NEW BILLING CODES

Remote Therapeutic Monitoring (RTM) 

New CPT® codes for modern physio.

 Exer's team helped develop new billing opportunities for physical therapy stakeholders who want to grow their business and achieve better patient outcomes.

Overview of Exer Physio

We are successfully billing across payors.

RTM Code

Billable Description

Frequency

Amount

98975
Initial set-up & patient education.
1x per episode
$24*
98977
RTM device & data transmission.
1x per 30 days
$69*
98980
First 20 minutes of RTM treatment management services.
1x per calendar month
$61*
98981
Each additional 20 minutes of RTM treatment management services.
Multiple per month
$49*

RTM Code

Billable Description

Amount

98975
Initial set-up & patient education.

1x per episode
$24*
98977
RTM device & data transmission.

1x per 30 days
$69*
98980
First 20 minutes of RTM treatment management services.

1x per calendar month
$61*
98981
Each addt'l 20 minutes of RTM treatment management services.

Multiple per month
$49*
*Exact reimbursement amounts vary by geographic regions, payors and plans.

Remote therapeudic monitoring, unlocked.

Mobile-ready, no extra hardware.

You can be billing RTM codes by next week.

Home exercise library included.

Improve adherence with how-to videos, form correction and HEP reminders.

Frequent RTM Questions

What practitioners can order & deliver Remote Therapeutic Monitoring?

Physicians and eligible qualified healthcare professionals, are permitted to bill RTM as general medicine services. A physician or other qualified healthcare professional is defined in the CPT Codebook as “an individual who is qualified by education, training, licensure/regulation (when applicable) and facility privileging (when applicable) who performs a professional service within his/her scope of practice and independently reports that professional service.”

Accordingly, RTM codes are available for use by physical therapists (PT) and occupational therapists (OT).

In the final rule, CMS stated the primary billers of RTM codes are projected to be physiatrists, nurse practitioners, and physical therapists. The new RTM codes, classified as general medicine codes, should open up opportunities for therapists, psychologists, and other eligible practitioners who cannot currently bill for RPM (as RPM is an E/M code).

How many minutes of service are required for RTM?

CPT code 98980 requires a minimum of 20 minutes of time in a month, dedicated to remote therapeutic monitoring treatment management of the patient. This time must also include at least one interactive communication with the patient/caregiver during the month (e.g., via phone or video).

CPT code 98981 has the same requirements as CPT code 98980, except is it used for additional 20 minutes per month, as an add-on code.

Is RTM limited to respiratory and musculoskeletal conditions?

Yes, the clinical use cases eligible for device supply reimbursement under RTM are limited to these areas. The RTM device supply code 98977 is similar to the RPM device supply code (99454), but not identical. The RTM device supply code descriptor indicates far more limited clinical use cases. Namely, 98977 is only for transmissions to monitor the musculoskeletal system.

How often can the RTM codes be billed?

Code 98975 may be billed once per episode of care. An episode of care begins when the remote therapeutic monitoring service initiates and ends with the attainment of targeted treatment goals.

Codes 98977 may be billed once per 30 days.

Code 98980 may be billed once per calendar month regardless of the number of therapeutic monitoring modalities performed in a given calendar month.

Code 98981 may be billed once per calendar month for each additional 20 minutes completed within such month.

How many days of data must the device monitor?

CPT code 98977 requires the RTM device to monitor at least 16 days of data per each 30-day period, in total.

Can RTM data be self-reported by the patient?

Yes.

CMS stated that self-reported/entered data may be part of the non-physiologic data for purposes of RTM codes.  (“Reportedly, RTM data can be patient reported, as well as digitally uploaded while RPM requires that data be physiologic and be digitally uploaded.”).  RTM codes still require the device used to meet the FDA’s definition of a medical device, self-reported RTM data via mob classified as Software as a Medical Device (SaMD) will qualify for reimbursement. This differs from RPM codes, which require the device to digitally (automatically) record and upload patient physiologic data (i.e., data cannot be patient self-recorded, self-reported, or entered manually into the device).
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