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).