Posted May 17, 2023

What is Remote Therapeutic Monitoring (RTM)?

Remote Therapeutic Monitoring (RTM) services monitor health conditions, including musculoskeletal system status, respiratory system status, therapy adherence, and therapy response.  RTM is intended for the management of patients utilizing medical devices that collect non-physiological data.

Who can perform RTM services?

RTM services can be performed by physical, occupational, and speech therapists.  Physical therapy and occupational therapy assistants may also perform RTM services under the supervision of their respective therapists.

When services are performed by PTAs or OTAs, the CQ/CO modifiers must be used.

What are the RTM codes and requirements for billing?

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 equipment.

Report this code only once per episode of care and only if monitoring occurs over a period of at least 16 days. Use this code to report the initial time spent setting up and teaching the patient/caregiver how to use the device.

Documentation should include the type of device being used, the specific education and training provided to the patient and/or caregiver, and any device set-up required.

CPT code 98976 ─ Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily).

Report this code only if monitoring a patient’s respiratory system, and only if the monitoring occurs over a period of at least 16 days.

Documentation should include the name and description of the device provided for monitoring of the respiratory system.

CPT code 98977 ─ Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days.

Report this code only when monitoring the musculoskeletal system, and only if monitoring occurs over a period of at least 16 sequential days.

Document the name and description of the device provided for monitoring of the musculoskeletal system.

CPT code 98980 ─ Remote therapeutic monitoring treatment management services, physician/ other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes.

Use to report the first 20-minute increment of time spent reviewing and integrating the data collected during remote monitoring to inform treatment goals; monitor the patient’s progress and adherence to the treatment plan; and provide clinical feedback to the patient/caregiver.

Count cumulative time spent in data review and patient/caregiver interaction in a calendar month (not each 30 days). Report the base and add-on codes together on the claim, based on total time, at the end of each calendar month. The base code (98980) may only be reported once per calendar month. Don’t report CPT code 98980 unless a full 20 minutes of monitoring has occurred.

Document the data gathered from the device, the date and time of the patient and/or caregiver interaction, and any decisions made that impact the treatment and plan of care as a result of the monitoring.

CPT code 98981 ─ Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure)

Use to report each subsequent 20-minute increment of time spent reviewing and integrating the data collected during remote monitoring to inform treatment goals; monitor the patient’s progress and adherence to the treatment plan; and provide clinical feedback to the patient/caregiver. Don’t report CPT code 98981 unless a full additional 20 minutes of monitoring has occurred. CPT code 98980 must be billed if CPT code 98981 is being billed.

What are the limitations for billing RTM codes?

Code 98975 can be billed once per episode of care. An episode of care begins with the initiation of the RTM service and terminates when the targeted treatment goals have been achieved.

Code 98976 and code 98977 can be billed once per 30 days.

Code 98980 and code 98981 can be billed once per calendar month regardless of the number of therapeutic modalities furnished in that month.

What kind of device must be used?

The device used for RTM must fall under the FDA’s definition of a device:

An instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part or accessory which is:

• Recognized in the official National Formulary, or the United States Pharmacopoeia, or any supplement to them,
• Intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease in man or other animals, or
• Intended to affect the structure or any function of the body of man or other animals.

The device should be either approved, cleared, or registered with the FDA.

Check the devices status: Devices@FDA

How does the data need to be transmitted? 

Data can be transmitted automatically by the device or it can be self-reported by the patient.

How much does Medicare reimburse for RTM services?

These figures represent the national payment amount, payment will differ depending on your area.

98975: $19.32

98976: $50.15

98977: $50.15

98980: $49.48

98981: $39.65

Reference

86 FR 64996