By HealthArc | May 30, 2022

Remote Therapeutic Monitoring, or RTM, involves remote delivery of therapeutic patient care pertaining to musculoskeletal and respiratory systems as well as medication adherence and cognitive behavioral therapy (CBT). RTM is distinct from remote patient monitoring (RPM) and even complements and supports it. It is intended to manage patients who use medical device or software that collect non-physiological data. The new RTM codes allow for the collection of data regarding indicators such as therapy/medication adherence, therapy/medication response, and pain level. Specifically, under these codes, CMS recognizes that “therapeutic” data—other than just “physiological” information—is also a significant source of remote evaluation of patient data.

RTM codes allow reimbursement for remote management and collection of data not related to a patient’s physiological condition. Comparatively, RPM reimburses only monitoring of physiological data. (That is why remote physiological monitoring is sometimes called RPM).

In a hypothetical situation, RTM might be used as follows:

During an asthma attack, the patient has been prescribed a rescue inhaler with an FDA-approved remote monitoring medical device that continually monitors when and how frequently the patient uses the inhaler, how many puffs or doses are used, and the pollen count and environmental factors present at the time of the attack. In this case, the data is not physiological. As a result, the treating professional can assess how well the asthmatic patient is responding to treatment and how well they are adhering to the treatment plan. The practitioner will be able to identify better how the patient is responding to the medication, what factors affect the patient’s respiratory system, and what changes can be made to improve the patient’s health as a whole.

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What are the differences between remote therapeutic monitoring (RTM) and remote patient monitoring (RPM)?

Despite similarities, CMS identified some key differences between RPM and RTM codes.

Scope of the Data Collection

In addition to monitoring musculoskeletal and respiratory conditions, adherence to therapy, and treatment response, RTM codes also provide non-physiological data.

Clinical Use Cases Qualified for RTM Reimbursement

There are no restrictions on the clinical or biological systems being monitored by RPM CPT Codes, although the data must be physiological. Contrary to this, RTM CPT Code 98976 is limited to transmissions of monitoring the respiratory system, whereas 98977 is limited to transmissions of monitoring the musculoskeletal system. As of today, RTM device supply codes are not available for other systems (e.g., neurological, vascular, endocrine, digestive, and other such disorders).

Methods of Collecting Data

Patients are able to self-report RTM data, which can be digitally uploaded via software-as-a-medical-devices (SaMD). An RPM device, in contrast, is required to record and upload patient’s physiological data automatically. The patient shouldn’t manually enter it.

Remote therapeutic monitoring: how can it benefit you?

The new RTM reimbursement codes have other benefits in addition to the obvious advantage of enabling at-home care. As they allow for more types of monitoring, for example, they open the door to get reimbursed for services other than physician-directed clinical care, which is the foundation for most of the existing RPM systems.

Additionally, because this rule allows data to be collected as part of “general medicine” as opposed to direct “evaluation and management,” practitioners who are not physicians may now bill for RTM services. In a sense, remote care is expanded beyond the immediate responsibility of physicians to include nurses, physical therapists, and occupational therapists.

In addition to enabling self-reporting, RTM allows patients to upload information to their devices manually. In contrast, RPM requires that medical devices upload data automatically – a requirement that could exclude certain devices from being reimbursed.

Consequently, the expanded use of this technology enables closer monitoring of adherence to the prescribed therapy. Practitioners can use this method to determine whether patients are following their care regimens and how well they’re doing. Thus, they are able to understand potential patient adherence problems better and then make the appropriate adjustments for better care.

In addition to improving medication adherence as well as respiratory and musculoskeletal status, more effective monitoring can reduce the number of re-hospitalizations, urgent care visits, and emergency room visits. In turn, this could offer providers the opportunity to lower costs, improve outcomes, and better adhere to the guidelines of value-based care.

Which CPT codes are associated with the RTM?

The CPT Editorial Panel created a family of five codes in October 2020 named RTM. Three codes in the RTM family are practice expense (PE)-only codes and two codes that are professional work-only codes.

So, with that background in mind, here is a breakdown of all the new RTM codes, followed by the CMS definitions, a simple explanation, and the amount of reimbursement:

CPT Code 98975

Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial setup and patient education on the use of equipment.

What does that mean?

This RTM code describes the initial setup of a therapeutic monitoring device or other equipment, as well as the education of the patient regarding its use. Only one episode of care can be billed per year (the period from the activation of the service to the resolution of the treatment objective).