Exploring CPT Code 98975: Initial Setup and Patient Education for RTM
Remote Therapeutic Monitoring (RTM) has become an essential tool for managing musculoskeletal (MSK) conditions, helping providers track patient progress and ensure effective treatment. There are six CPT codes associated with RTM, which are split into two categories: service codes and treatment management codes. Out of these, four are specifically related to MSK conditions.
Key RTM CPT Codes You Need to Know:
- CPT Code 98975: RTM Initial Setup and Patient Education
- CPT Code 98977: RTM App Supply for Monitoring Patient Condition
- CPT Code 98980: Initial 20 Minutes of Monitoring
- CPT Code 98981: Additional 20 Minutes of Monitoring
In this post, we’ll focus on CPT Code 98975, explaining what it covers, who can bill it, and the documentation requirements.
What Does CPT Code 98975 Cover?
CPT Code 98975 is used for the initial setup of RTM, including the installation of the RTM app and patient education on its usage. This code ensures that the patient understands how to use the RTM app and is equipped to track their progress.
Here’s how it works: The RTM care episode starts once the service is initiated, and it ends when treatment goals are met. During the initial phase, the provider should:
- Obtain patient consent
- Set up the RTM app
- Educate the patient on how to use the app
- Create a personalized home exercise program
For the patient to remain compliant, they need to engage with the RTM platform for at least 16 days within a 30-day rolling period. Depending on the RTM system, this engagement can be automatically tracked or manually recorded by the provider.
Who Can Bill CPT Code 98975?
The Centers for Medicare & Medicaid Services (CMS) allows several healthcare providers to bill CPT Code 98975, including:
- Physicians
- Physical Therapists
- Occupational Therapists
- Speech-Language Pathologists
The 2024 CMS Final Rule introduced clarification on General Supervision, which means that physical therapists and occupational therapists in private practice can now supervise RTM services provided by their assistants (PTAs and OTAs). This makes it easier for therapists to deliver RTM services remotely, extending care beyond the clinic to offer better support for patients at home.
It’s important to note that providers must comply with state laws and practice within their scope of practice when billing for RTM services.
Billing Frequency for CPT Code 98975
CPT Code 98975 can only be billed once per episode of care, and only after the patient has engaged with the RTM system for 16 days within 30 days.
Real-World Example of CPT Code 98975:
Let’s say a provider enrolls a patient in RTM and provides them with an app like PhyxUp Health. The patient uses the app to log their daily exercises and pain levels. If the patient continues to engage with the app for at least 16 days within the next 30-day period, the provider can bill CPT Code 98975 for the initial setup and education provided to the patient.
Documentation Requirements for CPT Code 98975
To ensure proper billing and compliance, make sure to document the following:
- Device Details: What type of device or platform is being used to monitor the patient’s musculoskeletal health?
- Education & Training: Document the education or training provided to the patient and/or caregiver about setting up and using the RTM app.
- Data Input Instructions: Make sure to document the guidance provided to the patient or caregiver on how to input the required data (e.g., home exercises, pain levels).
Got Questions About RTM CPT Codes?
If you have any questions about RTM CPT codes or need guidance on implementing RTM in your practice, PhyxUp Health offers expert solutions tailored to your needs. Our comprehensive RTM system simplifies patient monitoring, billing, and documentation ensuring seamless integration into your practice. With the right tools to enhance the monitoring experience, healthcare providers can extend support beyond the clinic, improving patient outcomes and streamlining care delivery.
