What is Remote Therapeutic Monitoring?
The nature of the data collected, more specifically therapeutic for RTM versus physiological for RPM.
RTM can be used for non-physiological medical devices like those used to support medical adherence (e.g., smart pill reminder systems) and medication symptom/adverse reaction applications.
Essentially, any information that a medical device — including software that fits the definition of a medical device — can collect that is not physiological can be collected and billed for under RTM.
Remote Therapeutic Monitoring Codes and Coverage and Coding
The RTM family includes three PE-only codes and two codes that include professional work — 98980 and 98981:
CENSON Health Services
AMA Remote Therapeutic Monitoring Codes: Rules and Requests
What are key coding rules therapists should know?
- Cumulative time spent for data review and patient/caregiver interaction is totaled for a calendar month (not each 30 days).
- The base code (98980) and add-on code (98981) are reported together on the claim based on total time following the end of the calendar month.
- We do not report these codes if activities total less than 20 minutes in a calendar month.
- Codes 98976 and 98977 represent the cost of supplies for specific types of monitoring systems.
What devices can be used for RTM?
Monitoring devices used must be approved by the U.S. Food and Drug Administration, and data collected by the device can be patient self-reported or automatically transmitted directly from the device to the clinician.
One example provided in the proposed rule is as follows:
An asthmatic patient is prescribed a rescue inhaler equipped with an FDA-approved medical device that monitors when the patient uses the inhaler, how many times during the day the patient uses the inhaler, how many puffs/doses the patient uses each time, and the pollen count and environmental factors that exist in the patient’s location at that time. This is non-physiologic data. The data is then used by the treating practitioner to assess the patient’s therapeutic response and adherence to the asthma treatment plan. This can enable the practitioner to better determine how well the patient is responding to the particular medication, what social or environmental factors affect the patient’s respiratory system status, and what changes could be made to improve the patient’s health.
How is RTM impacted by de minimis?
CMS clarified that the two device codes, CPT codes 98976 and 98977, are not subject to the de minimis standard that establishes the threshold for the statutorily required payment adjustment that applies to therapy services provided in whole or in part by therapy assistants.
However, the initial set-up and patient education services represented by CPT code 98975 are subject to the de minimis policy. For more information about how the de minimis policy is applied for services provided in full or in part by therapy assistants, see the Therapy pages at section II.H.1. of the final rule.