What is a Remote Therapeutic Monitoring (RTM) Program, and Why is it Important?

Remote Therapeutic Monitoring (RTM) is the most exciting form of value-based care. It was introduced in 2022 by the Centers for Medicare and Medicaid Services (CMS) and expanded in later rules. RTM allows monitoring of therapy adherence as well as response for applicable disciplines and still allows for remote monitoring in physical, respiratory, and behavioural health. 

RTM is different from Remote Patient Monitoring (RPM), which focuses on heart rate and blood pressure. RTM focuses on non-physiological data, which includes therapy compliance, pain, pharmacological response, and psychosocial reporting.

RTM offers a pathway of improved care with reimbursement incentives to professionals like occupational and physical therapists, behavioural health specialists, and other doctorate-level clinicians. RTM provides novel care enhancement methods as well as revenue opportunities through RTM CPT codes.

 

How is a Remote Therapeutic Monitoring Program Structured?

RTM programs utilize smart devices, apps, and educational materials to provide remote therapy as well as transfer clinical data and gather evaluation data. The data is analyzed on a patient-cantered basis. The typical flow of remote therapy includes:

Patient Introduction: Patient enrolment and in-RTM application onboard training is the first step. Education is given, and consent is taken.

Interventions and Provider Review: The care team monitors progress and gaps and makes necessary modifications to the treatment plans.

Reporting and Billing Tasks Completed: Communication and monitoring activities with the patients are billed under the RTM CPT code for reimbursement. This approach actively maintains participation, enhances adherence, and helps to prevent issues by more thoroughly analyzing the data to allow timely actions related to the insights.

 

RTM—What Opportunities are Available for Reimbursement?

Adoption of RTM is primarily driven by the opportunity for Medicare's reimbursement. New CPT codes have been established by CMS in relation to Remote Therapeutic Monitoring.

98975 – Initial setup and patient education.

98976 —device supply for respiratory conditions.

98977 —device supply for musculoskeletal conditions.

98980 —the first 20 minutes of Remote Therapeutic Management (this can be the clinician or other designated staff).

98981 —each additional 20 minutes thereafter. There is opportunity for reimbursement.

Remote therapy management can be billed and reimbursed to the provider for the portion of therapy provided.

 

2025 Updates to RTM Reimbursement:

RTM is recently considering ACO contracts, allowing more flexibility and opportunity in billing the remote therapeutic monitoring services provided.

Behavioural Health Expansion: CMS is looking into additional cases for real-time monitoring for the treatment of mental health and substance use, expanding its reach

EHR and Device Integration: The best real-time monitoring platforms now offer integration with electronic health records and wearable’s, decreasing administrative workload and enhancing patient experience.

AI-Driven Analytics: Some platforms are using AI to predict a patient’s lack of compliance and to expose risks of therapy far earlier than was possible, from several months to several weeks.

 

 

What Features Should You Look for in RTM Software?

For a healthcare provider to successfully manage a real-time monitoring RTM program, the following features on the software are a must:

Streamlined automated compliance and billing timer:  Synchronous automation of time spent tracking compliance and billing.

Patient tracking for symptoms with user-friendly apps:  The system allows for the customization of care plans that integrate various chronic conditions.

Interoperability with the electronic health records for enhanced workflow efficiency.

Data analytics provides real-time reporting, ensuring timely information and insights.

How Can HealthArc Help You Build a Successful RTM Program?

While RTM in health care settings is a complex undertaking, the use of the right platform simplifies the process. HealthArc.io is the all-in-one RTM solution for physical and respiratory therapists, behavioral health providers, and physicians. HealthArc simplifies the launch, scaling, and optimization of RTM programs through automated billing, patient-friendly apps, and AI-driven analytics, improving health outcomes and maximizing revenue.