What Are RTM and RPM?
Remote Therapeutic Monitoring (RTM) tracks non-physiological patient data, such as medication adherence, therapy responses, musculoskeletal activity, and respiratory function. RTM services include patient education, virtual therapy sessions, and digital adherence programs, aiming to enhance patient outcomes through proactive remote interventions.
Remote Patient Monitoring (RPM), in contrast, involves tracking physiological data, including vital signs such as heart rate, oxygen saturation, blood glucose, weight, and respiratory rate. RPM aims to provide real-time patient data to healthcare providers, enabling early intervention and improved health management.
RTM CPT Codes and Reimbursement Rates for 2024
In 2022, the AMA introduced five CPT codes specific to RTM:
98975: Device Setup & Patient Education
- Initial device setup and patient training.
- Requires 16 days of data collection per 30-day period.
- Reimbursement: $19.65 average national rate.
98976: Respiratory System Monitoring
- Device records respiratory data daily with alerts and transmissions.
- Requires 16 days of recorded data per month.
- Reimbursement: $46.83 average national rate.
98977: Musculoskeletal System Monitoring
- Monitors musculoskeletal activity with daily recordings and alerts.
- 16 days minimum of recorded data required monthly.
- Reimbursement: $46.83 average national rate.
98980: Initial 20-Minute Treatment Interaction
- Covers the initial 20 minutes of monthly RTM treatment management.
- Must include at least one interactive communication (phone/video).
- Reimbursement: $49.78 average national rate.
98981: Additional 20-Minute Treatment Interaction
- Applies to each subsequent 20-minute increment of monthly RTM management.
- Follows the same interactive requirements as 98980.
- Reimbursement: $39.30 average national rate.
RPM CPT Codes and Reimbursement Rates for 2024
RPM billing continues with existing codes, with updated reimbursement rates:
99453: Initial Device Setup
- Setup of RPM device and patient education.
- Billed once per patient, requires at least 16 days of monitoring.
- Reimbursement: $19.65 average national rate.
99454: Device Supply & Data Transmission
- Device provided for daily monitoring and data transmission.
- Requires at least 16 days of data collection monthly.
- Reimbursement: $46.50 average national rate.
99457: Initial 20-Minute Treatment Management
- Initial monthly 20 minutes of RPM management with interactive communication.
- Reimbursement: $48.14 average national rate.
99458: Additional 20-Minute Treatment Management
- Each additional 20-minute increment, up to 60 minutes total monthly.
- Documentation of communication methods required.
- Reimbursement: $38.64 average national rate.
99091: Data Interpretation & Communication
- Minimum 30 minutes monthly spent interpreting RPM data.
- Includes communication for medical management advice.
- Reimbursement: $52.71 average national rate.
Key Updates and Billing Rules for RTM and RPM in 2024
One Provider Per Service per Month
- RPM (99453, 99454) and RTM (98976, 98977, 98980, 98981) billing limited to one clinician per 30-day episode of care. First provider billed receives reimbursement.
Concurrent Billing Limitations
- RPM and RTM cannot both be billed in the same month for the same patient. However, they can be billed concurrently with other services:
- Chronic Care Management
- Transitional Care Management
- Behavioral Health Integration
- Principal Care Management
- Chronic Pain Management
Global Surgery Period
- RTM and RPM services are reimbursable during a global surgery period if billed by a different provider than the surgical service provider.
FQHCs and RHCs
- FQHCs and RHCs can now bill RPM or RTM monthly under CPT G0511 at $72.98 per month, but not both simultaneously.
RPM 2024 Highlights
- No new RPM CPT codes introduced in 2024.
- Medicare reimbursement rates updated.
- Providers continue using existing RPM codes (99453, 99454, 99457, 99458, 99091).
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