5 FAQs on the 2022 Medicare Remote Therapeutic Monitoring

Remote Therapeutic Monitoring (RTM) is created to complement the Medicare Remote Physiological Monitoring (RPM) codes. If you are not quite familiar with RTM, it is specifically designed to assist patients who are using medical devices that collect information about non-physiological data such as respiratory and musculoskeletal system status. The RTM is used to coordinate the services of healthcare professionals and qualified beneficiaries who use various technologies to monitor the health status of the patient and detect the onset of the events or conditions that will allow the patient to remain active in the community and to participate in the activities of daily living. The RTM services are available to Medicare beneficiaries who have been diagnosed with chronic conditions and are in need of remote monitoring using wireless, location monitoring, and wireless location monitoring. To help you learn more about the topic, here are the answers to five frequently asked questions about the 2022 Medicare RTM.

1. Does RTM require a medical device, or can it be used with just a wellness wearable?

The use of a medical device, not just a wellness device, is required in RTM as stated under the Federal Food, Drug, and Cosmetics Act.

2. Are the RTM codes subject to the de minimis standard?

No, the Medicare RTM codes are not subject to the de minimis standard. But RTM is subject to the education code. According to the final rule, the five RTM codes are designated by CMS as "sometimes therapy codes." This means that the RTM services can be billed outside a therapy plan as provided by some NPPs and physicians and as long as deemed necessary. Also, as stated by CMS, two RTM codes, CPT codes 98977 and 98976, are not subject to de minimis standard, showing the threshold for statutorily required payment adjustment, which applies to therapy services given in part or in whole by therapy assistants. On the other hand, CPT code 98975, the initial setup and patient education services are subject to de minimis standard, which requires payments of therapy assistants. If you wish to learn about the billing example, CM illustrates the final rule of how de minimis policy is applied to the RTM services, describing the communication between the patient/caregiver and the therapist/therapy assistant.

3. How often are RTM codes billed?

Billing for code 98975 is once every episode of care. This care begins during the initial stage of the remote therapeutic monitoring service and ends when the treatment goals have been attained. Billing for codes 98976 and 98977 is once every 30 days. Billing for code 98980 is once every month, regardless of how many therapeutic monitoring services were performed within that month. Billing for code 98981 is once per month for every additional 20 minutes within the given month.

4. How many days of data must the medical advice monitor?

At least 16 days of data for each month (30-day period) is required for the RTM device to monitor for CPT codes 98975, 98976, and 98977.

5. Can the RTM data be reported by the patient?

Yes. According to what CMS stated in the final rule, self-entered or self-reported data may be integrated into the non-physiological data. A patient can self-report the RTM data or digitally upload it through the medical device. In addition to that, RTM data coming from an online platform called Software as a Medical Device (SaMD) or a smartphone app may qualify for reimbursement.

Conclusion

Now is the time for entrepreneurs and medical equipment providers to take advantage of the promising remote monitoring technology. This technology will continue to thrive over the years. More and more medical health professionals, providers, and hospitals are using RTM, RPM, and other digital non-face-to-face technologies to cater to the needs of their patients and to improve the quality of patient health care experience. Medistics Health offers an accessible healthcare experience and the best care management solutions for patients and health care providers and professionals. Let us support your health journey with patient-centered care. Schedule an appointment with us today!