When (and how often) do you bill each RTM code?
Billing guidelines for each RTM code - including a cheatsheet
Healthcare providers utilizing Remote Therapeutic Monitoring (RTM) services need to understand when to bill for each RTM code to ensure accurate reimbursement. This article will outline the billing guidelines for each RTM code, helping healthcare providers navigate the billing process for these services.
RTM Code Billing Guidelines
- Code #98975 (Initial Set-Up and Education)
- >Bill at the end of the first 30-day cycle, provided the patient has completed 16 out of 30 active days. This code covers the initial set-up and patient education of the RTM device.
- >How often: Once per episode of care (RTM initiation thru the end of treatment).
- Code #98977 (Data Transmission and Supply of Device)
- >Bill at the end of each 30-day cycle in which the patient completes 16 out of 30 active days. This code covers data transmission services and the supply of the RTM device.
- >How often: Once per 30 days.
- Code #98980 (Treatment Management Services - First 20 Minutes)
- >Bill at the end of each calendar month in which the healthcare provider spends at least 20 minutes on assessment and evaluation including one interactive communication with the patient. This code covers the initial 20 minutes of treatment management services.
- >How often: Once per calendar month.
- Code #98981 (Additional Treatment Management Services - Each Additional 20 Minutes)
- >Bill at the end of each calendar month in which the healthcare provider spends additional 20 minute increments on assessment and evaluation including one interactive communication with the patient, beyond the initial 20 minutes covered by Code #98980. This code covers each additional 20-minute increment of treatment management services.
- >How often: Once per calendar month, for each additional 20 minutes.
Understanding when to bill for each RTM code is essential for healthcare providers to accurately claim reimbursement for their services. Staying informed about the billing process for RTM codes will enable healthcare providers to effectively utilize these RTM services and focus on providing high-quality remote care to their patients.
