When billing and evaluating with RTM codes, does that count towards a patient’s physical therapy or pre-authorized home care visits?

Does billing RTM codes affect a patient's pre-authorized physical therapy or home care visits?

Short answer: No.

RTM Billing and Its Effect on Patient Visits

When billing with RTM codes, it is essential to note that these codes do not count towards a patient's pre-authorized physical therapy or home care visits.

For instance, if a patient's insurance plan covers 12 physical therapy sessions, billing Exer Health for RTM services will not affect those 12 visits.

Instead, RTM serves as an extension of the therapy, rehabilitation, and care provided outside the clinic setting.

Insurance Plan Considerations

It is important to recognize that insurance plans can vary significantly based on the payor and individual circumstances. As RTM codes are relatively new, some Electronic Health Records (EHR) systems may not yet process them correctly. We've seen some systems that don't have them loaded in as an option yet. Therefore, healthcare providers are advised to conduct a thorough review of their EHR when billing RTM codes for the first time.

In summary, billing and evaluating with RTM codes does not impact a patient's pre-authorized physical therapy or home care visits.

These codes serve as an extension of the care provided outside the clinic and can be utilized without affecting a patient's allotted therapy sessions. To ensure proper billing, healthcare providers should carefully review their EHR systems and stay up-to-date with the latest developments in remote services and billing guidelines.