Effective January 1, 2022, there will be 5 new CPT codes to describe remote therapeutic monitoring (RTM). In this article, I will answer some of the questions I have been receiving about these new CPT codes.
All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.
This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.
Was there clarification in the final rule if RTM could be billed on a UB-04 and a 1500?
No, since no comments were submitted asking for a clarification.
Mr. Gawenda regarding RTM: 1) Can you bill for PT live sessions in the clinic and then 1x/mo bill RTM or are there certain requirements that have to be met such as with RPM? 2) Do you have any idea as to the type of documentation that is required, ie: SOAP format or the like, that needs to be submitted for billing with RTM? Thanks
We will have to wait under NCCI Version 28.0 is released to see what can and can’t be billed the same date of service as the RTM codes.
Interesting! I would love to see some real world examples of how we can use this to help our patients!
I don’t see the difference between 98976 and 98977. Can you enlighten?
Look at the last 2 words in each of them. They are different.
Hi ! How can I listen to the recording ?
This topic is an article on my website and not a webinar.
Will there be co-pays associated with the RTM billable each month?
For Medicare, 20% co-insurance would apply.
Aside from the Medicare 20%, will there be a commercial or managed Medicare co-pay applied to that service. Similar to an E&M code that may have a $30 co-pay at the time of the visit?
That will be up to each insurance carrier to determine.
A few questions:
1) Regarding 98977, can you elaborate a bit more on the day requirement? “Codes 98975, 98976, 98977 are not reported if monitoring is less than 16 days”. Does this mean that you have to monitor each day for at least 16 days (16 separate occurrences), or that you can log on once to monitor 16 days worth of data? There’s not a minute time component such as 20 minutes…Is there a minimum amount of time that needs to be spent to bill for it? Can you bill for it more than once every 30 days?
2) For 98980 and 98981, does the 20 minutes have to be in one sitting, or can it be accrued over multiple sittings?
3) Would an app installed on my patient’s phone be considered a qualifying monitoring device?