Your Inquiries Addressed: Remote Therapeutic Monitoring (Part 2)

August 2, 2023

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The CPT codes for RTM represent new opportunities for physical therapists enabling them to be reimbursed for providing additional care to Medicare patients. This development presents a notable opportunity for providers to increase their revenue streams, potentially generating over $160 per patient per episode of care. This also raises a number of questions about how RTM works and how to bill for it. In this blog post, we will address some of the most frequently asked questions related to RTM, offering insights and guidance to help you navigate these new billing codes and workstreams.

In our RTM Q/A series, we answer your most common questions about remote therapeutic monitoring.

  1. How should physical therapists approach billing for RTM?
  2. Billing for remote therapeutic monitoring (RTM) requires accurate documentation or a platform like BlueJayRTM, which handles the RTM requirements. Physical therapists should ensure that their documentation clearly demonstrates the necessity and scope of the remote monitoring services provided. It is recommended to seek guidance or consult with professional organizations to stay updated on any changes or updates related to RTM billing procedures.1


  3. Who can bill for RTM?
  4. Physicians and other "eligible qualified healthcare professionals" are allowed to submit RTM claims, according to CMS. In the final rule for 2022, CMS stated that the primary billers of RTM codes include physiatrists, nurse practitioners, and physical therapists. However, other healthcare professionals such as clinical social workers, physician assistants, speech-language pathologists, and occupational therapists can also bill through the RTM codes for their services.2


  5. How does BlueJay’s turnkey RTM solution help you?
  6. The BlueJayRTM offers a comprehensive suite of tools to help healthcare providers streamline the documentation process for patients and assign Home Exercise Programs (HEPs). Providers can enroll patients in RTM, use all CPT codes, monitor patient engagement with the HEPs, and then bill for the codes after 30 days by submitting documentation to Medicare and insurance companies for reimbursement. BlueJay can help meet the growing demand for effective RTM services, driving better patient outcomes and increased revenues for healthcare providers.3


  7. How can I determine if my patient has completed 16 days of activity?
  8. If you are utilizing BlueJayRTM, you can access the RTM Dashboard to review the activities of all your patients.
    When using BlueJayRTM, you can see four columns listed below (depending on your organization's policy) to determine activity data:

    *Remember CPT codes 98975 and 98977 require the RTM solution to monitor at least 16 days of data per each 30-day period, in total for it to be sent for reimbursement.


  9. Can I use RTM after a patient has been discharged?
  10. No, once a patient is discharged from an episode of care they are NOT eligible to be billed for RTM.


  11. What's the reimbursement amount for all RTM codes? Or how much will I get reimbursed?
  12. Each RTM code is associated with different reimbursement rates. For BlueJayRTM users, the reimbursement rate stands at $160 per episode per patient after one month. However, it is important to note that these rates are subject to potential changes, necessitating verification with the payer for their specific reimbursement rates. Read our detailed blog on RTM codes to gain further insights. Click Here


  13. Who pays for RTM services?
  14. The primary payers for RTM services are private insurance and Medicare. However, the level of coverage a patient receives depends on their individual insurance plan. To determine the exact extent of coverage and reimbursement rates, it is essential to contact the respective insurance company directly.


Get Reimbursed with BlueJayRTM

BlueJayRTM

When it comes to billing for RTM, accurate documentation and adherence to guidelines are crucial. Healthcare professionals such as physical therapists can bill for RTM services. BlueJayRTM offers a turnkey solution to streamline documentation, assign Home Exercise Programs (HEPs), and optimize revenue potential. Through BlueJayRTM, providers can easily track RTM services using filters like touch points, days, billing cycle, and time spent. With RTM and platforms like BlueJayRTM, healthcare providers can enhance patient care and maximize revenue potential.



REFERENCES:

  1. www.medcitynews.com
  2. www.apta.org/news
  3. www.bluejayhealth.com/products/RTM