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RTM (Remote TherapeuticMonitoring) CPT codes

remote-therapeutic-monitoring-cpt-codes
With the rise in telehealth, reimbursement opportunities have expanded significantly. Recently, the Centers for Medicare & Medicaid Services (CMS) introduced new remote therapeutic monitoring CPT codes. These codes aim to enhance the management and reimbursement of remote therapeutic services, boosting the efficiency of telehealth programs.
Remote therapeutic monitoring (RTM) focuses on respiratory and musculoskeletal systems, distinguishing it from remote patient monitoring (RPM). This specialization allows providers to monitor these critical areas more effectively, improving patient care. In this blog, we will explore the essential remote therapeutic monitoring CPT codes vital for your remote care program.

What CPT Codes Are and Why They're Crucial for Remote Therapeutic Monitoring?

CPT codes, or Current Procedural Terminology codes, are standardized codes used in healthcare to describe medical, surgical, and diagnostic services. They play a crucial role in ensuring accurate billing and reimbursement for healthcare services provided.

What Are CPT Codes in Healthcare?

CPT codes serve as a universal language for reporting medical procedures and services. They enable healthcare providers to communicate effectively with insurers and government agencies for reimbursement purposes.
For example, a physical therapist may use CPT codes to bill for specific therapeutic exercises conducted during a patient’s session.

CPT Codes in Remote Therapeutic Monitoring

Remote therapeutic monitoring (RTM) involves healthcare providers monitoring and managing patients’ health remotely using digital devices. This approach allows for continuous assessment and intervention, particularly beneficial for conditions like musculoskeletal and respiratory issues.

The Role of CPT Codes in RTM and Reimbursement

CPT codes play a crucial role in remote therapeutic monitoring (RTM) by enabling healthcare providers to accurately document and bill for remote patient management services. These codes ensure proper reimbursement for services rendered, facilitating the integration of remote monitoring technologies into patient care strategies.
Billing for RTM Services:
  • Streamlines reimbursement processes.
  • Ensures accurate billing documentation.
  • Supports financial viability of RTM programs.
  • Facilitates compliance with regulatory requirements.
  • Enhances overall patient care outcomes.
RTM CPT codes empower healthcare providers, such as physical and occupational therapists, to expand their service offerings beyond traditional in-person visits. By utilizing these codes, providers can effectively manage and monitor patients remotely, improving both patient engagement and treatment outcomes.

What Are the Latest Remote Therapeutic Monitoring Codes?

Remote therapeutic monitoring (RTM) codes for 2024 enable healthcare providers, including physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs), to offer remote monitoring services under general supervision.
These codes facilitate “sometimes therapy,” allowing a broader range of healthcare professionals like physicians, nurse practitioners, physician assistants, and clinical nurse specialists to perform RTM.

CPT Code 98975: Initial setup and patient education on equipment. Billed once per 16 days. 

Average reimbursement rate: $19.65.

CPT Code 98976: Pays for respiratory devices with scheduled recordings and alerts. Billed every 30 days. Average reimbursement rate: $46.83.

CPT Code 98977: Reimburses musculoskeletal devices with scheduled recordings and alerts. Billed every 30 days. 

Average reimbursement rate: $55.72.

CPT Code 98980: Bills for the initial 20 minutes of treatment time per month, including interactive communication. 

Average reimbursement rate: $49.78.

CPT Code 98981: Covers each additional 20 minutes of treatment time per month with interactive communication requirements. 

Average reimbursement rate: $39.30.

Below is the Tabular Representation of Remote Therapeutic Monitoring Codes for 2024
Treatment CPT Code Description Billing Frequency  Average Reimbursement Rate 
Initial setup & Education  98975 Setup and patient education for equipment Once per 16 days $19.65
Respiratory Devices 98976 Monitoring devices for respiratory system Every 30 days $46.83
Musculoskeletal Devices 98977 Monitoring devices for musculoskeletal system Every 30 days $55.72
Initial Treatment 98980 First 20 minutes of treatment with interaction Monthly $49.78
Additional Treatment 98981 Additional 20 minutes of treatment with interaction Monthly $39.30
These codes offer healthcare providers structured billing opportunities to effectively manage and monitor patients remotely in 2024, enhancing patient care delivery and operational efficiency.

Billing and Coding Guidelines

Remote Therapeutic Monitoring (RTM) involves specific criteria for both billing and coding to ensure accurate reporting and reimbursement.

Billing Criteria

  • RTM services should be an integral part of the overall treatment plan.
  • CPT Code 98980 is billed once per month, regardless of the number of monitoring devices used.
  • Providers must spend a minimum of 20 minutes on CPT Code 98980 to qualify for billing.
  • Time spent on RTM services excludes any clinical staff time needed for data collection.
  • At least one interactive session with the patient or caregiver is required each calendar month.

Coding Criteria

  • Only bill RTM codes for services lasting at least 20 minutes.
  • CPT Code 98980 and its Add-on Code 98981 are invoiced based on the cumulative time by the end of the month.
  • These codes cannot be reported on the same day as an Evaluation and Management (E/M) service by the same healthcare professional.
  • RTM services can be reported in the same month as care management, transitional care management, primary care management, or behavioral health integration services, but not concurrently.
These guidelines ensure adherence to coding and billing standards while enabling effective management and monitoring of patients through remote therapeutic monitoring services.

Final Thoughts

Remote therapeutic monitoring (RTM) CPT codes represent a pivotal advancement in healthcare delivery, particularly in telehealth. With CMS’s introduction of these codes, providers can manage patients remotely, using devices for respiratory and musculoskeletal conditions. This enhances patient care and streamlines reimbursement processes.
These codes empower healthcare professionals to expand services under supervision and integrate remote monitoring technologies seamlessly. By leveraging RTM CPT codes, providers maximize their remote care capabilities, providing effective interventions and advancing healthcare delivery. As telehealth evolves, RTM CPT codes foster patient engagement, support regulatory compliance, and enhance overall care quality.

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