From Patient Care to Profit: How Real-Time Monitoring Can Help Physical Therapists Boost Revenue

May 16, 2023

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As a physical therapist, the main focus is always on providing quality care to patients. But let's face it, the success of your practice also depends on your ability to generate revenue.

Remote therapeutic monitoring (RTM) is an increasingly popular healthcare topic. While it is an exciting new development, there are several factors to consider before billing for RTM services. RTM allows for the remote management of non-physiological patient data, such as musculoskeletal and respiratory systems. To learn more about RTM, check out our previous blog.

To bill for RTM services, CMS approved five new CPT codes on January 1, 2022 - 98975, 98976, 98977, 98980, and 98981.

In November 2022, CMS announced new policies related to RTM services that are reimbursed by Medicare. The 2023 Physician Fee Schedule final rule expands on previous RTM guidance, and CMS clarified,

“Any RTM service may be furnished under general supervision requirement.”

This marks a significant milestone for physical therapists and medical practices, providing a framework for the implementation of effective RTM services and getting reimbursed. Physicians, nurse practitioners, and physician assistants can utilize outsourced clinical staff for monitoring and management services, while other Qualified Health Care Providers may need further guidance. This declaration is a positive step in widening the utilization of RTM services and thus improving patient care while generating additional revenue for providers.

The 2022 MPFS described each of the RTM codes as follows:

CPT Codes Description Billing Frequency Reimbursement
98975 Initial set-up & patient education Once per episode $19.38*
98977 RTM software & data transmission for monitoring musculoskeletal system 16 days of documentation- Once each 30 days $55.72*
98980 First 20 minutes of RTM treatment management services in a month Once per calendar month $50.18*
98981 Each additional 20 minutes of RTM treatment management services in a month Multiple times per calendar month $40.84*

* Reimbursement amounts listed are a national average based on CMS 2022 non-facility pay rate and are subject to geographic variation.

Benefits of reimbursement for PTs:

The new CPT codes for RTM represent a significant milestone for physical therapists enabling them to be reimbursed for providing additional care to Medicare patients, which was previously unfeasible. This development presents a notable opportunity for providers to increase their revenue streams, potentially generating over $200 per patient per episode of care. Moreover, providers can leverage the flexibility of the CPT code 98981 to bill for multiple episodes of care beyond the initial 20 minutes, further boosting their revenue potential. Overall, this is a promising development that stands to benefit both providers and patients alike.

How does BlueJay make everything so easy?

The BlueJay Health Remote Therapeutic Monitoring Solution offers a comprehensive suite of tools to help healthcare providers streamline the documentation process for patients and efficiently assign personalized Home Exercise Programs (HEPs) comprising educational resources and tailored exercise routines. Providers can enroll patients in RTM, use all CPT codes, monitor patient engagement with the HEP, and then bill for the codes after 30 days by submitting documentation to insurance companies for reimbursement. Our platform also facilitates seamless communication between patients and their care team, all through a user-friendly interface. By leveraging these advanced capabilities, BlueJay can help meet the growing demand for effective RTM services, driving improved patient outcomes and increased profitability for healthcare providers.

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