Medicare simply launched the brand new 2022 Doctor Charge Schedule on RTM Codes or Distant Therapeutic Monitoring. These new CPT codes might result in hundreds of extra {dollars} in reimbursement for PT and OT clinics with out them having to do something greater than monitoring house train program compliance by means of a easy sensible app.
Immediately I’ll clarify the RTM codes and present you how one can get began straight away with a monitoring software that you could be already be utilizing in your clinic.
What are RTM Codes?
Beginning January 1, 2022, CMS accepted 5 new CPT codes for Distant Therapeutic Monitoring (98975, 98976, 98977, 98980, 98981). These are completely different from RPM codes or distant affected person monitoring in that RTM codes don’t require monitoring of physiologic information. In reality Distant Therapeutic Monitoring codes had been particularly designed to trace non-physiologic information associated to the musculoskeletal or respiratory system. It additionally contains monitoring the adherence and response to remedy, together with house train program compliance.
5 Distant Therapeutic Monitoring Codes
CPT 98975
CPT code 98975: (Distant therapeutic monitoring (e.g., respiratory system standing, musculoskeletal system standing, remedy adherence, remedy response); preliminary set-up and affected person schooling on use of
tools) *quoted from 2022 Charge Schedule
What Does That Imply?
CPT Code 98975 is used for preliminary setup of a monitoring system in addition to affected person schooling for utilizing the system or tools. Medicare gives a one-time reimbursement of about $20 for this code per episode of care. Satisfying this within the clinic could be so simple as sending a HEP to your affected person the place they will entry their workouts by means of a web based platform and observe their progress. Monitoring must be in place for a minimum of 16 days to qualify for reimbursement, so maintain this in thoughts as you need to be sure you fulfill this requirement for Distant Therapeutic Monitoring.
CPT 98976
CPT code 98976: (Distant therapeutic monitoring (e.g., respiratory system standing,
musculoskeletal system standing, remedy adherence, remedy response); system(s) provide with
scheduled (e.g., day by day) recording(s) and/or programmed alert(s) transmission to observe
respiratory system, every 30 days) *quoted from 2022 Charge Schedule
CPT 98976
CPT code 98977: (Distant therapeutic monitoring (e.g., respiratory system standing, musculoskeletal system standing, remedy adherence, remedy response); system(s) provide with scheduled (e.g., day by day) recording(s) and/or programmed alert(s) transmission to observe musculoskeletal system, every 30 days). *quoted from 2022 Charge Schedule
What Does That Imply?
CPT Codes 98976 and 98977 are almost an identical besides 98976 is for monitoring respiratory system and 98977 is for monitoring the musculoskeletal system. Most PTs/OTs are going to make use of 98977, which reimburses you about $55 per individual per 30 days (actually a 30 day interval). Medicare permits sufferers to supply self-reported information which could be collected and transmitted through Software program as a Medical Gadget. In different phrases, sufferers can use their very own cell telephones to submit information through the HEP software program you’re offering them entry to, which can rely as Software program as a Medical Gadget. Once more, you need to ensure to solely submit this code when you could have met 16 days of monitoring information in a 30 day interval.
CPT 98980
CPT Code 98980: Distant therapeutic monitoring remedy, doctor/different certified well being care skilled time in a calendar month requiring a minimum of one interactive communication with the affected person/caregiver in the course of the calendar month; first 20 minutes *quoted from 2022 Charge Schedule
CPT 98981
Distant therapeutic monitoring remedy, doctor/different certified well being care skilled time in a calendar month requiring a minimum of one interactive communication with the affected person/caregiver in the course of the calendar month; every extra 20 minutes *quoted from 2022 Charge Schedule
What Does That Imply?
The final two CPT Codes 98980 and 98981 must do with managing the RTM information. Medicare will reimburse a therapist for monitoring and speaking with the affected person in regards to the information collected remotely. The primary code 98980 covers the primary full 20 minutes {that a} supplier consults with the affected person and the CPT code 98981 is used for every extra full 20 minutes of session with a affected person throughout a calendar month. CPT 98980 reimburses the clinician about $50 and 98981 reimburses an extra $40 for every extra full 20 minutes spent consulting with the affected person in regards to the information.
Methods to Begin Utilizing RTM Codes within the Clinic
Now that is the place it will get enjoyable as a result of each PT and OT that I’ve ever labored with prescribes house train packages. In case you’re like me and also you’ve been utilizing a program like MedBridge to assign your own home train program – you’re in luck as a result of every part might already be arrange so that you can begin utilizing the brand new RTM codes.
For clinics utilizing the MedBridge Enterprise answer, you could have entry to the HEP+ program. This permits your clinicians to make use of the MedBridge HEP Builder and the free MedBridge GO app for sufferers which gives entry to their workouts. Clinicians can observe affected person adherence to the train packages and likewise obtain affected person suggestions immediately by means of the app. Because the supplier, you’ll be able to merely log into your dashboard and look at what number of instances they’ve accessed this system and observe compliance, satisfying the monitoring necessities for the brand new CPT codes.
Medicare merely requires that you simply monitor adherence by means of a distant monitoring system. In your dashboard, you’ll be able to simply see what number of instances your affected person has logged into their HEP and use this information to help your use of RTM codes by means of documentation.
All of that is included within the MedBridge Enterprise answer which is discounted by over 40% whenever you use the promo code PTProgress. In case you’re a clinic proprietor eager to implement RTM codes with out signing up for costly recurring month-to-month plans of different house train apps, take into account giving every of your therapists entry to MedBridge by means of the Enterprise answer which gives them with entry to incomes limitless CEUs and likewise entry to the HEP builder as a part of their premium entry.
Monetary Affect of Distant Therapeutic Monitoring (RTM Codes)
MedBridge will virtually pay for itself after utilizing RTM codes with two sufferers. And since most PTs deal with greater than two sufferers every month, which means your clinic goes to profit in an enormous approach financially. I personally pay for a single license annually for simply $250 utilizing the promo code PTProgress, and it pays for itself based mostly solely on the persevering with schooling I earn.
Right here’s an instance of the way it would possibly search for one affected person who’s coming to PT for remedy.
Day 1 – Analysis, remedy, and setup RTM
RTM code 98975 is about $20 per episode of care, however requires 16 days of monitoring so as so that you can use it. It’s best to doc the preliminary setup of the RTM system, however wait to invoice 98975 till 16 days of monitoring is accomplished. So let’s quick ahead a couple of weeks.
Day 21 – Progress word and submit RTM codes 98975,98977, 98980
Immediately you resolve to do a progress word (that’s not required, however it’s a great time to summarize the info along with your affected person to fulfill CPT 98980). You word 16 days of lively monitoring of the house train program, so that you fulfill the necessities for the preliminary setup CPT code 98975. You may as well submit for 98977 which is for monitoring the therapeutic information that’s transmitted to you relating to the affected person’s adherence to their house train program so long as it’s been tracked for 16 of the previous 30 days. That is happy whenever you take the time to assessment the info and analyze its affect on the affected person’s plan of care, then doc your findings. Medicare will reimburse about $55 per affected person each 30 days.
Now CPT code 98980 is for monitoring and speaking with the affected person in regards to the information collected remotely. So should you take the trip of your session to assessment the info, adherence, and deal with any questions or implications of the info because it applies to their plan of care, you’ll be able to invoice for 98980 for the primary full 20 minutes of this seek the advice of and medicare will reimburse you about $50.
To this point that’s an extra $125 in reimbursement within the first 30 days however the RTM codes don’t cease there! As a result of you’ll be able to invoice for CPT codes 98977 and 98980 once more in the course of the subsequent 30 days of the affected person’s care. That is roughly one other $100 the next month for a similar affected person and also you merely proceed to observe adherence to their HEP by logging in to MedBridge to trace the affected person reported information by means of the app.
That is over $225 in extra reimbursement per Medicare affected person and may simply lead to an extra $100 per affected person per 30 days for monitoring and administration of the HEP compliance information.
Documenting RTM Codes – Get Began!
After all, you do must doc your findings and help your medical reasoning for utilizing these CPT codes, which I present examples for within the handout that you could find right here. However think about a clinician who treats simply 10 medicare sufferers a month – that’s an extra $125 per affected person per 30 days, which may simply herald an extra $1,200 by means of Medicare reimbursement since you merely took the time to assign and observe your HEP by means of a wise program like MedBridge. You are able to do the mathematics for a clinic with 4 or 5 or 10 clinicians and the affect is completely large.
Just lately, MedBridge simply had a stay webinar about utilizing these new RTM codes and offered a slide that estimated over $400,000 in extra web income for a clinic with 20 PTs! Unbelievable!
CMS FINALLY did one thing proper with the brand new RTM code!
In case you’re on the fence about utilizing RTM codes, get the free handout I made for you and you should definitely take a look at MedBridge for his or her enterprise answer utilizing the promo code PTProgress to save lots of over 40% on the implementation prices.
