The addition of remote therapeutic monitoring (RTM) CPT codes earlier this year is a win for rehab therapists looking to improve patient engagement, optimize outcomes, and earn more revenue. And while many rehab therapists have been employing RTM in their work with patients for some time (without reimbursement), many others who haven’t yet given it a go may wonder if it’s worth the effort—especially considering how much change the industry has faced these past couple of years. This is why we’re shedding some light on how RTM can help you increase your profits while improving patient care—without upending your clinic’s operations.
What exactly is RTM and how does it benefit me?
If you’re new to remote therapeutic monitoring, here’s the relatively quick overview: RTM is similar to remote patient monitoring (RPM) in that it allows therapists to use apps and devices to collect information on a patient’s adherence and response to dosage and treatment. There are some important distinctions between the two, however; RTM only collects non-physiologic data (i.e., medication adherence, medication response, therapy adherence, and therapy response), and RPM and RTM have separate billing guidelines.
CMS has made digital health a key component in its push for patient-centered treatment, and the introduction of RTM CPT codes is an indication of how valuable CMS believes RTM to be as part of this ongoing shift. For rehab therapists who are currently part of a value-based care program (like MIPS), RTM encourages further engagement with patients outside of the clinic, which leads to better outcomes—the guiding star for value-based care.
For many rehab therapists, this may be rehashing something that they’ve known for years. The only difference? Now, they can finally bill CMS for the work they’ve been doing.
How can I use RTM to help boost my clinic’s revenue?
Using RTM in your clinic isn’t quite so simple as ordering some devices and handing them out—at least, if you’re planning to qualify for reimbursement. To qualify for RTM under CMS, the technology used to collect the data must meet the FDA’s definition of a medical device, which includes “software as a medical device,” like Keet Health’s platform. That device then automatically transmits that data to providers—simpler and more reliable than counting on a patient’s recollections during their next visit.
Once you have the correct software device in place, you can start billing Medicare for the RTM services you provide. Here’s a table showing the respective reimbursement rates for each RTM CPT code. (Please note that these numbers can vary slightly depending upon your area of the country.)
|Treatment||CPT Code||Description||Billing Frequency||Reimbursement Amount|
|Initial Set-up and Patient Education||98975||Remote therapeutic monitoring e.g., respiratory system status, Musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment||Billed once during the episode||$19.38|
|Monthly data transmission–respiratory system||98976||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||Can be billed every 30 days||$55.72|
|Supply of device for monitoring musculoskeletal system||98977||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||Can be billedevery 30 days||$55.72|
|Monitoring/treatment management services, first 20 minutes||98980||Remote therapeutic monitoring treatment management services, physician/ other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes.||Can be billed every calendar month||$50.18|
|Monitoring/treatment management services, each additional 20 minutes||98981||Remote therapeutic monitoringtreatment management services, physician/ other qualified healthcare professional time in a calendar month requiring at leastone interactive communicationwith the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure)||Can be billed every calendar month||$40.84|
What do those rates add up to in the aggregate? According to Phil Strebeck, Enterprise Sales Manager at Keet Health, therapists billing for 98975, 98977, 98980, and 98981 using the Keet app could potentially get reimbursed for up to $160 per patient, as opposed to the market average of $90 per patient.
Consider that difference in revenue across the number of patients who would benefit from RTM, and you can see how these new codes can be a boon to rehab therapists struggling with reimbursement cuts. And for those concerned about the cost of implementation, using RTM with just a fraction of your patients can bring in enough additional revenue for your software to pay for itself in no time and return a profit, especially in multi-practitioner clinics.
What’s a good example of when to use RTM in the clinic?
RTM can be used in a number of different scenarios in the clinic, and we’ll be outlining those more in our next blog post. For the time being, here’s a straightforward use case to get your mind moving in the right direction:
A patient comes into your clinic for an initial evaluation following a jet ski accident. During that evaluation, the therapist determines that the patient has suffered a shoulder injury and creates a plan of care with the patient, including a home exercise program (HEP). The therapist then has the patient download an app that will track their progress at home and allow them to answer surveys on outcomes and pain levels.
Over the next month, the patient is able to complete home exercises using the educational material provided on the app, while providing their therapist with periodic patient-reported outcomes. The therapist is able to keep tabs on the patient’s progress and adherence through the app, give them exercise checks and pain checks periodically, and make adjustments to their care as needed. For any questions that may arise, the patient can use the app to chat with their therapist
In this particular example, you would be able to bill for CPT code 98975 for setting up the app and providing education and training for at least 16 out of 30 days of data and code 98977 for continued supply of the device for 16 out of 30 days of data setting up the app and educating the patient, and CPT codes 98980 and 98981 for the RTM treatment management services provided between appointments based on the collective time spent by the provider for each 30-day period. Assuming that treatment continues into the next month, you could continue to bill for the same CPT codes, except for setup (98975), assuming that the patient provides data for 16 days.
Use our RTM ROI calculator to see how you can amplify your revenue.
To show you what a difference RTM can make in your clinic’s finances, we’ve included our own RTM ROI calculator so you can run the numbers yourself:
RTM ROI Calculator – Per Provider (Adjust the number in Blue Cells)
A few notes on how to use our handy calculator: the CPT codes and their respective reimbursement rates are self-explanatory, but some other columns require a bit more information.
- “Evaluations Per Month” is, as you might imagine, the number of evaluations you have per month. You can include your individual figure or, if you’re looking to get an idea of what your entire clinic could earn with RTM, slot in the estimated total evals for all providers in that month.
- “Medicare Distribution” is the percentage of those evals that are Medicare patients.
- “RTM Patients” is the percentage of those patients that you’ll have using RTM.
From there, our formulas take over to give you what you could roughly expect to earn (per month) from implementing RTM codes.
RTM codes provide a tremendous opportunity to rehab therapists to both provide better care with better outcomes and to actually get compensated for that work; why not take advantage of something that can benefit patients and providers alike?
If you’re interested in a platform that can help you with both RTM and outcomes measures, Keet is now available through the WebPT platform.