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What to Know About the 2022 Medicare Remote Therapeutic Monitoring (Part 2)

In the first half of this series, we introduced the essential information you may need regarding Remote Therapeutic Monitoring (RTM). We answered some frequently asked questions, but it hasn’t stopped there. Read on to learn more about RTM through this second part of the series!

FAQ: Is RTM only used to treat respiratory or musculoskeletal issues?

Yes, RTM reimburses for device supplies in cases of restricted clinical utilization. RTM device supply codes (98976, 98977) are approximately identical to RPM device supply codes (98976, 98977) but are not completely identical (99454). The data must be physiological in order to use CPT code 99454. The two RTM device supply code descriptors, on the other hand, suggest a narrower clinical application. 98976 is solely for respiratory transmissions, while 98977 is just for musculoskeletal transmissions. They are not aimed at any other systems (e.g., neurological, vascular, endocrine, digestive, etc.). 

CMS acknowledged in the final rule that it received comments suggesting the adoption of a system-agnostic generic device code, with RTM reimbursement limited to musculoskeletal and respiratory monitoring. However, CMS omitted a generic device code from the final rule.

CMS stakeholders predict that the list of qualifying conditions will be expanded in the future. In early November 2021, the AMA recoded CBT monitoring services.

FAQ: How are RTM codes classified?

The RTM codes are intended for general medicine, not E/M. RPM, on the other hand, is an E/M service.

FAQ: Who is in charge of ordering and delivering RTM?

RTM may be charged as general medicine by physicians and other competent healthcare practitioners, such as persons who perform a professional service within the boundaries of their practice and independently document that professional activity.

Physical therapists, occupational therapists, speech-language pathologists, physician assistants, nurse practitioners, and clinical social workers can use RTM codes. The new RTM codes, which are general medicine codes, should make it possible for therapists, psychologists, and other competent practitioners to bill for RPM, which is an E/M code.

FAQ: Can RTM be used for billing purposes?

No. Since RTM treatment management codes 98980 and 99881 are not E/M codes, they are ineligible for reimbursement as care management services. When work is performed by non-physicians under general supervision, a physician cannot order or bill for RTM services.

Clinical workers can be billed incidentally under RPM. Clinical staff are not permitted to undertake RTM services for the billing provider under the RTM code for general medicine. RTM services must be provided directly by the billing practitioner or, in the case of a therapist, by a therapy assistant working under the therapist’s supervision. The RTM codes, in contrast to the RPM CPT code explanations, do not include information concerning clinical staff time.

FAQ: How long does it take for RTM to complete?

CPT code 98980 necessitates at least 20 minutes of remote treatment monitoring per month. Each month, at least one engaging conversation with the patient/caregiver is required (e.g., via phone or video). To add, CPT code 98981 is a monthly add-on code that takes an extra twenty minutes.

Conclusion

RTM is the utilization of technology to monitor patient monitoring via the usage of telecommunication technology. It can be achieved through telecommunication technology, making its effectiveness unrivaled. With the ability to track and monitor patients from a distance, patients won’t need to be physically present in hospitals anymore. Instead, the location of the patient will no longer be a factor.

For the best care management solutions, Medistics Heath offers remote monitoring and patient care that tackles all types of physical, chronic, and behavioral health conditions. With our humanized and simplified healthcare approach, you’ll be worry-free! Schedule a FREE consultation with us today!

Profit Calculator Assumptions: 40% of total Medicare patients enrolling is based on (i) Medicare Chart Book’s data showing that ~68% of medicare patients qualify for CCM (2 or more chronic conditions), and (ii) that ~40% of eligible patients will enroll.

For typical providers, $46.67 of net profit per patient per month is based on a Medicare reimbursement per patient per month (national average) for various care management CPT codes.

CPT and other codes, descriptions and other data are copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).