Remote Therapeutic Monitoring: A Guide to RTM Codes for Orthopedic Surgeons

Digital health is no longer the new frontier — it's part of our everyday lives. From telehealth physical therapy to mobile health apps, remote care has made healthcare services more accessible while strengthening the relationship between patients and their providers. In 2022, building on the success of remote patient monitoring, Medicare released new CPT codes for remote therapeutic monitoring as another advancement for reimbursement in digital health.

With remote therapeutic monitoring, orthopedic surgeons can oversee their patients’ recovery without needing to be directly involved in their treatment activities - especially while patients are at home. New RTM codes enable orthopedic practices to continue generating revenue even within the post-operative 90-day global period.

What is remote therapeutic monitoring?

Remote therapeutic monitoring (RTM) is the process of collecting and evaluating non-physiological data, like musculoskeletal system status, therapy adherence, and therapy response, without direct contact with patients. Remote therapeutic monitoring differs from remote patient monitoring (RPM), which captures physiological data like blood pressure, temperature, and weight.

Unlike remote patient monitoring, you aren’t required to use a medical device to collect remote therapeutic monitoring data. The latter also involves collecting self-reported patient data, like exercise adherence and pain levels. Methods for remote therapeutic monitoring include:

• Recording patient data via FDA-approved medical devices: Acceptable devices can range from exercise bikes that use electric currents to stimulate a patient’s nerves to robotic exoskeletons that measure a patient’s gait and range of motion.
• Receiving patient-reported data: Patients can self-report RTM data through a web portal or mobile app which qualifies as Software as a Medical Device (SaMD) under the FDA’s definition of a medical device.
• Asking patients about their recovery during virtual visits: Although this is less convenient than other methods, telehealth appointments can be billed under remote therapeutic monitoring codes.

RTM data that is digitally uploaded via medical devices is more accurate. However, patient-reported outcomes (PROs) still grant valuable information about patients’ health conditions, provided you choose the right method and cadence. Take self-reported pain levels, for example: you could ask your patient about their pain at your next follow-up appointment, but that might not be for another month. Alternatively, if they complete a weekly survey about their pain levels, you will have a better picture of your patient’s recovery.

Benefits of remote therapeutic monitoring for orthopedic surgeons

Remote therapeutic monitoring gives orthopedic surgeons further insight into their patients’ rehabilitation, whether or not they’re recovering from surgery. It also enables them to bill for additional services during post-operative patient care.

For instance, if you prescribe physical therapy to a non-operative patient you can use remote therapeutic monitoring to oversee their progress. If their RTM data shows the treatment plan isn’t effective after several weeks, you might then decide that a surgical procedure is necessary. After the procedure is complete, RTM enables you to regularly evaluate your patient’s recovery. You can collect self-reported pain levels to see if your patient is healing well or ask them to use an app to record their range of motion measurements.

RTM codes do not require the use of equipment, so you can implement remote therapeutic monitoring at a low cost. Here are some of the other benefits you can expect from adding RTM services to your practice:

• Increased revenue with minimal impact on your clinical staff’s existing workload
• Improved patient engagement during post-operative recovery
• In-depth visibility into patient adherence, pain levels, and response to treatment
• Faster interventions if your patients aren’t progressing as planned
• Accurate data to improve clinical reasoning
• Better communication between you and your patients
• More personalized treatment plans based on the latest patient data

How orthopedic practices can use RTM codes

RTM codes were fast-tracked by CMS when it become clear that providers needed better options for virtual health experiences. They are available for orthopedic surgeons, physical therapists, and clinicians when supervising a patient’s treatment activities performed at home or away from the practice. The global period restricts orthopedic surgeons from billing for additional services for 90 days after a primary procedure. But because remote therapeutic monitoring is exempt, you can bill these new RTM codes right away to open up additional revenue streams for your practice.

To successfully bill RTM codes, you can supplement your orthopedic care by monitoring patients in between visits. If you refer a patient to physical therapy, it’s likely that they will see their physical therapist more often than you. However, whether your patient is recovering from knee surgery or rehabilitating a sports-related injury, you still need better visibility into how they’re doing outside of your office.

Use software like Exer Health to implement remote therapeutic monitoring with your patients. Exer uses artificial intelligence to measure a patient’s joint mobility - range of motion - accurately in under a minute. Would accurate, self-administered range of motion measurements from all of your patients, every week, be a powerful addition to your practice? For orthopedic surgeons, this is usually incredibly valuable: Exer's data enables you to evaluate a patient’s recovery without the need for frequent hands-on care, and because it's billable you can consider this a growth lever for your business.

Remote therapeutic monitoring FAQs

What are the new remote therapeutic monitoring codes?

• CPT code 98975: Initial setup and patient education on the use of a remote therapeutic monitoring device or other equipment for ~$24*
• CPT code 98977: Remote therapeutic monitoring for the musculoskeletal system for ~$69*
• CPT code 98980: First 20 minutes of interactive communication with a patient regarding remote therapeutic monitoring, such as a video conference or phone call, for ~$61*
• CPT code 98981: Each additional 20 minutes of interactive communication with a patient regarding remote therapeutic monitoring for ~$49*

*Exact reimbursement amounts vary by geographic regions, payors, and insurance plans.

Who can bill for remote therapeutic monitoring?

Unlike remote patient monitoring, which is restricted to physicians, RTM codes are available to qualified healthcare professionals like physical therapists (PTs), occupational therapists (OTs), and physical therapy assistants (PTAs). That’s because RPM codes fall under the evaluation and management (E/M) category, while RTM codes can be billed under general supervision. Obviously, surgeons can bill these codes if they're the one evaluating the data - we're seeing successful billing across all insurers.

How often can you bill RTM codes?

• CPT code 98975: Once per episode of care
• CPT code 98977: Once every 30 days
• CPT code 98980: Once per calendar month
• CPT code 98981: Multiple times per calendar month

How much data must be collected to bill RTM codes?

Although RTM codes do not have a threshold for data collection, CPT code 98977 requires at least 16 days of remote therapeutic monitoring for each 30-day period.

Can you bill for both RTM and RPM?

Yes, you can bill RTM and RPM codes if your services meet their requirements. However, it is important to note that physicians and non-physician qualified healthcare professionals cannot bill RTM codes for the same patient.

Modernize your orthopedic practice with remote therapeutic monitoring

The recent RTM codes open up many new billing opportunities for orthopedic practices as remote monitoring continues to expand. Because it’s based on existing processes like gathering and evaluating data and communicating with patients, remote therapeutic monitoring enables you to increase revenue instead of your workload.