Disclaimer
Use of RTM codes should be in compliance with payer guidelines. Providers seeking guidance on the use of RTM codes may contact CMS, their Medicare Administrative Contractor (MAC), relevant payers, and relevant state and national associations. This information does not constitute professional or legal advice on reimbursement and should be used at your sole liability and discretion.
The RTM (Remote Therapeutic Monitoring) Billing dashboard aggregates information from the Keet platform that is required for billing RTM codes. While the dashboard will contain useful data, it is ultimately up to the provider to determine how to document and bill for each code in their EMR. Refer to the RTM Billing Dashboard article (include link) for information on what the dashboard contains and how to read the data provided.
Documentation and billing will vary based on the EMR and the billing software your clinic uses, as well as on clinic practices and procedures.
When the RTM codes are billed/provided under a therapy plan of care the services will apply to the annual therapy dollar threshold, but the Multiple Procedure Payment Reduction (MPPR) policy will not apply. The CPT codes 98975, 98980 and 98981 are also subject to the de minimis standard if provided in whole or in part by a PTA or COTA.
Documentation for Each Code
While documentation is ultimately at the sole discretion and liability of the provider, we do recommend including the following notes when documenting services related to Remote Therapeutic Monitoring.
Remote Therapeutic Monitoring should be documented in the Initial Evaluation Note as part of the plan of care. The CPT codes for RTM should follow a similar standard of practice for services to be included in the patient's plan of care with the referring provider notified of their inclusion in the treatment plan.
- 98975
- Document the device/software that will be used, training and education provided and date provided, any set up required, and that the required 16 days out of 30 were met.
- (This code is untimed.)
- 98977 (Musculoskeletal) / 98976 (Respiratory)
- Document the name and description of the device/software provided to the patient and that the required 16 days out of 30 were met.
- (These codes are untimed.)
- 98980
- Document the type of data and information gathered on the device/software, the time spent monitoring the data, the date and time of the synchronous communication, and any changes or updates to the POC/treatment based on the monitoring that took place. This code is billed in a 20 minute increment.
- 98981
- Document the type of data and information gathered on the device/software, the time spent monitoring the data, the date and time of the synchronous communication, and any changes or updates to the POC/treatment based on the monitoring that took place. This code is billed in 20 minute increments, when a full 20 additional minutes have been met.
When to bill
RTM services should only be billed for if included in the plan of care, and furnished under that therapy plan of care.
- 98975
- Only bill this code if and when the initial set up and education has been provided, AND when the patient has met 16 days of engagement out of 30.
- Do not report or bill if less than 16 days of engagement out of the 30 day interval
- This code can only be billed once per Episode of Care.
- 98977 (Musculoskeletal) / 98976 (Respiratory)
- Do not report or bill if less than 16 days of engagement out of the 30 day interval
- Can be billed once for each 30 day interval.
- 98980
- Billable once per calendar month
- 98981
- Can be billed, if eligible, multiple times a calendar month
Note
Providers should also refer to the CPT guidelines regarding billing RTM billing codes at the same time as other CPT codes.