The main differences are the types of data collected and how. RTM codes allow for the monitoring of “non-physiologic data” focusing on patient data through signs, symptoms and functions of a therapeutic response (e.g. therapy adherence and response). RPM focuses on physiologic data that is generally understood to be parameters generated by the body (e.g. ECG, blood pressure, etc.) that are detectable by a signal acquisition medical device/system. In order to bill for RPM, data must be automatically transmitted by a connected medical device. On the other hand, RTM data are subjective inputs reported by a patient that must be transmitted through a medical device.

RTM codes are classified as General Medicine services, as opposed to RPM codes which are classified as Evaluation and Management services. Physicians and  some nonphysician practitioners can bill for general medicine services. RTM codes could thereby be reported by physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified nurse midwives, and CMS very specifically has stated physical therapists and occupational therapists.

No, because RTM codes are considered general medicine services instead of evaluation and management services they cannot be considered for care management. A physician cannot order and bill for RTM services when work is being done remotely by clinical staff or auxiliary personnel under general supervision.

No, physicians cannot bill for the same patient for both RTM and RPM. Providers should consider which patients in their panel would be better served by RTM or RPM. Due to the emphasis on medication adherence, RTM may be the preferred reimbursement model for the respiratory care management of a patient depending on their overall health and relevant comorbidities.

In order to bill for RTM (i.e., 98975, 98976, 98977), a medical device must monitor at least 16 days of medication event data per 30-day period.

Codes 98980 requires at least one interactive communication as part of the 20 minute billing increment between the physician or billing provider and the patient/caregiver. Code 98981 is used for each additional 20 minutes thereafter.

Yes, RTM codes can be billed during the same service period as chronic care management services, transitional care management services, principle care management services and behavioral health integration services.

RTM is a beneficial option for any practice delivering healthcare for those experiencing high incidence of COPD, and/or chronic asthma. Leveraging Propeller for RTM provides clinicians with objective data on medication adherence, triggers and exacerbations, enabling them to make informed care decisions and have open conversations with patients.