Everything you want to know about Remote Therapeutic Monitoring (RTM)

The CMS has proposed a new category of digital health services—Remote Therapeutic Monitoring (RTM)—to complement the existing suite of Remote Physiological Monitoring (RPM) codes covered under Medicare. These codes are planned to start in January 2022. The structure and nature of RTM services resemble RPM services.

What are the CPT codes associated with RTM?

  • CPT Code 989X1
    Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on the use of equipment.
  • CPT code 989X2
    Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days.
  • CPT Code 989X3
    Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days.
  • CPT Code 989X4
    Remote therapeutic monitoring treatment management services, physician/ other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes.
  • CPT Code 989X5
    Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes.

How Does RTM Differ from RPM?

While there are similarities between the RPM and RTM codes, CMS identified some key differences between the two.

  1. Nature of the data to be collected
    RTM codes monitor health conditions including, but not limited to, musculoskeletal system status, respiratory system status, therapy adherence, and therapy response, and as such, allow non-physiologic data to be collected.
  1. Clinical use cases eligible for device supply reimbursement under RTM
    RPM CPT Code 99454 does not restrict the clinical or biological systems being monitored, although the data must be physiological. In contrast, RTM CPT Code 989X2 is only for transmissions to monitor the respiratory system, whereas 989X3 is only for transmissions to monitor the musculoskeletal system. The current RTM device supply codes do not target other systems (e.g., neurological, vascular, endocrine, digestive, etc.).
  1. How the device collects data?
    RTM data can be self-reported by the patient, as well as digitally uploaded via the device. In contrast, RPM requires the device to digitally (that is, automatically) record and upload patient physiologic data, i.e., data cannot be patient self-recorded, self-reported, or entered manually into the device).
  1. Which clinicians can order and bill for RTM services?
    The primary billers of RTM are intended to be Nurses and Physical Therapists. The idea is that the new RTM codes would allow practitioners who cannot bill RPM codes to furnish and bill for services that look like those of RPM.

Conclusion

HealthArc has been an industry leader in Remote Patient Monitoring for some time, and the interdisciplinary approach, flexible interface, and seamless interoperability can easily be scaled for Remote Therapeutic Monitoring.

The CMS proposed rules regarding RTM promote the clinicians to use remote monitoring technologies to improve the patient care experience, but the technical details still need to be ironed out. We will continue to monitor CMS for any rule changes or guidance that affect or improve both RPM & RTM opportunities.