Many healthcare organizations and individual practitioners have been reaching out to us recently with questions about remote therapeutic monitoring (RTM), which allows clinicians to be reimbursed for collecting therapeutic data using the virtual patient engagement and monitoring techniques that many of them are already performing today.
In a previous article, we answered some of your top questions on the basics of RTM. In this follow-up article, we take a deeper dive by responding to another round of your most pressing questions about this important opportunity for improving patient outcomes and increasing revenue.
What constitutes an approved RTM device?
Billing against Medicare’s RTM codes requires the use of technology satisfying the FDA’s definition of a medical device, which includes software used to diagnose, prevent, monitor, or treat health conditions. While final billing decisions should be made by the treating clinician, the MedBridge platform provides automated functionality to track, monitor, and report on patient engagement in their home exercise programs.
Can an administrative employee provide RTM services?
No, RTM service must be ordered and administered by a physician or other qualified healthcare professional as defined by CMS. 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, dietitians, physician assistants, nurse practitioners, and clinical social workers.
For codes 98980 and 98981, can you count the amount of time communicating with the patient towards the total time requirement?
Codes 98980 and 98981 are based on the cumulative time of the RTM treatment management service during the calendar month of reporting, and they require at least one interactive session that must have an audio component, either a phone call or telehealth. That session does count towards the total time that you bill.
Can a patient on home health receive RTM as well?
At this time, the CPT codes are available to providers who are billing Medicare Part B. Because of this, traditional home health services would not receive additional revenue for providing RTM (but they aren’t prohibited from incorporating it into a patient’s plan of care, similar to RPM).
How do we get our patients to adopt RTM?
Explaining to patients how virtual engagement can benefit them, helping them set up the device they’ll be using, and ensuring that they can easily set up and access their care programs electronically should help increase the rate of adoption. Patients tend to appreciate the ability to give feedback and receive guidance between visits because it helps them progress faster and more easily. Also, when programs are assigned electronically to patients, via text or email, we’ve seen that they’re nine times more likely to log in and access it.
What is the difference between the two categories of codes?
The new RTM codes are divided into two categories: service codes and timed-based RTM management codes.
RTM service codes (98975, 98976, and 98977) reimburse for expenses associated with establishing RTM services, including initial device set-up and patient education, and the transmission of the data used to monitor the respiratory and/or musculoskeletal systems.
RTM management codes (98980 and 98981) are monthly time-based codes that use the results of RTM to manage a patient under a specific treatment plan. This may include activities such as updating a program or a phone conversation with the patient. The RTM management codes require that at least one interactive session have an audio component: either telehealth or a phone call.
Does billing an RTM code count towards authorized in-person physical therapy visits?
This would depend on the individual insurance payor and how they authorize their payments. The best way to find out would be to contact the insurance plans you’re in network with to determine whether they recognize the RTM codes and what their payment policies are for this scenario.
Does the provider need to have a direct access license or other special credentialing to provide RTM?
No. As long as services are provided by a qualified healthcare professional, that person doesn’t need to have any other special credentials related to RTM.
Can you give an example of the type of data that’s monitored through RTM?
With RTM, clinicians monitor non-physiologic data related to patient symptoms and the patient experience; for example, whether an exercise felt too difficult or too easy, or whether the patient experienced pain or felt drowsy after taking a medication.
By contrast, remote patient monitoring allows clinicians to monitor physiological data such as lung function, heart rate, and blood sugar.
How Can MedBridge Help with Remote Therapeutic Monitoring?
MedBridge’s Patient Engagement Solution has been updated to allow providers to collect the data needed to bill for RTM. Here’s how it works:
Step 1: The clinician enrolls a patient in MedBridge HEP Standard.
Step 2: The clinician assigns a program to their patient based on that device and educates the patient on how to use it.
CPT code 98975
Step 3: The clinician implements the patient program, including tracking patient adherence and feedback on pain and difficulty.
CPT codes 98976 and 98977
Step 4: The clinician communicates with the patient about how things are going.
CPT codes 98980 and 98981
Step 5: The clinician references the data that MedBridge has logged to report and bill for RTM.
About MedBridge Patient Engagement Solution for RTM
Our Patient Engagement Solution allows providers to perform remote therapeutic monitoring by digitally assigning programs to patients with musculoskeletal, respiratory and other conditions. Providers can then monitor non-physiologic patient data including program adherence, pain levels, and patient feedback; communicate with patients between sessions using in-app messaging and virtual visits, and adjust the program as needed to optimize patient outcomes.
Our effective, evidence-based solution satisfies the FDA requirements for a medical device and is eligible to be used for patient monitoring. It integrates MedBridge’s Home Exercise Program, Patient Education, Patient Mobile App, Adherence Tracking and Reporting, Telehealth Virtual Visits, and Net Promoter Score for monitoring and improving patient satisfaction.