The healthcare industry is always changing, and technology plays a big part in how patients receive care. One way that technology is helping is through Remote Therapeutic Monitoring (RTM). This blog will explore what RTM is, why it matters, and how it can benefit both healthcare providers and patients.

What is Remote Therapeutic Monitoring (RTM)?

  • RTM Codes focus on remotely collecting and monitoring non-physiologic patient data.
  • Typical RTM monitoring devices have included sensors to collect physiological data, which is then stored in the vendor’s platform or software. RTM codes for therapy are geared to collect information on pain, ROM, decreasing falls, or Respiratory Monitoring.One primary objective is to track the effectiveness of various treatments or therapies. This includes monitoring patient responses to therapy exercises, assessing their Home Exercise Program (HEP) tolerance and compliance, evaluating pre- and post-exercise pain levels, and measuring overall treatment outcomes.
  • The data can be self-reported by the patient. Patients are encouraged to have an active role by uploading relevant information using FDA-Approved and connected medical devices. For example, a sensor can be attached to their walking device and connected to their cellphone using the medical device’s app platform. By doing so, healthcare providers can obtain a comprehensive understanding of the patient’s condition.
  • RTM can be provided by Physical Therapists (PTs), Occupational Therapists (OTs), and Speech-Language Pathologists (SLP) under the Medicare Physician Fee Schedule as of January 1, 2023.

What are the five (5) RTM Current Procedural Terminology (CPT) Codes?

  • CPT Code 98975
    • “Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response): initial set-up and patient education on use of the equipment.”
    • For setting up and educating the patient on using equipment for respiratory and musculoskeletal status, therapy adherence, and response.
    • Billed once per episode of care, covering 16 days of patient self-reported data. An episode of care starts at RTM initiation and ends when treatment goals are met.
  • CPT 98976 (Respiratory)
    • Supplies RTM device(s) for monitoring the respiratory system.
    • Billed each 30 days, requiring 16 days of collected data/measures on respiratory system status, which is self-reported by the patient within the RTM reporting platform being utilized.
  • CPT 98977 (Musculoskeletal)
    • Supplies RTM device(s) for monitoring the musculoskeletal system.
    • Billed each 30 days, requiring 16 days of collected data/measures on musculoskeletal system status, which is self-reported by the patient within the RTM platform being utilized.
  • CPT Code 98980**
    • This code is for monitoring treatment management services by a physician or other qualified healthcare professional.
    • It can be billed once every 30 days.
    • It is a time-based code; it covers the first 20 minutes of interactive communication, such as phone or video communication with the patient or caregiver during that month.
    • Even if various therapeutic monitoring activities are done, this code focuses on the time spent communicating, and the first 20 minutes are covered by this code each month.
  • CPT Code 98981**
    • This code is for monitoring treatment management services by a physician or other qualified healthcare professional.
    • RTM is a time-based code billed once each 30 days; each additional 20 minutes of interactive communication (like phone or video calls) with the patient or caregiver during that month.
    • Even if various therapeutic monitoring activities are done, this code focuses on the time spent communicating, and each additional 20 minutes are covered by this code each month.

** For CPT codes 98980 and 98981, when we talk about interactive communication (like phone or video calls), it is important to note that text messages are not considered interactive communication. This means sending texts does not qualify for billing under these codes. When using these codes for activities requiring communication, remember that text messages do not count as billable interactions.

What are examples of how RTM can be applied in therapy?

  • Physical Therapy (PT)
    • RTM allows PTs to monitor patients performing prescribed exercises remotely, ensuring proper form and adherence.
    • Wearable devices can track movement patterns, helping PTs assess gait and biomechanics.
    • Immediate feedback through phone or video calls can enhance therapeutic exercises’ effectiveness.
  • Occupational Therapy (OT)
    • OTs can assess and adjust the use of adaptive equipment remotely for patients facing challenges in daily activities.
    • RTM helps OTs guide patients in modifying their homes for safety and accessibility.
    • OTs monitor patients doing daily tasks at home, getting valuable info to customize interventions.
  • Speech-Language Pathology (SLP)
    • SLPs remotely monitor patients’ vocal health, adjusting therapy plans accordingly.
    • RTM guides speech exercises, making them more accurate and effective.
    • Continuous monitoring helps SLPs assess progress in speech skills like articulation, fluency, or language.

What are the advantages of RTM for therapists?

  • With RTM, therapists can access real-time data regarding a patient’s progress, by monitoring patient input and feedback, allowing therapists to monitor treatment compliance and adjust treatment plans to promote a more effective and efficient outcome.
  • RTM allows for flexibility in providing patient care, by allowing the patient to report on progress and receive the service from their homes. This flexibility allows providers to provide greater quality for those patients facing challenges in coming to the clinic due to geography or mobility issues. With RTM, patients from their homes can connect with their therapists using video conferencing or other forms of interactive communication, ensuring the patient receives the care they need.
  • RTM enables therapists to make instant changes to treatment plans, ensuring patients receive the most effective care possible. For example, if a patient reports concerns about walking to the bathroom at night, a therapist can recommend the use and placement of the bedside commode, improving patient safety and outcomes and enhancing the overall quality of care.

What are the compliance considerations for therapists?

  • Assistant supervision, Compact Licensure, Place of Service (POS), and State Practices must be reviewed prior to expanding RTM services within your practice.
  • Understand your KPIs and patient needs. Not all areas of the country have WiFi access, patients may not have smart phones or unlimited data plans, and other patients may prefer logging into a patient portal. One of HIPAA’s individual right states for patients to determine how they wish to receive confidential communication.
  • RTM are required to be provided under an established plan of care certification.
  • RTM CPT codes are considered Sometimes Therapy, applying towards the therapy threshold requiring the GO, GN, GP, and KX Modifiers as appropriate, but are not subject to the Multiple Procedural Payment Reduction (MPPR).
  • The CMS di minimis standard applies to CPT Codes 98975, 98980, and 98981 if provided by an assistant meeting the in whole or in part description which requires application of the Modifier CO and CQ to the claims.
  • RTM can be provided by therapists providing Medicare Part B services in private practice, Rehab Agencies, Part B Nursing facilities, Home Health Part B, Hospital Outpatient, and Comprehensive Rehabilitation Facilities.
  • Medicare Advantage and Commercial payor plans do not necessarily pay for these services. It is recommended a review of each payors medical policy prior to billing for the services to ensure payment.
  • HIPAA compliant platforms must be considered when partnering with RTM vendors.
  • Some patients might not have access to the necessary technology or may not be familiar with digital tools.
  • Safeguarding patient data during remote sessions is essential to ensure privacy and maintain security standards.
  • Therapists need to stay updated on RTM regulations and reimbursement policies to comply with the rules and provide effective care.

In conclusion, RTM is changing how therapists provide care as a hybrid model of care and case management will be the norm, not the exception to managing populations and ensuring access to necessary care for all. RTM creates opportunities for increased personalized, efficient, and effective care. Therapists welcoming this shift to hybrid services are promoting increased value to payors for therapy services by improving outcomes and having a positive impact on the Quadruple Aim of improving patient experiences, reduced costs, improved provider satisfaction, and improved outcomes.

LW Consulting, Inc. (LWCI) offers a comprehensive range of services that can assist your organization in maintaining compliance, identifying trends, providing education and training,  or conducting documentation and coding audits. For more information, contact LWCI to connect with one of our experts!