Somatic Health and RTM

RTM has been introduced to encourage providers to follow-up with patients between in-clinic visits and eventually help improve satisfaction and outcomes for patients. The 2022 Medicare Physician Fee Schedule final rule introduced five CPT codes for RTM, offering a new pathway to enhance patient follow-up and improve treatment outcomes.

The Five RTM Codes:

The five RTM codes offer a structured approach to documenting treatment necessity and effectiveness. Originally, CMS restricted PTs from billing RTM codes, citing that these were "incident to" services. However, following advocacy from the American Physical Therapy Association (APTA), PTs are now allowed to bill these codes. The codes are divided into two categories: monitoring services and RTM treatment management services.

Monitoring Services Codes

• 98975 is for the initial set-up and patient education on equipment use. It can only be billed once per episode of care and requires at least 16 days of monitoring.
• 98976 and 98977 cover remote therapeutic monitoring devices for respiratory and musculoskeletal systems, respectively. These can be billed for a 30-day period with at least 16 days of monitoring.
  • (A).16 days of monitoring is primarily defined as communicating with patients 16 times during the 30-day period. This could be exercise prescriptions, surveys, reminders and other messages.
  • (B).Somatic Health has developed a fully automated system that will send out exercises and surveys automatically within the time frame. Once set, everything will go out as an email or text as planned. Providers will be able to monitor the progress easily through patients' dashboard.

Monitoring Services Codes

• 98980 is for the first 20 minutes of monitoring treatment management in a calendar month, with at least one interactive communication with the patient or caregiver.
  • (A).It could be done through phone calls or telehealth. It requires at least one interactive communication instance. Somatic Health has a fully integrated, secure, interactive Telehealth module. In addition, providers can easily login phone calls instead of using the Telehealth function.
• 98981 is for each additional 20-minute block of monitoring treatment management in a calendar month.

These codes are accessible to PTs under Medicare and may also be accepted by commercial insurance plans, providing flexibility in billing and practice management.

CMS may revise the codes in future rulemaking as it continues to engage with stakeholders to refine the RTM framework. This collaborative approach underscores the importance of feedback from providers and patients alike in shaping the future of remote therapeutic monitoring.

By Integrating RTM into your practice you can streamline patient care, improve treatment outcomes, and unlock new revenue streams. Although most EMR software providers do not offer RTM solutions yet, Somatic Health is constantly reaching out to EMR software providers to provide a single and seamless solution for healthcare providers. However, in the meantime we provide simple document transfer solutions which will make the process as easy as possible.