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How is Remote Therapeutic Monitoring (RTM) different from Remote Physiologic Monitoring (RPM)?

The Centers for Medicare & Medicaid Services (CMS) proposed a new classification of reimbursable digital health services. The Remote Therapeutic Monitoring (RTM) codes were designed to complement the existing suite of Remote Physiological Monitoring (RPM) codes and expand the scope of digital health technologies to include monitoring non-physiologic data.

The current RTM codes recognize the benefit of remote monitoring as they continue to foster the use of digital health tools that give clinicians a more comprehensive data set of their patients’ health conditions. While there are some similarities between the RPM and RTM codes, CMS specified some primary differences like the type of data collected, how it is collected, and who are eligible to order and bill for RTM services.

 

The CMS final rule on RTM advanced the ability of clinicians to employ remote monitoring technologies. Providers and ACOs who offer remote monitoring technologies and services should start utilizing these new revenue streams to drive recurring revenue and improve the patient care experience.

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Remote Therapeutic Monitoring; FAQs!

Continuing the trend of expanded Medicare reimbursement programs for remote monitoring, the Centers for Medicare and Medicaid Services (CMS) released five new Remote Therapeutic Monitoring (RTM) codes.

In the 2022 Final Rule, CMS emphasized its intent to maintain payment parity between the RPM and RTM treatment management codes. CMS also mirrored the RTM codes for initial setup and patient education and supply of medical devices to the corresponding RPM codes. CMS aligned the RPM and RTM codes to achieve the dual goals of extending the categories of patient data utilized to monitor treatment management services remotely, and augmenting the types of health practitioners who can order and bill for these services. This is a promising opportunity for practitioners and digital health companies alike, and most importantly, for patients.

We at TrueBlue MD understand that there are some typical questions that practitioners may have about RTM, and we’re here to answer them.

 

  • Which types of patient data can physicians monitor via the Remote Therapeutic Monitoring codes?

CMS discussed “therapy adherence” and “therapy response” concerning RTM, referring to monitoring health conditions where “non-physiologic data” is collected that’s related to musculoskeletal system status and respiratory system status.

Interpretation of “health conditions” is broad, and the focus on “musculoskeletal system status” and “respiratory system status” plays a significant role in limiting reimbursement for “device supply” to devices related exclusively to those two systems.

 

  • Which physicians’ taxonomies can order and bill for Remote Therapeutic Monitoring?

Qualified Health Care Practitioners (QHCPs) who are eligible to bill the general Medicine codes can order and bill for RTM services like physical therapists, occupational therapists, dietitians, and clinical psychologists.

These practitioners can order and bill the RTM codes without needing a physician, non-physician practitioner (NPP), or supervision requirements, expanding general use cases for RTM considerably.

 

  • Which devices are used for Remote Therapeutic Monitoring?

All devices used for RTM must meet the FDA’s definition of a medical device (as opposed to, for example, a general wellness device). Patients’ self-reported data is collected and transmitted via Software as a Medical Device in addition to standalone peripheral devices.

As finalized, the RTM treatment codes are not limited to musculoskeletal and respiratory systems health conditions. However, both “device supply” codes specifically refer to musculoskeletal monitoring and respiratory monitoring devices, leaving significantly fewer reimbursement opportunities for devices that do not fall into either category.

 

  • How are Remote Therapeutic Monitoring codes classified?

Unlike RPM codes, which are classified as Evaluation and Management (E/M) services, the RTM codes are considered general medicine codes that QHCPs can bill for without the supervision of a physician.

 

  • What are the minimum minutes required to bill for Remote Therapeutic Monitoring services?

CPT code 98980 is billed for a minimum of 20 minutes in 30 days dedicated to RTM treatment management of the patient, including at least one interactive communication (via phone or video) with the patient/caregiver during that month.

CPT code 98981 has the exact requirements as CPT code 98980, but it’s used for an extra 20 minutes per month as an add-on.

 

  • How many days must the device monitor the patient’s data?

The RTM device must monitor at least 16 days of data in 30 days to be able to bill for CPT codes 98976 and 98977

 

  • Will the patient be able to report their Remote Therapeutic Monitoring data manually?

Yes. In fact, CMS stated that self-reported/entered data is a part of the non-physiologic data included in the RTM codes. It can be self-reported by the patient or digitally reported via the device. According to CMS, self-reported RTM data via a smartphone app or online platform is classified as Software as a Medical Device (SaMD) and may qualify for reimbursement.

 

Remote monitoring won’t stop growing ins an area of significant technological potential over the coming years. Hospitals and providers use RPM, RTM, and other non-face-to-face technologies to seize these new revenue stream opportunities under CMS reimbursement programs. Practices must start offering remote monitoring technologies and services to develop patient population health, drive recurring revenue, and improve the patient care experience. Don’t you agree?

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Remote Therapeutic Monitoring; A new revenue stream in the final 2022 Medicare Physician Fee Schedule

The healthcare technological revolution has commenced and will continue attaining further momentum in 2022. Providers and patients are always looking for new and better ways to improve access to care. That’s why the Centers for Medicare & Medicaid Services (CMS) issued the final rule on the 2022 Medicare Physician Payment Schedule updating payment policies, payment rates, and other provisions for services and clarifying the Remote Therapeutic Monitoring codes.

Therapy teams should utilize the newly approved access to the RTM CPT codes to support effective transitions across care environments and, most importantly, the evolution of alternative digital options to traditional care models.

Physicians struggle to discharge patients who suffer from significant clinical complexity and comorbidity that requires continued, sometimes even lifelong, monitoring of multiple body systems. As Physical Therapists exert all their efforts in providing extensive patient and caregiver training to ensure adequate understanding of safety and compensatory techniques, they still hope that all the lessons stick when patients return to their homes.

 

What if there was something that would allow them to monitor respiratory system status, musculoskeletal system status, therapy adherence, and therapy response; Remote therapeutic monitoring would.

 

So what exactly is Remote Therapeutic Monitoring (RTM)?

Remote Therapeutic Monitoring (RTM) is the recent release of CPT codes that support the management of patients who use medical devices to keep track of their non-physiological data. It’s a suite of five codes created by the CPT Editorial Panel in October 2020 and valued by the RUC at its January 2021 meeting.

 

What are the Remote Therapeutic Monitoring (RTM) CPT codes?

The Remote Therapeutic Monitoring/Treatment Management CPT codes are 98975, 98976, 98977, 98980, and 98981, elaborated as the following:

  • CPT# 98975
    Initial set-up and patient education on using the equipment for the respiratory system, musculoskeletal system, therapy adherence, and therapy response.
  • CPT# 98976
    Device(s) supply with scheduled periodic (daily, weekly, or monthly) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days
  • CPT# 98977
    Device(s) supply with scheduled periodic (daily, weekly, or monthly) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days
  • CPT# 98980
    Remote therapeutic monitoring treatment, at least one interactive communication between the clinical staff and the patient during a calendar month, for 20 minutes
  • CPT#98981
    Remote therapeutic monitoring treatment, at least one interactive communication between the clinical staff and the patient during a calendar month, for additional 20 minutes

 

These codes allow the opportunity for patient engagement and ongoing conversation, maximizing the efficiency of these healthcare services and acknowledging significant challenges that emerged from physicians and ACOs about not broadening the remote patient monitoring services.

 

The wait for Remote Therapeutic Monitoring (RTM) is finally over. Is your practice ready for it?

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5 Reasons why Physicians are in-deep need of RPM in 2020

Since the healthcare world is moving towards establishing remote medical services as the norm, Remote Patient Monitoring (RPM) is becoming increasingly valuable and in high demand. What infused this approach is the COVID-19 outbreak, making RPM one of the most influential infection-control measures on a global scale. The benefits of RPM are more evident to physicians, healthcare professionals, hospitals, patients, and individuals since the technology is throwing them a lifeline to not only curb the 2019 Coronavirus (COVID-19) pandemic but managing chronic conditions as well.

The US Government & Medicare’s Crucial Steps to Support Curbing COVID-19

As COVID-19 continues to spread, the US government considers RPM technology as one of the safest and most effective methods for doctor-patient communication, since it provides healthcare follow-ups via phone, audio/video, text messaging, and email. The government also announced expanding Medicare telehealth coverage, allowing people to receive healthcare services from their doctors without having to commute to a healthcare facility. This ensures that Medicare beneficiaries can follow-up with their healthcare providers from their homes, avoiding being put at risk of getting infected with the virus or infecting others.

As reported by cms.gov, US Healthcare providers requested the following steps from the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act:

  1. Expand the healthcare workforce by removing obstacles for physicians, nurses, and other clinicians to get hired from the local community or other states.
  2. Ensure that local hospitals and health systems can treat COVID-19 patients through temporary expansion sites (also known as the CMS Hospital Without Walls initiative).
  3. Increase access to remote medical care solutions for Medicare patients so they can get care from their physicians and other clinicians from the safety of their homes.
  4. Expand at-home and community-based testing to minimize transmission of COVID-19 among Medicare and Medicaid beneficiaries.
  5. Put patients over paperwork by giving providers, healthcare facilities, Medicare Advantage and Part D plans, and states temporary relief from many reporting and audit requirements so they can focus on patient care.

 

Why NOW is the Best Time for Physicians to Start Using RPM Technology!

  1. Experiencing Better Health Outcomes

Improving the health outcomes of patients and treating them efficiently and effectively is the physicians’ ultimate goal. In this critical time, RPM helps healthcare providers with the early detection of any COVID-19 symptoms. The software technology helps them in monitoring and engaging with their patients and directing them to treatment and the infection-control procedures to be considered.

The real-time transmission of data helps educate and motivate patients to reshape their lifestyle and experience better clinical results. Furthermore, patients’ behavioral changes lead to improved care and quality outcomes with a positive impact on their overall health. Hence, we can fairly say that remote patient monitoring helps resolve critical challenges in care coordination.

  1. Increasing The Practice’s Revenue

Due to the global pandemic, hospitals and healthcare organizations were beaten by a major loss of revenues. The integration of RPM technology into their systems as an infection-control measure turns out to be one of the most effective means of bridging the gap of the lost revenue caused by the COVID-19 outbreak. Other than being HIPAA-compliant, some of the invaluable features of RPM are seamless patient experience and enrollment, analyzable care plans, a comprehensive dashboard, 24/7 patient access portal, and the support for almost all devices.

Moreover, RPM has Medicare reimbursement codes: CPT 99453 with $21 on-time payment for RPM setup and patients’ education, CPT 99454 with $69 monthly payment for RPM device supply, and CPT 99457 with $53 monthly payment for RPM periodic monitoring. When connecting the dots, you will realize that RPM offers services to help your practice generate even more revenue while providing your patients with better care.

  1. Achieving Higher Efficiency with Maximum Support

Support takes two! Patients’ approval and support are crucial for the successful implementation of RPM programs. RPM software’s seamless integration into physicians’ workflows is among the proposed efforts to curb COVID-19, helping medical practitioners offer patients with the support and education needed to use RPM devices and technology.

Consequently, this effective doctor-patient collaboration to use RPM increases the efficiency of the medical treatments provided. Being senior-friendly is one of the main reasons why RPM technology is attractive. Also, having efficient, personalized care plans for every patient with secure two-way messaging gives both patients and doctors a safe method of communication with ultimate support.

  1. Accessing Patients’ Data 24/7

RPM technology collects, tracks, and transmits patient health data from a patient’s home to a healthcare provider in a different location. To detect any early symptoms of COVID-19, patients need a device with RPM software to upload their vitals and health-related readings to, so their physicians can keep track of their overall health. Since country lockdowns are in-effect, individuals avoid going out of their home, especially to any medical facility with direct exposure to patients and medical staff.

Being able to access the data on the RPM’s comprehensive dashboard at any time of the day is the safe door to medical follow-ups until the crisis is over. The easy-to-use RPM software is designed to save time for both patients and physicians with 24/7 access to patients’ portals. The ease of accessibility to patients’ data and information attracts them to maintain updating their health readings and vital parameters periodically through the health trackers.

  1. Reducing Face-To-Face Visits

With countrywide lockdowns taking place to impose social distancing and self-isolation, reducing, if not entirely hindering, face-to-face medical visits are a necessary step. RPM offers medical practices the ability to provide medical care to patients without risking coming into contact with infected individuals at healthcare facilities.

To execute the worldwide protocols and procedures of curbing the virus, reducing face-to-face interactions between patients, individuals, and healthcare practitioners are the main aim. They are all strongly encouraged to use RPM technology to continue their medical care plans without the risk of exposure.

Remote monitoring helps increase the work capability of physicians, providing treatment to more people at a time. As more healthcare providers open their businesses to emerging RPM technology, patients across the nation will attain better access to high-quality medical care right from their own homes. With or without COVID-19, RPM is not an option but rather a necessity, not only to cope with the worldwide procedures and measures but to shape a brighter future of healthcare and medical practices.

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Remote Patient Monitoring Throws a Lifeline to Physicians to Combat COVID-19

In times of social distancing and pandemic scare, the obligation for offering adequate healthcare for all has dominated conversations. Since the COVID-19 virus wreaks havoc with the healthcare system, telehealth is stepping up into the spotlight and helping healthcare provider organizations and caregivers better reply to the requirements of the Americans who need to connect with their providers on the status of their health. You could be thinking, that’s great, but now isn’t the time to be implementing a brand-new IT solution. Offering telehealth services nowadays couldn’t be simpler and it could prevent you and your patients from catching the virus, and under newly announced HIPAA. “enforcement discretion,” you don’t have to worry about running afoul of HIPAA law.

Telehealth is Bridging the Gap Between Patients, Physicians & Health Systems
Telehealth is bridging the gap between patients, physicians, and health systems, enabling everyone, especially symptomatic patients, to remain and communicate with physicians through virtual channels, helping to curb the spread of the virus to mass populations and thus the medical staff on the frontlines. By deploying telehealth solutions and programs, those who are affected by other medical ailments can receive care from home, without entering medical facilities, minimizing their risk of contagion.

What is Remote Patient Monitoring?
In 2020, CMS created new reimbursement opportunities for connected care services that enable providers to manage and coordinate patient care remotely. Remote Patient Monitoring (RPM) can be used to deliver healthcare services to patients regardless of their physical location or condition. The recent expansion and unbundling of reimbursable services by CMS present several opportunities for providers to submit claims and receive reimbursement from Medicare.
Remote patient monitoring has received new Medicare reimbursement codes:

– CPT 99453 – RPM INITIAL SETUP & PATIENT EDUCATION
$21 One-time Payment
Reimbursement for the initial, one-time cost of setting up and educating a patient on the use of remote patient monitoring tools.

– CPT 99454 – RPM DEVICE SUPPLY
$69 Monthly Payment
Reimbursement for the supply of the RPM device. The device must be capable of transmitting patient data and/or alerts on a daily basis and supplied to the patient by the billing practitioner.

– CPT 99457 – RPM PERIODIC MONITORING
$52 Monthly Payment
Reimbursement for the time spent by the physician, QHCP, and/or clinical staff reviewing physiologic patient data gathered by RPM devices and communicating with the patient. Service is billable for 20 or more minutes of qualifying time each calendar month.

Remote Patient Monitoring Becomes the Ultimate Care Option
The Remote Patient Monitoring technology allows the engagement of patients in their homes. The capabilities also facilitate communication between quarantined people and their healthcare providers and maintain the visibility of those who are recently discharged. In the age of coronavirus, Remote Patient Monitoring tools provide a secure eye on patients while they’re in quarantine or reception. If their clinical situation deteriorates, the system, supported by clinician oversight, can respond rapidly and choose if they have more intensive levels of treatment

Investing in RPM is a win-win— conclusively, patients can still maintain regular checkups with their doctors for ongoing conditions without having to depart their home, and physicians still get paid for their time without any risk of exposure to COVID-19.

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Can Your Practice Adapt to the Post-pandemic New Normal?

The Post-pandemic New Normal That
Practices Are Adapting to
Since the beginning of the COVID-19 outbreak, forgone visits have established cumulative deficits in patients’ treatment and practice revenue. The ‘temporary’ easing of telehealth made by the US governments and by health authorities in other countries raised the questions of how long the pandemic will persist, and what exactly is the post-pandemic era? A considerable number of experts predicted that the COVID-19 pandemic would not end within this year and could be prolonged for more than two years. Although it is still uncertain, the consequences of COVID-19 will never be short-lived.

Amid the continued global spread, humans have adapted to a new normal, and since this new normal has been generated because of infectious disease, healthcare is at the center of the post-pandemic era.

Specifically, the pandemic is expected to morph into how hospitals and practices manage and handle adaptability, flexibility, remote care, and IT infrastructure.

Adaptability and Flexibility
Hospitals, multi-specialty practices, and solo practices were profoundly shaken by the pandemic. Some had to furlough almost half of their staff, others witnessed a remarkable drop in their revenue, and others had to face both situations in addition to not being able to treat patients. One of the main lessons this pandemic has changed in the healthcare industry is its preparedness to face any sudden changes that might pop up. Many practices had to adapt to implementing new workflows, deploying RPM and CCM to continue treating their patients and working with less staff to curb COVID-19.

Remote Care
To decrease the risk of transmitting the virus to either patients or physicians, healthcare professionals are focusing their efforts on providing their medical services through remote patient monitoring technology. Outpatient practices and hospitals adaptation to this new normal way of delivering care encourages patients to ask for remote visits to stay safe during the pandemic. Although it started because of the pandemic, the healthcare industry is expected to still work with remote care as the new normalcy for high-quality care. To cultivate adaptability and flexibility, healthcare professionals are on the path of changing the shape of healthcare altogether to be always ready for any zoonotic diseases or pandemics that might appear in the future. Remote patient monitoring and chronic care management programs are now being deployed, changing the traditional medical care delivery as we know it.

IT Infrastructure
Due to the COVID-19 outbreak, the use of telehealth and remote patient monitoring RPM software is no longer a luxury, rather, a necessity. The most fundamental change in the healthcare sector is people’s increased awareness of health. Having solid RPM software is a competitive advantage that patients look for now when choosing their healthcare providers. This criterion is not temporary to the COVID-19 era, but rather to distinguish the top-notch healthcare providers from other less precautious ones.

These facts encouraged numerous healthcare providers to start innovating their IT infrastructure to ensure that their infrastructure is sufficiently ready to cope with the advent of digitalization. Since non-contact services include health management using chatbots, AI speakers, and IoT, the radical change in healthcare IT was inevitable.

Conclusion
With the advent of digitalization, hospitals and practices are leveraging technology to benefit their institutions and patients. Healthcare professionals are working on having interoperable health information systems, robust cybersecurity defenses, and a digitally savvy healthcare workforce.

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RPM Solutions: Illinois Family Practice Transforms Revenue Cycle into a 6-figure Profit

Introduction

As we reach the latter end of the year, 2020 has undoubtedly witnessed the explosion of Remote Patient Monitoring services in the healthcare community, irrevocably placing a significant impact on reshaping the medical landscape for physicians and practices worldwide. A recent benefactor of RPM is our client, a family-focused medicine practice based in Illinois, with over 30 years of attaining successful treatment outcomes placing patients at the forefront of clinical priorities.

 

Challenges

Given the imminent need to adapt to the unfolding situation, the client was initially hesitant in outsourcing their chronic care services, however as the patient is always the priority, our client made the smart move to adopt and integrate our specialized TrueBlue MD remote patient monitoring patient services as a direct smart solution with immediate effect.
70% of the practice’s Medicare population suffers from chronic diseases that required ongoing close monitoring but due to the unprecedented outbreak of COVID-19 were unable to attend and therefore access their regular in-office appointments.
Consequently, the practice experienced a drastic decrease in revenue intake due to the sudden drop-in office appointments.

The Mission

TrueBlue MD presented a number of measurable action plans customized to the needs of the family practice with the aforementioned challenges in mind.

The first port of call included an action plan detailing new viable streams of generating income into the revenue cycle, including establishing new channels of communication across all levels of workflow from practice to patient.
To launch an expert team of certified personnel trained to provide medical expertise over the phone and to offer immediate around-the-clock assistance to patients with inquiries related to their condition on the app.
Ship medical devices to patient’s homes for the purpose of recording patient health metrics while addressing any significant changes in data parameters registered by patients on the app. In such cases, TrueBlue MD team of on-call experts will receive an alarm notification informing them of any sudden changes, prompting our trained clinical staff to call the patient directly and investigate further to determine if an escalation to the office is required.
To conduct health coaching calls on a monthly basis for patients through our fully qualified clinical staff, to review and update patient charts, updating health status in real-time, and ultimately fill the care gap in aiding patients to achieve their health goals in measurable time.

Achievements

TrueBlue MD was able to successfully remodel the family practice’s revenue cycle resulting in the opening of additional channels of positive cash flow unattainable in previous day-to-day practice operations. Specially,

36% of the Medicare patient population expressed a strong interest in joining the program. Given the financial potential of reimbursement payments as outlined in the new 2020 CMS CPT codes for chronic care patients, this holds enormous potential for securing a healthy bottom line in extending the longevity of the practice, therefore, allowing for the continuation of optimal healthcare services.
All interested patients were connected directly to a live channel of trained clinical staff via the phone and app channels and were, therefore, able to immediately access medical expertise and access their physician if required in real-time from the safety of their home thus reducing potential exposure to COVID-19 and other potential diseases.
Newly added $2000 in revenue per year per patient was achieved. For every 300 patients, this translates to an astounding $580k annually-the future is clearly in favor of RPM.

Conclusion

As a direct result of TrueBlue MD RPM integration, all levels of the workflow from administrative staff to physicians were able to focus on more critical aspects of clinical operations thereby delivering more seamless and efficient healthcare outcomes in the most cost-effective timely manner possible.

In TrueBlue MD, there is no substitute for excellence, we are committed to shaping your future.