Are you having trouble understanding how remote patient monitoring (RPM) is different from remote therapeutic monitoring (RTM) when both provide remote care services to patients? If yes, this guide is for you!
In this guide, we will discuss how RTM and RPM are distinct in terms of their functionality, billing guidelines, and coding requirements. We will also look at the common RTM and RPM CPT codes to help you understand the differences in coding and why you should not use an RPM code while billing for RTM services, and vice versa.
What is Remote Therapeutic Monitoring (RTM)?
The practice focuses on non-physiological patient data. Physicians and qualified healthcare professionals, including speech-language pathologists (SLPs), occupational therapists (OTs), and physical therapists (PTs), leverage RTM. It can help providers monitor respiratory activity, musculoskeletal (MSK) function, adherence to exercise, therapy response, etc.
Contrarily to RPM, the data patients collect through RTM devices (spirometers, remote peak flow meters, etc.) is self-reported and communicated to the practitioners.
What is Remote Patient Monitoring (RMP)?
It focuses on monitoring and collecting physiological data, allowing providers to track patients’ vital signs outside a typical healthcare setting.
All healthcare practitioners and mid-level providers eligible to bill evaluation and management (E/M) services can utilize RPM. Besides, providers equip patients registered in the RPM program with FDA-approved devices to measure vitals, such as glucose levels, pulse rate, weight, heart rate, and oxygen saturation. When the patient measures the vital signs, the values are sent directly to the healthcare provider’s RPM dashboard.
RTM vs RPM – Understanding the Difference
The table below will give you a quick glimpse into the similarities and differences between RTM and RPM:
| RPM | Similarities | RTM |
|---|---|---|
| It collects physiological data. | Both use a device to measure and collect the patient data. | It collects therapeutic data. |
| It involves automatic data transmission at a periodic interval or in real-time. | Both require 16 days of device data. | It involves self-reporting of data collected by the patient to the healthcare provider. |
| Non-physician providers (NPPs) and physicians can order and bill it. | Both cannot be billed in the same month. | Physicians, SLPs, OTs, and PTs can order and bill it. |
| The device code is condition agnostic. | Both are subject to general supervision. | The device code is limited to respiratory and MSK. |
Functional Differences – RTM vs RPM
Remote patient monitoring and remote therapeutic monitoring help healthcare providers to monitor their patients remotely. However, their similarities can often confuse physicians about which approach to choose. Which technique can benefit their patient population, RPM or RTM? And what are the functional differences of both?
If you want to track your patient’s response to treatment or therapy adherence, RTM is the way to go! It will enable you to track the status related to the respiratory and musculoskeletal system. The data collected from the device is self-reported to the provider.
Conversely, where you need to monitor your patient’s physiological data, RPM is suitable. The devices used in RPM transmit data to the provider at periodic intervals or in real time.
Besides, whether your patient requires clinical or therapeutic intervention is another deciding factor. RPM is more suitable for the former, while you can better manage the latter via RTM.
Differences in Medical Billing – RTM vs RPM
RPM and RTM are distinct healthcare models with different billing requirements. Healthcare providers utilize E/M CPT codes for billing remote patient monitoring services. Remote therapeutic monitoring uses general medicine codes, enabling a range of healthcare practitioners to bill for care services.
As discussed above, physicians, SLPs, OTs, and PTs are eligible to bill for RTM services, while physicians and NPPs can bill for RPM services. From a reimbursement point of view, RTM payment is lower compared to RPM payment because it involves less complicated data collection and analysis.
Simply put, RPM and RTM are complementary service models that can be used together to offer a comprehensive care plan to patients. However, one should not bill for RPM codes while providing RTM services, aiming to receive higher reimbursements, as it can result in claim denials, financial penalties, and lawsuits.
Differences in CMS Coding – RTM vs RPM
Here, we will look into the various RTM and RPM CPT codes to help you understand the differences in their coding requirements. Since both models involve remote monitoring of patients, thus there are different CPT codes for the device setup, educating caregivers/patients on how to use the equipment and the time spent on providing care services.
So, without further ado, let’s first see the remote patient monitoring CPT codes:
| RPM CPT Codes | Description |
|---|---|
| 99453 | You may assign this CPT code for setting up the RPM device and training the patient on its proper usage. |
| 99454 | It identifies that the provider supplied the RPM equipment and receives daily alerts on the data recordings. |
| 99457 | You can use this code to report the first 20 minutes of a physician, clinical staff, or other qualified provider’s time spent monitoring the patient’s data and interacting with the caregiver/patient to update the treatment plan. |
| 99458 | You can use this code to report the additional 20 minutes of a physician, clinical staff, or other qualified provider’s time spent monitoring the patient’s data and interacting with the caregiver/patient to update the treatment plan. |
| 99091 | You can bill this CPT code for interpreting blood pressure results, glucose monitoring, and ECG recording received from the patient/caregiver, requiring at least 30 minutes of the provider’s time. |
The table below discusses the different remote therapeutic monitoring CPT codes:
| RTM CPT Codes | Description |
|---|---|
| 98975 | You can report this for initially setting up and training the patient on the use of the RTM device. |
| 98976 | You can bill it for supplying one or more RTM devices to the patient for remote respiratory system monitoring. It also covers programmed alerts and scheduled recordings. This code can only be used once every 30 days. |
| 98977 | You can bill it for supplying one or more RTM devices to the patient for remote MSK system monitoring. It also covers programmed alerts/ scheduled recordings and should be used once per 30 days. |
| 98980 | Physicians or other qualified providers can assign this CPT code for performing treatment management services for respiratory and MSK systems, spending 20 minutes in a calendar month. It includes at least one interactive session with the patient or caregiver. |
| 98981 | Physicians or other qualified providers can bill this CPT code for performing treatment management services for respiratory and MSK systems, spending an additional 20 minutes in a calendar month. It, too, includes at least one interactive session with the patient or caregiver. |
Conclusion
Remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) cover the diagnosis, treatment, and devices for remote patients. While RPM collects physiological data and sends it directly to the physician, RTM involves collecting therapeutic data, which the patient self-reports and shares with the provider.
To summarize, RPM and RTM are distinct based on functionality, billing guidelines, and coding requirements. You can use the distinct RTM and RPM CPT codes to bill services under their unique care models.
Yet, if you find it challenging to handle RTM or RPM billing and coding in-house, you can hire MediBill MD. We can ensure you receive timely payments.
