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Remote Therapeutic Monitoring for Physical Therapy in 2023

Remote Therapeutic Monitoring for Physical Therapy in 2023


The introduction of Remote Therapeutic Monitoring CPT codes in 2022 provided a long-awaited solution for billing services that many clinics have been providing for years. Despite this, the majority of clinics have yet to adopt these codes as of 2023. This blog post aims to shed light on RTM codes and outline best practices to ensure you aren’t leaving money on the table.





What is Remote Therapeutic Monitoring?


Remote Therapeutic Monitoring (RTM) is designed to monitor patients in-between visits using medical devices that collect non-physiological data. This data relates to the signs, symptoms, and functional response to therapy and provides a comprehensive representation of the patient's status and progress


What are the RTM codes relevant to Physical Therapists?


Below are the four primary RTM codes that are relevant to Physical Therapists:

CPT Code

Description

Requirements

Avg. Reimbursement

98975

Initial set-up

- Initial setup on new RTM device

- Data Points on 16+ days

~$19

98977

RTM data transmission

- Data Points on 16+ days of 30 day period

~$55

98980

First 20-min RTM services

- 20-minutes of RTM services per calendar month

- One interactive communication


~$50

98981

Additional 20-min RTM services

- Additional 20-minute block(s) of services RTM per calendar month

~$40


What’s an example case of billing RTM codes?


A patient is evaluated by a PT on January 7th, 2023. The PT designs a Home Exercise Program on a clinic-branded PT Wired app (a system that meets the FDA definition of a Software as a Medical Device). The PT guides the patient on the use of the app, explains the process of capturing and inputting data, and answers any questions the patient may have.


From January 7th, 2023 to February 5th, 2023, the app collects patient data for 17 days, including exercise completion data and pain ratings. That data is transmitted to the PT Wired provider portal where the PT is able to analyze and interpret the data collected.


From January 7th, 2023 to January 31, 2023, the PT performs the following RTM management services:


1/11/23 - Edit HEP - 3.5 minutes

1/13/23 - Analyze RTM Data - 1 minute

1/13/23 - Message Patient - 2 minutes

1/17/23 - Analyze RTM Data - 1 minute

1/17/23 - Live Call with Patient - 4 minutes

1/17/23 - Edit HEP - 3 minutes

1/19/23 - Analyze RTM Data - 1 minute

1/24/23 - Analyze RTM Data - 1 minute

1/26/23 - Edit HEP - 4 minutes

Total Time: 20.5 minutes


These services are all conducted at times when the PT is not billing any other CPT code.


The PT bills the following RTM codes on the following days:


January 31st, 2023 - 98980

February 5th, 2023 - 98975, 98977


What insurances will pay for RTM?


RTM codes are active codes for Original Medicare. Medicare Advantage plans must also provide the same services as Original Medicare.


In the past few months, we’ve also had reports of several commercial insurers covering RTM codes. Because this varies based on your region, we recommend contacting your payers to determine coverage.


We’re keeping a running list of payers by region based on reports from PT Wired clients. Feel free to contact us and we may be able to provide you with information!


How do I get started?


To start billing for remote therapeutic monitoring, ensure that your RTM system meets FDA's definition of a Software as a Medical Device. If not, implement a qualified system such as the PT Wired app.


Next, you’ll need to create processes and procedures to keep track of billing requirements for patients enrolled in RTM. A system that automatically tracks requirements makes this significantly easier. (Click here to see how requirements are tracked on PT Wired).


Finally, create a clinic-wide strategy to optimize RTM billing.


Here are some things to consider:


  • Will your providers be responsible for meeting RTM requirements with their own patients or will a designated provider perform the monitoring services for all patients?

  • Will providers have designated time for RTM or will they need to work around visits and cancellations to ensure requirements are met?

  • Will you provide training to providers to properly explain the device/app to maximize the patient’s usage?

  • Will you prepare content (such as informational handouts, QR codes, etc.) to give to patients to help educate them on the device and simplify onboarding?

  • What are your goals in terms of RTM patient enrollments and percentage of enrollments that ultimately fulfill the requirements for billing?

At PT Wired, we’ve spent a lot of time discussing these questions with many types of practices. If you’d like to clarify anything regarding RTM codes, discuss recommendations on RTM strategy, or examine the Prompt-integrated PT Wired RTM solution, feel free to book a call with our team!


About PT Wired


PT Wired is a Prompt-integrated patient engagement solution that helps PT clinics prevent patient dropout, improve satisfaction, and boost revenue through RTM.


PT practices receive a fully-branded mobile app available via iOS, Android, and Web that patients can download to access their Home Exercise Program with videos, notes, and reminders. In addition, patients can securely message their therapist, schedule appointments, pay bills, and access clinic marketing content.


Therapists can quickly and easily customize patient prescriptions and track RTM requirements through the provider portal.


For more information, please visit www.ptwired.com.

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