Remote Therapeutic Monitoring (RTM) Overview & Benefits

 

RTM Overview 

 

Effective January 1, 2022, CMS introduced a new category of digital health services – Remote Therapeutic Monitoring (RTM) –  to complement the existing suite of Remote Patient Monitoring codes covered under Medicare. The new RTM codes broaden Medicare reimbursement for remote monitoring beyond the existing Remote Physiologic Monitoring (RPM) codes and represent one of the latest advancements to modernize reimbursement for digital health. The new codes are intended to expand the scope and reach of digital health technologies to reimburse monitoring of non-physiologic data. 

 

CMS recognizes therapeutic data as an important category of patient information that can be assessed remotely. RTM is designed for the management of patients using devices that collect therapeutic, non-physiologic data. Data around indicators such as therapy/medication adherence, therapy/medication response, and pain level can be collected and billed under the new RTM codes. Non-physiologic measures can allow a provider to determine how well a patient is responding to a medication, what social or environmental factors affect the patient’s respiratory or musculoskeletal health status, and what changes could be made to improve the patient’s health. This differs from RPM codes, which only can be used in conjunction with tracking physiologic data (e.g. heart rate, blood pressure and blood sugar levels) – patient status vitals important to ongoing chronic care management. RTM can be used for non-physiologic medical devices like those used to support medical adherence (smart pill reminder systems) and medication symptom/adverse reaction applications.  Really any medical device that can collect data that is non-physiological can be collected and billed under RTM.

 

The intent for RTM is different in scope and data gathering methodology from RPM. Additional codes and new reimbursement for these RTM services have been added. The main differences between RPM and RTM are expansion beyond internal medicine providers and tracking non-physiologic versus physiological data. The codes are limited to the musculoskeletal system and respiratory system, and are intended to be non-physiologic in nature with attention to therapy, adherence and response. The expansion beyond internal medicine providers and the addition of specialty areas, shows that providers that currently can’t bill for RPM (depending on specialty area) may be able to bill for RTM. 

 

Also, the clinical scope of what’s covered is fairly limited – clinical uses eligible for monitoring device reimbursement only are only for respiratory condition data transmissions or musculoskeletal condition data transmissions. Most stakeholders are optimistic that CMS will expand the list of clinical conditions in the future. It’s important to note that the RTM codes are classified as general medicine codes, not evaluation and management (E/M) codes.  RPM codes are classified as an E/M service because they are for physiologic monitoring. Because the two RTM treatment codes (98980 and 98981) are not E/M codes, they cannot be designated as care management service – and a physician could not order and bill for RTM services while having remote-based, non-physician practitioners perform the work under general supervision. 

 

Finally, CMS will allow self-reported/entered data for non-physiologic data RTM codes, but requires use of an FDA approved medical device, not a wellness device.  This is another significant difference from RPM code requirements, which also require the device to digitally (automatically) record and upload patient physiologic data – and specifically do not allow patient self-recorded, reported or manually entered data. 

 

Key features of RTM, and how it differs from RPM:

 

  • RTM is non-physiologic, therapeutic data
  • RTM allows for respiratory and musculoskeletal data only
  • RTM allows for both self-reported data as well as automated digital uploads
  • RTM is intended for nurses, physical therapists and overseeing specialty providers.  Intent was expansion to allow more practitioners previously unable to transmit and bill for RTM to be able to. 

 

RTM codes offer the promise of expansion and broader applications for patient care down the road.   It is expected that the coding, scope, range and specificity of RTM coverage, provider specialty and services will grow and change in the coming years as CMS further defines its policy.  

 

Benefits of RTM 

 

RTM will allow physicians to gain more information on how a patient’s daily life is impacting their conditions and overall health.  This allows for the personalization of care plans to enable the best possible outcomes.  Monitoring patients in the ways described by RTM provides opportunities for lowering spending on preventable hospitalizations, ED visits and urgent care too. 

 

Medsien’s RTM program can help your patients and practices benefit from these growing trends in patient care by improving outcomes, patient engagement, patient satisfaction and increasing reimbursement. 

 

Improves:

  • Health outcomes
  • Patient engagement
  • Patient satisfaction
  • Reimbursement 

 

Decreases

  • Costs

 

To learn more about Medsien RTM services visit www.medsien.com/remote-therapeutic-monitoring

 

 

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