Physical therapists are no strangers to the use of technology in their profession. Nearly all outpatient rehab clinics leverage EMRs, and the same can be said for everything from patient scheduling and billing platforms to a variety of different patient engagement solutions. What most in physical therapy aren’t accustomed to, on the other hand, is actually being paid to deploy these various tools. While they may provide a strong return on investment, they usually don’t do so through direct reimbursement.
The big news for 2022 is now there’s an exception to this trend. In the CMS 2022 Final Rule, Medicare announced changes to its CPT code set that make outpatient therapists eligible to bill for remote therapeutic monitoring (RTM). Physical therapy practices that use patient engagement technologies to monitor and communicate with patients beyond the clinic walls can now be reimbursed for those tools and services as long as they submit the appropriate codes. Here’s a look at what you need to know to get paid for RTM in 2022.
What are RTM codes?
The new CPT codes for remote therapeutic monitoring were created to encourage outpatient therapists to use digital health tools to improve patient care. There are five codes in the RTM family, but only four apply to physical therapy. CPT codes 98975 and 98977 are for RTM “services” like supplying monitoring devices to patients and providing instructions on their use; while CPT codes 98980 and 98981, for RTM “treatment management services,” cover time spent by the therapist reviewing and monitoring patient data related to their treatment.
How can I take advantage of these codes in 2022?
Simple: Use a qualifying device or software (like Keet) to engage with patients outside of the clinic, and you can bill Medicare for the work you do to get the technology up and running. That includes downloading the app to the patient’s phone, and it includes teaching them how to use it to track their home exercise program and transmit data back to the clinic.
After the patient leaves the clinic, they’ll use the app regularly between appointments to record information about their musculoskeletal system status and their adherence to their prescribed plan of care, and to complete patient-reported outcomes surveys. As their provider, you’ll have access to this information online, and you can use it to suggest changes to the patient when you occasionally check in with them via telehealth or over the phone. Every 30 days, you can bill Medicare with CPT codes in alignment with the time you spend providing these services.
What benefits are there to using RTM codes in practice?
First and foremost, you’ll see additional revenue—possibly more than $200 per patient per episode of care. And for those who’ve already embraced patient engagement outside of the clinic? Here’s your chance to be reimbursed for that work and for your investment in the required technologies.
How will RTM codes change how therapists provide patient care?
The introduction of RTM codes could get practices that, up until now, questioned the value of patient engagement to finally change their tune, as those that don’t will be leaving money on the table. In the long run, it should lead to better care as therapists shift from providing services strictly in the clinic to managing patient treatment remotely as well.
Are there any drawbacks to using RTM codes?
The short answer is, none that we can think of. One potential frustration for now is that RTM codes can only be used to bill Medicare and Medicare Advantage plans. That should change in the near future, however, as commercial payers usually follow Medicare’s lead.
The only real drawbacks in the RTM arena will likely be for those who ignore the codes and go on with business as usual. As Medicare pushes providers to enroll in value-based programs like MIPS and MVPs—and as the cuts to fee-for-service reimbursement keep coming year after year—RTM codes are yet another incentive for therapists to use patient engagement to drive improvements in care.