In 2022, CMS released the 2022 Final Rule that made remote therapeutic monitoring (RTM) a billable service for rehab therapists. RTM involves the collecting and monitoring of non-physiological data, such as pain duration or severity, from patient feedback or via a medical device that meets the criteria set forth by the FDA. Unlike RPM’s requirement that patient data be collected and transmitted automatically, RTM data can be self-reported by the patient. The non-physiologic data covered by RTM codes includes medication adherence and response, as well as therapy adherence and response—all crucial for rehab therapists.
Patients are also able to self-report data within their devices and software, which is essential for therapists looking to monitor patients’ pain levels during care. Importantly, CMS has committed to keeping RTM CPT codes as payable by Medicare in its 2023 final rule.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The advent of RTM is an important development in the drive toward value-based care. And while some clinicians have made use of it in their own practices, many others are still unfamiliar with RTM. In fact, a data lake shows that RTM codes are vastly underutilized with only 0.1% code usage. Here’s how incorporating it into your practices can help you offer the best patient care.
Do what’s clinically appropriate
For too long, clinicians have been under enormous billing pressure in order to compensate for inflation and declining reimbursements from CMS and private payers. In most cases, this has forced clinics to spend an inordinate amount of time and resources focusing on ways to maximize profitability through circuitous and complex billing and coding techniques that optimize payment. Although such focus may be necessary to meet the bottom lines of running a business, this constant spotlight on how, when, and what to bill for services provided has conditioned therapists to hesitate prior to moving forward with new offerings to bill for clinical care that in years past would not be financially prudent.
Fortunately, with RTM codes, time spent checking in on patients between visits to ensure they’re completing their home exercise plan, answering questions, and assessing progress isn’t lost revenue. RTM codes cover treatment-related communications with patients over chat or telephone, so you can both help patients and bill for your work. And the returns can be significant with a therapist who could potentially bill for an additional $160 per patient in certain cases. The best part, that is so near and dear to every clinician’s heart, is that with RTM patients can now get the care they need between visits.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Improve patient engagement
Therapy adherence remains a struggle for almost every therapist. Approximately 20% of PT patients drop out of treatment within the first three visits, while 70% patients do not complete their full course of care. While RTM doesn’t necessarily make home exercises any easier, it can help keep patients on track with their recovery goals. RTM gives providers access to patient data and outcomes, allowing them to intervene, change care plans, and send reminders if needed. This improved communication helps providers ensure that their patients stay motivated, which in turn reduces the chance of dropout.
For patients, simply knowing that their provider is going to see how fully and completely they complete their HEP may motivate them to adhere to their plan more closely. As such, they’ll make better progress and be less likely to drop out. The best part? Engaged patients are more likely to complete their course of care, which in turn leads to improved satisfaction with the care experience, better outcomes and lower healthcare costs.
Collecting better patient data
More data on your patients during treatment allows you to make more informed decisions. It allows you to evaluate a plan of care and patient response, adjusting those plans as needed to best suit patient needs. It will also provide more information for you to share with a patient’s physician, if necessary.
Moreover, collecting better data on your valuable work with patients is important for the future of rehab therapy. If PTs, OTs, and SLPs hope to push back against the continuous cuts to reimbursements, hard data is needed to demonstrate the effectiveness of their services. With this new tool that can aid in measuring outcomes, rehab therapists will be able to make a stronger case to CMS and other payers for more money.
Conclusion
When used correctly, RTM can have a great impact on both your patient care and your clinic’s revenue. CMS has shown that they understand the value and efficacy of remote care as a billable service for rehab therapists—let’s not miss this opportunity to take the best care of our patients while getting paid.
Photo: Kanawa_Studio, Getty Images
Susan Lofton is a physical therapist with 25 years of experience in clinical care, operations, and senior-level management. Susan has worked in multiple healthcare settings including acute, IRF, skilled nursing, home health and outpatient, giving her exceptional insight into the transitional needs of patients and the inner workings of the healthcare ecosystem. Susan is passionate about improving health care and has deep expertise in regulatory compliance and optimizing strategies for success. Susan serves as VP, Outcomes and Clinical Transformation for WebPT and is ED of Keet Outcomes Qualified Clinical Data Registry (QCDR) for participation in MIPS and other quality payment programs.
