Remote Therapeutic Monitoring/Treatment Mgmt

5 New CPT Codes for Remote Therapeutic Monitoring in 2022

CMS released the 2022 Physician Fee Schedule on RTM codes that took effect on January 1, 2022. 

The Centers for Medicare and Medicaid Services (CMS) released the final rule for the 2022 Physician Fee Schedule (PFS)[1] on its new Remote Therapeutic Monitoring (RTM) codes, officially titled “Remote Therapeutic Monitoring/Treatment Management”. There are five new RTM codes that will all go into effect on January 1, 2022.

Backed by the American Physical Therapy Association (APTA), PTs can now bill five remote therapeutic monitoring (RTM) codes related to the cost, set-up, and monitoring of devices that measure patient therapy adherence and therapy response. The APTA now provides a practice advisory to assist you in implementing those codes.

The new RTM codes expand the use cases for Medicare coverage of remote monitoring beyond the existing Remote Patient Monitoring (RPM) codes, and are one of the most recent breakthroughs in digital health reimbursement. Stakeholders have suggested that the new RTM coding was created to allow practitioners who cannot bill RPM codes, to furnish and bill for services that are similar to those described by the RPM codes.

What are the five RTM Codes?

The new RTM codes included in the 2022 PFS are as follows:

CPT code 98975

Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment

Code 98975 is only allowed to be billed once each episode of care. An episode of care begins when the remote therapeutic monitoring service is activated and concludes when the specific treatment goals are met.

CPT code 98976

Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, every 30 days

CPT code 98977

Remote therapeutic monitoring (e.g. respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g. daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, every 30 days
*Codes 98976 and 98977 can be billed only once per 30 days.

CPT code 98980

Remote therapeutic monitoring treatment, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes

CPT code 98980 requires at least 20 minutes of time per month dedicated to remote therapeutic monitoring and management of the patient. During the month, this period must also contain at least one interactive communication with the patient/caregiver (e.g., via phone or video).

CPT code 98981

Remote therapeutic monitoring treatment, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes