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?
A brief overview of remote therapeutic monitoring and the benefits of RTM
“…remote therapeutic monitoring, or RTM, refers to the remote delivery of therapeutic patient care … specifically, monitoring a patient’s musculoskeletal status, or respiratory status, as well as related medication and program adherence.
What is remote therapeutic monitoring (RTM)?
Just as its name suggests, remote therapeutic monitoring, or RTM, refers to the remote delivery of therapeutic patient care. As the RTM codes are currently defined, that specifically means actively monitoring a patient’s musculoskeletal status or respiratory status, as well as medication response and adherence and other key indicators.
98975, 98976, 98977, 98980 & 98981: Get a complete guide to current remote therapeutic monitoring codes here.
For healthcare organizations, it may be more helpful to think of the definition of remote therapeutic monitoring 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, CMS’ remote therapeutic monitoring codes allow reimbursement for the remote managing and collection of non-physiological patient data. This is in contrast to the RPM codes, which reimburses the monitoring of physiological data only. (For this reason, RPM is also sometimes referred to as “remote physiological monitoring.”)
Reimbursement for general (RPM) vs direct supervision (RTM)
Another big difference between remote patient monitoring and remote therapeutic monitoring is that the data collected under the RPM rules is reimbursed as “general supervision.” That means these services can be performed by a physician or Qualified Health Care Professionals (QHPs) like nurse practitioners or physician assistants, as well as staff members operating under their general direction.
Remote therapeutic monitoring, on the other hand, offers reimbursement on a “direct supervision” basis. That means that the eligible practitioner — for instance, the physical therapist, occupational therapist or other billing provider — must always be present, even during a virtual check-in.
A caveat to this requirement is that real-time, audio-visual interactive communication is accepted as direct supervision during the still-ongoing (as of September, 2022) Covid-19 public health emergency (PHE), Nevertheless, this may change upon the end of the PHE, and is therefore an important factor for clinical providers to consider.
Why RTM represents an expansion of reimbursement for the use of remote monitoring technologies
The new RTM codes, then, essentially broaden the practical applications of remote patient monitoring technology 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).
What’s the difference between telehealth, RPM and RTM? Get a primer on the terminology for digital health technologies here.
Used primarily in recent years to manage patients with chronic conditions like COPD or heart disease, remote patient monitoring is now expanding to cover many other patient types. During the ongoing PHE, reimbursement has expanded to include other at-risk patients. 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 remote therapeutic monitoring?
Beyond the obvious advantages of further enabling at-home care, the new RTM reimbursement codes could benefit providers in other ways. Because they allow for more types of monitoring, for instance, they open the door for reimbursement beyond physician-directed clinical care — the basis for much of the existing RPM billing 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 medical devices. RPM, on the other hand, has traditionally required that data be uploaded automatically by the device — a requirement that could exclude certain medical devices from qualifying for reimbursement.
What devices are used for remote therapeutic monitoring? Get an overview of RTM devices here.
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.
The more effective monitoring of all of these elements — medication and respiratory system status, therapy adherence, therapy response, respiratory system status and musculoskeletal system 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 updates on remote therapeutic monitoring and more
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.
And if you’re seeking guidance on the use of remote care technology, we invite you to download our free Reimbursement Tree, 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.