Remote Therapeutic Monitoring – New revenue for allergists?

Remote Therapeutic Monitoring – New revenue for allergists?

On Jan.1, 2022, Medicare will begin paying for remote therapeutic monitoring (RTM) services. RTM services allow for nonphysiologic data to be collected. Data can be self-reported by the patient, as well as transmitted automatically by a device.

One of the new RTM codes, CPT Code 98976, is specifically for respiratory monitoring and was developed with input from the manufacturer of a device that monitors inhaler usage by patients with asthma or other respiratory conditions. Allergists may want to make use of this and other new and innovative technologies to help manage patients with asthma.

When providing RTM, a physician (or nonphysician practitioner such as a nurse practitioner or physician assistant) must directly supervise clinical staff who are furnishing the treatment management part of the service, which means they must be present in the office when clinical staff is performing the remote service. This creates a significant obstacle in the use of RTM and makes it practically impossible to have the service provided by third-party vendors. We understand that CMS is in dialogue with stakeholders and the AMA CPT Editorial Panel on ways to resolve this issue.

Below are the new RTM codes which, except for the set-up service, can be billed every 30 days until treatment goals have been met.

RTM Code Description
98975 Set-up (billable once per episode)
98976 Respiratory monitoring (technical component)
98977 Musculo-skeletal monitoring (technical component)
98980 Treatment Mgmt. (first 20 min.) (professional service)
98981 Treatment Mgmt. (each add. 20 min.) (professional service)

In the meantime, allergists may be able to monitor and manage treatment of asthma patients using remote physiological monitoring technology (also known as remote patient monitoring).

Remote physiological monitoring (RPM) service codes have been in place for about two years and allow physicians to provide and be paid for monitoring of patient physiological data (e.g., heart rate, respiratory rate, blood pressure, weight, spirometry) that is automatically transmitted electronically via a device for purposes of treatment management. These services can be provided under general physician supervision, which means the services can be provided by a physician’s clinical staff without the physician being in the office or on-site.

RPM Code Description
99453 RPM set-up
99454 RPM monitoring/30 days
99457 RPM treatment management – first 20 minutes
99458 RPM treatment management – additional 20 minutes
99091 RPM treatment management – 30 minutes

The Advocacy Council – Advocating for Allergists and Their Patients.

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