Studies continue to demonstrate the positive impact remote tools can have on patients and clinicians, especially for chronic care management. However, clinicians and healthcare practices have struggled to implement or widely adopt these technologies because their clinical resources are already strained and – until now – there have been limited reimbursement options. That changed this January when the Centers for Medicare & Medicaid Services (CMS) expanded reimbursement for remote monitoring. With the new set of remote therapeutic monitoring (RTM) codes, which are built upon existing codes for remote physiologic monitoring (RPM), clinicians now have more opportunities to improve patient outcomes through digital health enabled care.
Before considering implementing a remote monitoring program, here are the top three things clinicians need to know about RTM:
1. What’s the difference between RTM and RPM?
The biggest difference between RTM and RPM is the type of data that can be monitored and how that data must be collected.
RPM codes only allow for the monitoring of physiologic data, which are measurements generated from bodily functions such as a patient’s heart rate, blood pressure or respiration rate. RTM codes allow for the monitoring of non-physiologic data such as the signs, symptoms and functions of a patient’s therapeutic response. This includes medication adherence or how well a patient responds to their treatment.1
Whereas RPM data must be automatically collected by a connected medical device, RTM data can be self-reported by a patient through a medical device, increasing the streams of data clinicians can use to inform their care decisions.
2. What are the requirements to bill for RTM?
In order to bill for RTM, a clinician must have at least 16 days of medication event data – for example, when a patient uses or responds to their medication – per 30-day period. Interactive clinician-patient communications, which are a critical component of effective care routines and interventions, can also be billed against RTM in 20 minute increments.1
Since RTM codes are classified as general medicine services, both physicians and some non-physician practitioners can bill for RTM. This can include physician assistants, nurse practitioners, clinical nurse specialists, physical therapists and occupational therapists.*
*Clinical staff or auxiliary personnel may require direct physician supervision to perform some of the services related to RTM.
3. How exactly does RTM benefit patients and healthcare practices?
Whether for a small private practice or large health system, remote monitoring programs often support the following goals:
Improving patient outcomes
Research shows that remote monitoring has been proven to impact health outcomes across chronic conditions, including chronic respiratory diseases. In one study, 190 Medicare-eligible adults with COPD experienced a 63% reduction in mean rescue inhaler puffs per day and 73% reduction in nighttime rescue inhaler use after 12 months of a remote monitoring intervention.2
Reducing healthcare utilization
Remote monitoring can help identify high-risk patients who would benefit from proactive care intervention, such as a phone consultation or in-person visit. These proactive measures, which may be reimbursable through RTM codes, can help keep patients healthier at home and prevent unnecessary emergency department visits or hospitalizations by providing the right care at the right time.3
Making care coordination more efficient
When RTM is successful, clinicians have a reliable and objective source of data at the point of care, since they will not be reliant on patients to summarize months’ worth of symptoms from memory. This allows for more time to discuss important health concerns and treatment plans during office visits.
Even after a patient has left the clinic, RTM can continue to enhance care coordination. Clinical staff can remotely monitor their entire patient panel and focus more effort on patients who are not adhering to their treatment or who are still experiencing poor disease control.
If you’re interested in learning more about how RTM programs can help improve health outcomes for patients with chronic respiratory disease, including older patients with COPD, register for our upcoming webinar.
1 Centers for Medicare & Medicaid Services. CY 2022 Physician Fee Schedule final rule, CMS-1751-F (Link)
2 Chen et al. JMIR Form Res 2019 (Link)
3 Alshabani et al. Journal of Telemedicine and Telecare 2019 (Link)
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