Remote Therapeutic Monitoring Clinical Content Setup

Effective January 1, 2022, CMS introduced 5 new Remote Therapeutic Monitoring (RTM) codes that may be utilized by PT, OT, and SLPs. An RTM device may be a tool to progress and monitor home exercises, such as Keet, or another device specifically used for therapeutic monitoring.

Three of the codes are used to bill for set up and supply of remote monitoring devices and two of the codes are used to bill for ongoing remote patient management.

RTM Set Up and Supply Codes

When initiating RTM services, you may bill for the initial set up and patient education on use of the equipment using code 98975. Use 98976 as a charge for the supply used for remote therapeutic monitoring. You may charge for the supply each 30 days.

Code Description Billing Frequency
98975 RTM setup and education At initial setup of RTM device
98976 RTM Device Supply with Scheduled Recordings/Alerts Respiratory, each 30 days At initial set up and each 30 days as needed
98977 RTM Device Supply with Scheduled Recordings/Alerts MSK, each 30 days At initial set up and each 30 days as needed

RTM Treatment Codes

Charges for the cumulative time providing remote monitoring services are billed using codes 98980 and 98981 for each calendar month.

Code Description Billing Frequency
98980 RTM Treatment, first 20 minutes of cumulative monitoring and interactive communication Once per calendar month
98981 RTM Treatment, all subsequent monitoring and interactive communication for the episode of care, each 20 minutes

The typical conventions for aggregating timed units do not apply for RTM treatment. To bill the first unit of RTM treatment, documentation must show at least 20 minutes of service. The first unit is billed with the 98980 procedure code and subsequent whole 20 minute units of service are billed with the 98981 procedure code.

To simplify billing RTM for our users, we added a billing rule to the standard CCI Edits to automatically roll 98980 into 98981 after the first 20 minutes of RTM treatment. CCI Edits are typically applied to all Medicare category payers. If you would like the RTM billing rule to be added for payers that do not have CCI Edits applied, please reach out to Clinicient support.

RTM Treatment Requirements and Documentation

  • The documentation must show that RTM occurred on at least 16 different days within the calendar month.
  • Each 20-minute unit of RTM treatment must include at least one instance of interactive communication with the patient. RTM treatment that includes interactive communication should be clearly documented.

Assistant Modifiers for RTM Services

Similar to any other PT or OT service, RTM services are subject to application of the assistant modifier when the assistant provides more than 10% of the minutes of service. Insight will automatically apply the assistant modifier as needed if Assistant Modifier Payer Rules are enabled.

RTM Topic Organization

We recommend users follow the best practices listed below to organize Topics for RTM in Insight.

Please see Manage Clinical Content for best practices on managing your clinical content library.

Note: This example shows musculoskeletal codes only, and defaults RTM treatment to 5 minutes.

Create an RTM Topic

  1. From the Templates menu, select Topics Management.
  2. Click Add.
  3. Enter the topic name as “Remote Therapeutic Monitoring”, then click OK.
  4. Exit Topics Management.

Add RTM Items to the Topic Tree

  1. From the Templates menu, select Topic Editor.
  2. Beneath the Objective Area, Categories should be added for Initial Setup and Monthly Summary.
    1. Initial Setup may include items such as Justification, Patient Education, Description of Device, Plan, etc.
    2. Monthly Summary should indicate whether the patient has been compliant with the plan of care and continued treatment is appropriate.

  3. Select the Subcategory you added titled Remote Therapeutic Monitoring. Then, under Topics for Selected Item, check the box for the “Remote Therapeutic Monitoring” Topic. This will associate the RTM topic items you created with the RTM Topic, allowing users to easily locate RTM content.

  4. Click Save.

RTM Procedures

  1. Next, a category for RTM should be added under Procedures.
  2. Beneath the RTM Procedure category, subcategories for Initial Setup, Monitoring, and Device Communication should be added.
  3. Under Initial Setup, add items for:
    1. RTM Setup and Education (CPT code 98975)
    2. RTM Device Supply (CPT codes 98976 and 98977)
  4. Under Monitoring, add items for RTM Data Collection numbered 1-31. RTM treatment is reported monthly in daily instances, and there should be 31 available to report all daily occurrences of RTM treatment over a month-long period.
    1. In our example we used a default procedure length of 5 minutes. However, you may want to use a longer or shorter default depending on the average time your therapists spend monitoring.
  5. Under Device Communication, add items for RTM Interactive Communication. This allows users to document time spent in communication exchange with the patient. Interactive communication uses the same CPT codes (98980, 98981) as data collection but must be broken down separately in documentation as each 20-minute unit of RTM treatment must include at least on instance of communication.
    1. In our example, we added 4 numbered instances of RTM Interactive Communication. You may want to add more instances of RTM Interactive Communication depending on how frequently your therapists communicate with patients regarding RTM.

  6. Select the Procedures Subcategory titled Remote Therapeutic Monitoring. Then, under Topics for Selected Item, check the box for the “Remote Therapeutic Monitoring” Topic.

  7. Click Save.

RTM Templates

We are currently seeking clarity on documentation and billing for RTM services to ensure that we are providing the best knowledge possible. Please stand by, more information on how to setup RTM templates will be coming soon.

Add RTM Codes to Fee and Reimbursement Schedules

INSIGHT and INSIGHT clients must add RTM CPT Codes to their Fee and Reimbursement Schedules. Total INSIGHT clients must reach out to Clinicient support via the Empower site or by calling 503-525-0275 to have these codes added.

Please see the articles below for instructions on how to update Fee and Expected Reimbursement Schedules and access Medicare RVUs.

Charges and Expected Reimbursement

Introduction to Fee Schedule Setup

Expected Reimbursement Setup

Medicare Fee Schedule Overview

Note: The information provided herein is intended to be general in nature. It is not offered as legal or insurance related advice and is not a complete description intended to replace or to be an interpretation of specific Medicare requirements. Although every effort has been made to ensure the content herein is correct, we assume no responsibility or liability for its accuracy. Contact the Department of Health & Human Services (DHHS) Centers for Medicare and Medicaid Services (CMS) for more information.

 

Related Topics:

Remote Therapeutic Monitoring Documentation

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