“…remote therapeutic monitoring, or RTM, refers to the remote monitoring and management of therapy services. Specifically, that means the monitoring of general medicine categories like musculoskeletal status, and medication and therapy adherence and response.”
A Quick Guide to Remote Therapeutic Monitoring and Why It Matters in 2022
With the addition of remote therapeutic monitoring to the 2022 CMS physician fee schedule, there’s been a surge of awareness and conversation around the term. So, what is remote therapeutic monitoring, exactly, and why does it matter for America’s healthcare providers?
What Is Remote Therapeutic Monitoring (RTM)?
Just as its name implies, remote therapeutic monitoring, or RTM, refers to the remote monitoring and management of therapy services. Specifically, that means the monitoring of general medicine categories like musculoskeletal status, and medication and therapy adherence and response.
Beyond its literal definition, though, it’s perhaps more helpful to define RTM in the terms put forward by The Centers for Medicare & Medicaid Services (CMS). The agency, which dictates the reimbursement standards for care delivery in the United States, has positioned RTM as separate from remote patient monitoring (RPM), and even supplementing and supporting it.
More specifically, the new RTM codes allow reimbursement for the remote managing and collection of non-physiological patient data. This is in contrast to RPM, which reimburses the monitoring of physiological data only. (For this reason, RPM is also sometimes referred to as “remote physiological monitoring.”)
General (RPM) VS Direct Supervision (RTM)
Another big difference: the data collected under the older RPM codes is reimbursed as “general supervision,” which means that it can be performed under the physician’s overall direction by clinical staff. On the other hand, the new RTM codes allow reimbursement on a “direct supervision” basis. That means that the eligible practitioner, for instance, the physical or occupational therapist billing for the service, must be physically present to manage the virtual care team. A caveat to this requirement is that real-time audio-visual communication is accepted as direct supervision until the year in which the Public Health Emergency (PHE) ends, which covers 2022, but it is nevertheless an important factor to consider for providers who are interested in RTM.
How RTM Expands Remote Care Reimbursement
The new RTM codes, then, essentially broaden the practical applications of remote patient monitoring by expanding how it can be used, and by whom. As such, RTM can be seen as part of CMS’ ongoing expansion of reimbursement codes to better accommodate the delivery of remote care (or telehealth, as per the terminology used by CMS).
Used primarily in recent years to manage patients with chronic conditions like COPD or heart disease, remote patient monitoring has been somewhat limited in scope due to a lack of more comprehensive reimbursement guidelines.
However, that’s changed a lot in the last two years. In 2020, CMS expanded the use of RPM codes to better accommodate at-home care as a response to the Covid-19 public health emergency (PHE). And there’s informed speculation among industry observers that this expansion is here to stay, even as the global pandemic winds down. (Or maybe more accurately, as it refuses to go away.)
What are the Benefits of RTM?
Beyond the obvious advantages of further enabling at-home care, the new RTM reimbursement codes could benefit providers in other ways. Because they explicitly allow for more types of monitoring, for instance, they open the door for reimbursement beyond physician-directed clinical care — the basis for much of existing the RPM structure.
And because it allows for the “general medicine” collection of data — as opposed to direct “evaluation and management” — the new rule enables billing of RTM care by practitioners who are not physicians. That expands reimbursement for remote care beyond the immediate purview of physicians to potentially include nurses, physical therapists and occupational therapists.
RTM also expands remote care usage by allowing patients to self-report data, or to upload info manually to their devices. RPM, on the other hand, has traditionally required that data be uploaded automatically by the device — a requirement that could exclude certain devices from qualifying for reimbursement.
The upshot of this expanded usage is enabling a closer monitoring of a patient’s adherence to a prescribed therapy. This can let practitioners determine whether patients are following their care regimen, and how effectively it’s working. This, in turn, can help them understand any potential failures of patient adherence, and then make the appropriate adjustments for more effective care.
More effective monitoring of medication and therapy adherence, or respiratory or musculoskeletal status, also has the potential to help providers lower the rate of rehospitalizations, or urgent care and ER visits. This, in turn, could give providers a significant opportunity to lower costs, improve outcomes, and adhere more closely to the guidelines of value-based care.
Follow CareSimple for RTM Information
This is just the beginning. Join us next week for a detailed breakdown of the new RTM codes, and how they can be applied throughout your organization. And remember to bookmark the CareSimple blog, where you’ll find ongoing updates and insider info on the state of reimbursement for all aspects of remote care.
Finally, if you’re seeking guidance on the use of remote care technology, we invite you to download our free “Reimbursement Tree” guide, a convenient, one-page summary of the new CMS reimbursement codes.
Questions about RTM or other types of remote care? CareSimple is standing by to help answer them. Contact us today to get in touch with one of our experts.