RTM may be a beneficial option for any practice delivering healthcare for those experiencing high incidence of COPD, and/or chronic asthma. Propeller provides clinicians objective data on their patients’ medication adherence, triggers and exacerbations, to help enable informed care decisions and have open conversations with patients.

According to the CMS 2021 final rule Remote Physiologic Monitoring codes involve the collection of physiologic patient data to guide treatment plans.⁴ 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 codes focus 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. RTM data can be patient reported and digitally uploaded, while RPM data can only be digitally uploaded. For both sets of codes, the device used must meet the FDA definition of a device as described in section 201(h) of the Federal Food, Drug and Cosmetic Act (FFDCA).⁴ Propeller’s inhaler sensors meet this definition and have received FDA clearance.

RTM codes are classified as General Medicine services. Physicians and eligible qualified healthcare professionals (including but not limited to therapists, physiatrists, nurse practitioners, and other practitioners with Medicare billing privileges) are permitted to bill using the RTM codes. Where the practitioner’s Medicare benefit does not include services furnished incident to their professional services, the items and services described by these codes must be furnished directly by the billing practitioner or, in the case of a physical therapist or occupational therapist, by a therapy assistant under the physical therapist’s or occupational therapist’s supervision.^4.1

No.  Because RTM codes are considered general medicine services instead of evaluation and management services, they cannot be considered care management services.⁴ 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 in the same 30 day period.⁴ Providers should work with a billing expert to consider which patients in their panel would be better served by RTM or RPM.

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.

In order to submit a claim that includes RTM codes (i.e., 98975, 98976, 98977), your patient must use a medical device to monitor at least 16 days of medication event data per 30-day period.⁴

Code 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.⁴

RTM codes may be able to 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.⁴ Work with a billing advisor or other expert to help determine whether it is appropriate to bill different combinations of codes.