The Centers for Medicare and Medicaid Services approved the Medicare Physician Fee Schedule (PFS) for 2022 in December 2021. The Proposed Rule for 2022 included the implementation of remote therapeutic monitoring as the new solution in digital healthcare, and it acts as a counterpart to the remote patient monitoring system. Resembling the CPT codes in remote patient monitoring, five new codes under remote therapeutic monitoring 2022 has been established. The inclusion of these CPT codes is intended to extend the capacity and range of reimbursable forms of digital healthcare applications. It also includes the monitoring of non-physiological data.
Significance of Remote Therapeutic Monitoring
Remote therapeutic monitoring acts as the umbrella terminology for the set of five RTM CPT codes established in 2022 by the CPT editorial panel. The approval of remote patient monitoring by CMS provides coverage to new categories of self-reported and non-physiological data corresponding to the status of respiratory systems, musculoskeletal systems, medication response and adherence, and pain levels. RTM supports remote monitoring in healthcare settings for a vast number of non-physiological data, and not just specific to the therapeutic information.
According to CMS, eligible and qualified healthcare professionals and physicians are permitted for billing when using remote therapeutic monitoring. In the final rule for 2022, CMS stated that the primary billers for RTM codes include nurse practitioners (NPs), psychiatrists, physical therapists, social workers, physician assistants, clinical psychologists, physical and occupational therapists, and speech-language pathologists.
The Difference Between RTM and RPM
The key differentiator between remote therapeutic monitoring and remote patient monitoring can be observed as:
- Remote patient monitoring uses digital technology to analyze and capture the physiological data of patients, like glucose levels, blood pressure, and lung functioning. Whereas remote therapeutic monitoring concentrates more on the non-physiological data like recording pain levels and patient adherences.
- Remote therapeutic monitoring doesn’t necessarily require the usage of a technological device; a simple platform to track the quantitative data of patients can suffice. Whereas RPM requires a digital platform to quantify the data collected. For RTM, there are various ways to collect this data with software, healthcare solutions provider portals, mobile applications, etc.
Benefits of Remote Therapeutic Monitoring 2022
Additional to the financial benefits, remote therapeutic monitoring also provides valuable advantages like:
- Significant insights into patient satisfaction and adherence.
- Improving patient rapport, engagement, and activation.
- Early care interventions for patients under care programs.
- Advanced data offerings to providers for improving care-related decision-making.
- Improving patient pain levels and functional outcomes.
- Reduced expenses during rapid patient improvements.
- Enhanced patient-provider communication over longer periods.
- Enhancing the self-efficacy of patients in learning to better manage their care conditions.
How can Rainbow Health Assist with Remote Therapeutic Monitoring?
Rainbow Health’s comprehensive and unified technology platform offers enhanced home-based care delivery services improving care coordination and management. Remote therapeutic monitoring is primarily designed toward catering to patients with musculoskeletal, respiratory, and other chronic conditions. Rainbow Health’s platform typically considers and provides services to the network of provider groups including pharmacists and paramedics. This can be leveraged in providing enhanced healthcare services inclined towards remote therapeutic monitoring.
To cite a use case, providers need to observe 16 out of 30 days of episodes when monitoring patients, so that they don’t fall off their care programs, and providers receive their payments. As service providers for at-home care, proper facilitation of care coordination with provider groups is necessary. Rainbow Health’s platform notifies paramedics to intervene when monitoring a patient while also checking the correct implementation and usage of the digital devices. Clinical pharmacists can be involved in the process via virtual consultation to offer the proper dosage of medication and offer the necessary assistance to patients to deliver the best healthcare services and generate increased revenues. It is necessary to ensure that at least 16 days of data is appropriately captured when implementing remote therapeutic monitoring combined with 20 minutes of interaction between patients and providers, or else providers cannot bill for their services. Hence, patients need to adhere to protocols for better revenue generation through enhanced 5G enabled digital healthcare devices. The capabilities of 5G enabled devices vs broadband/wifi supported is related to a continuous data feed from 5G devices located even in remote areas. This makes monitoring of patients highly effective compared to wife/broadband-enabled devices, which may take longer intervals and can cause unforeseen interruptions in data syncing.
To name a few of the 5G-enabled suite of devices:
- Medication Monitoring Devices
- Cellular Smart Cap
- Bluetooth Smart Cap
- 5G Medical Hub
Remote therapeutic monitoring codes enable Rainbow Health’s platform to bill and increase the revenue with the adherence data. Meanwhile, Rainbow’s services can assist clinical social workers, nurse practitioners (NPs), and paramedic-led groups can utilize the offering in providing at-home care services to patients. Entrepreneurs and providers who are looking for services to offer remote monitoring services and technologies and gear up in taking steps to understand this billing opportunity listed under Medicare services.
Once organizations and healthcare providers understand the key factors between RPM and RTM, it is important to discuss the next phase of strategies with digital healthcare solutions companies like Rainbow Health who work with innovators in closely monitoring the industry trends, reimbursement pathways, and integrated services such as paramedics at home and additional virtual pharmacist oversight will provide valuable insights towards the growth of healthcare facilities and businesses.