Therapeutic Monitoring

Our services

Our Inclusions:

If you are not getting ALL these services with your RPM solution - it is time to contact CENSON Health.

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:

  • CPT code 98980: Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes — base code.
  • CPT code 98981: Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional add on code 20 minutes (list separately in addition to code for primary procedure).
  • CPT code 98975: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment.
  • CPT code 98976: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days.
  • CPT code 98977: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days. (Specific to ARIA Physical Therapy device.)

  • CENSON Health Services

    follow the Process

    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.

    Looking for guidance on the best way to maximize your reimbursement potential?  Reach out using the chat button below or book a consultation and our experts will share their insights and get you on the right path.