any service, supply, procedure or treatment rendered, as well as to document the medical necessity for any service provided to a patient. Providers and physicians should contact their legal counsel or reimbursement consultants, or contact third-party payers directly, for specific and current information on coding, coverage, and payment policies. The information provided herein is without any other warranty or guarantee of any kind, expressed or implied, as to completeness, accuracy, or otherwise. Celloscope, DBA OneStep, does not provide any assurance or guarantee of medical benefits coverage or reimbursement for these services.
