Remote Therapeutic Monitoring (RTM) refers to the use of technology to monitor and manage a patient's medical condition remotely, allowing healthcare providers to track relevant health data between in-person visits. In 2022, the Centers for Medicare & Medicaid Services (CMS) implemented a new set of billing codes specifically for Remote Therapeutic Monitoring. These codes provide reimbursement for time spent monitoring health data related to a patient’s respiratory system, musculoskeletal system, or cognitive behavior.

The goal of RTM is to enhance patient care by providing continuous, real-time information about the patient's health status. Through data collected through RTM, healthcare providers can make data-driven decisions and, with that, more timely interventions to further improve the health outcomes of their patients. Additionally, RTM empowers patients by engaging them in their own healthcare and providing them improved access to their health data.

The TheraTec RTM platform allows for patient and provider to stay connected throughout the patient’s Home Exercise Program (HEP). It consists of a provider portal, patient mobile app, and wearable range-of-motion sensor.

Through the provider portal, healthcare providers can create and modify their patients’ HEPs, collect patient data securely while maintaining privacy regulations, stay connected to patients with real time messaging and feedback, and monitor progress between in-person visits.

The mobile patient application guides patients through their home exercise program and allows healthcare providers to keep track of their progress to better address their needs. Our team is here to guide and support you every step of the way, allowing you to focus on what matters, your patient.

At TheraTec, we are committed to the success of our healthcare providers as you navigate CMS’s new RTM codes and offer continuous, personalized support. For more information or to connect with a member of the TheraTec team, please visittheratec.com.

98975
Service Initiation: This covers initial set-up and patient education on the use of remote therapeutic monitoring equipment. 98975 can be billed once per patient per episode of care. Education given to patient/caregiver regarding what data to input, how to input data, and frequency of input data needs to be provided. This code requires 16 days of collected data that can be self-reported before you can bill.
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98977
Device Supply and Data Transmission: Remote therapeutic monitoring device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system. The data collected by the medical device could include adherence/compliance to HEP, if patient signed in, whether the patient has completed device setup, and any messaging that occurred. This code requires 16 days of collected data that can be self-reported before you can bill and is reported once per 30 days.

98980
‍Remote Treatment Management: 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. Documentation should include the date that the interactive communication occur(s), what kind of communication occurred, any changes to HEP, ROM, etc.

98981
‍Remote Treatment Management (Additional 20 Minutes): 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 (listed separately in addition to 98980). Documentation should include the date that the interactive communication occur(s), what kind of communication occurred, any changes to HEP, ROM, etc.
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Physical therapists/physical therapist assistants, occupational therapists/certified occupational therapist assistants, physicians, speech language pathologists, physician assistants, nurse practitioners, and clinical social workers.

Monitoring involves reviewing patient activity, responding to patient messages, and updating patient prescribed programs while staying within scope of practice. Any time spent monitoring a patient will go towards billing 98980/98981 for that calendar month.

There is an approved list of clinicians that can provide for RTM including, but not limited to: physical therapists/physical therapist assistants, occupational therapists/certified occupational therapist assistants, speech language pathologists, physicians, physician assistants, nurse practitioners, and clinical social workers. The clinicians/providers performing RTM and billing need to be licensed in the state where the patient is physically located. The Compact Agreement is an agreement between member states that gives clinicians the ability to practice in multiple states. When considering who can bill for RTM codes, you need to consider what is being monitored, which code is being billed, and scope of practice.

Code 98975:
‍Set up and education code. This code can be billed by those in the above list and approved clinicians once a patient has 16 days of monitoring has been performed.
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Code 98976:
Device supply and data transmission referring to monitoring of the respiratory system. This code can be billed once 16 days of data transmission is completed within a 30-day period. Speech-language pathologists, physicians, physician assistants, nurse practitioners, etc. will be seen billing this code as long as clinicians are following scope of practice.
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Code 98977:
Device supply and data transmission referring to monitoring of the musculoskeletal system. This code can be billed once 16 days of data transmission is completed within a 30-day period. Physical therapists/physical therapist assistants, occupational therapists/certified occupational therapist assistants, physicians, physician assists, nurse practioners, etc., will be seen billing this code as long as clinicians are following scope of practice.
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Code 98980/98981:
‍Remote Treatment and Monitoring. These codes are billed each calendar month and are billed according to time spent monitoring for each patient by approved clinicians in the above list with clinicians following scope of practice.
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RTM involves the monitoring of patient health data which must be acquired from the patient through a medical device as defined by the FDA. In the context of an HEP, both a wearable sensor (which collects range of motion data) and an app on a patient’s smartphone (which collects self-reported data) qualify as the medical device required to bill for RTM. According to CMS, RTM data can be self-reported by the patient and digitally uploaded via the device, as this is classified as Software as a Medical Device (SaMD).

Interactive communication can occur by phone call, 2-way audio/visual call, such as FaceTime/Zoom, interactive messaging portal on medical device, and during in person clinic visits.

To bill for 98980/98981, the provider and patient must have at least 1 episode of interactive communication for each calendar month in which you bill for these codes. This time spent communicating will contribute to the overall time that will be billed for these codes.

See the AMA's Future of Health issue brief Commercial Payer Coverage for Digital Medicine Codes It is recommended to have the office do a Verification of Benefits for the patients being considered for RTM services. A good reminder is that one patient’s contract for a given payer does not cover RTM does not mean all contracts for that payer will not cover RTM services.

There may be the de minimis standard applied to CPT codes 98975. 98980, and 98981when performed in whole or part of by certain clinicians. This rule does not apply to CPT codes 98976. 98977, or 98978. Modifiers may need to be attached depending on the clinician performing the RTM.

Some commercial insurances may count towards a person’s visit eligibility if RTM is billed on a separate date of service. Best practice and our recommendation is to reach out to the payor contact for clarification.

Remote Physiological Monitoring (RPM) was created for providers who can perform Evaluation and Management (E/M) codes (99202-99215) to use a device to objectively measure and transmit physiological information that a patient cannot alter to their provider. RPM typically involves the continuous or intermittent collection of physiological data such as heart rate, blood pressure, glucose levels, etc. The goal is to monitor patients remotely and provide timely interventions to manage chronic conditions. Upon further use of RPM, CMS decided to create the Remote Therapeutic Monitoring (RTM)codes to allow providers who cannot use E/M codes to perform Remote Monitoring services.

RTM codes, however, were designed for monitoring and managing patients undergoing therapeutic interventions or treatments, such as physical therapy, chemotherapy, or other medical procedures. RTM informs the provider of subjective and/or objective information about the physiological response to therapeutic treatments being prescribed to ensure effectiveness and the patient's well-being.