How is RTM Different from RPM (Remote Patient Monitoring) Billing?

Today, monitoring patients remotely has become essential for doctors seeking to follow up on the health of a patient not within clinical walls. Two popular methods—Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM)—allow physicians and other qualified health care professionals to create new reimbursement streams by leveraging technology in a way that benefits patient outcomes.

Though the names are too close to get confused, they can’t be interchanged at your choice. The two categories are split by the definition of each, the providers that can be paid through them, CPT codes, and patient situations they treat. This blog will briefly discuss what separates these two, namely identifying remote therapeutic monitoring CPT codes and also delineating between remote patient monitoring services to help providers improve care delivery while also ensuring proper billing.

What is Remote Patient Monitoring (and where to begin)?

Remote Patient Monitoring (RPM) is a digital health service that enables providers to monitor patient physiological data outside of the clinic. This involves taking measurements of vitals, including:

• Blood pressure
• Heart rate
• Glucose levels
• Oxygen saturation
• Weight

CPT Codes Used:

• 99453 – Establish RPs & educate patient on RPM device.
• 99454 – Supply of device with daily recordings and readings transmission.
• 99457 – Initial 20 minutes of clinical staff/physician/qualified healthcare professional time.
• 99458 – Each additional 20 minutes for monitoring/management.
• Providers Eligible providers are: Physicians; Nurse practitioners; and Physician assistants who act within the scope of their practice.
• Payment Model: Payments for RPM billing cover both the technical setup and ongoing professional time spent on patient data management.

Example of RPM in Action

One patient who is diabetic has a glucose meter connected to their provider that sends the readings. The physician looks at the data every week, modifies the medication and writes down how much time. The latter type of activities are reimbursable as remote patient monitoring services.

What is Remote Therapeutic Monitoring (RTM) anyway?

Remote Therapeutic Monitoring (RTM)—CMS category in 2022 This is a newer category defined in 2022 by the Centers for Medicare & Medicaid Services (CMS). It concentrates on non-physiological information with respect to musculoskeletal and respiratory diseases. Unlike RPM, RTM is not restricted to FDA-cleared medical devices. Instead, patients could digitally self-report data using an app or other platform.

Key Features of RTM Billing

Data collection: 

Therapy-specific and non-physiological data including:

• Pain levels
• Medication adherence
• Physical therapy progress
• Respiratory function tracking

CPT Codes Used:

• 98975 – INITIAL PATIENT EDUCATION AND SETUP.
• 98976 – Device distribution for monitoring of the respiratory system.
• 98977 – Musculoskeletal System Monitoring Device supply.
• 98980 First 20 minutes of RTM management each month.
• 98981—For every next twenty minutes of RTM management

Eligible Providers

RPM has a broader reach—eligible providers are not limited to physicians but also encompass qualified non-physician health professionals like physical therapists and occupational therapists.

Reimbursement Model

Neither CH and N nor F billing reimburses for monitoring physiological values; both reimburse for measuring patient adherence to therapy and response.

Example of RTM in Action

A physical therapist assigns exercises to a patient rehabilitating after an injury to the knee. The patient logs pain scores and adherence to exercise in a mobile application. Data are reviewed, feedback is offered and therapy is modified accordingly. These are remote therapeutic monitoring CPT codes.

Differences between RTM and RPM Billing

Although both RTM and RPM seek to improve care beyond the clinic, there are key differences:

Feature	RTM Billing	RPM Billing
Focus	Monitors therapeutic, nonphysiological data (pain, medication use, adherence).	Monitors physiological data (vital signs, biometric readings).
CPT Codes	98975–98981	99453–99458
Eligible Providers	Includes therapists (PT, OT), non-physician practitioners, and physicians.	Limited to physicians, nurse practitioners, and PAs.
Devices Required	Can use digital apps or patient self-reports; not restricted to FDA-approved devices.	Requires FDA-approved medical devices.
Conditions Targeted	Movement, breaths, and positive changes in the patient’s therapy.	Hypertension, diabetes mellitus, chronic obstructive pulmonary disease, and congestive heart failure—all four are chronic diseases.   .
Reimbursement	Encourages treatment, patient education, and communication.	Supports the process of device installation, remote monitoring, and clinical management of physiological data. .

Billing and Coding Challenges

RTM Billing Challenges

• Verifying the accuracy of self-reported information.
• Monitoring the time allocated to therapeutic management.
• Limited payer adoption since RTM is relatively new.

RPM Billing Challenges

• Ensuring patients use devices correctly and consistently.
• Compliance with payer-specific daily transmission requirements.
• Preventing service overlap between patients under RPM and RTM.

Benefits of RTM and RPM

Benefits of RTM

Increases availability of coverage for therapists and other related health professionals that can both provide service in the location of choice, better enabling treatments to be carried out at home or in a school setting.

• Enhances patient engagement in therapy adherence.
• Offers flexible monitoring methods beyond devices.

Benefits of RPM

Provides continuous physiological insights to improve chronic disease management.

Decreases readmissions to the hospital by recognizing problems at an early stage.

Generates new sources of revenue for practices caring for at-risk patients.

Compliance and Best Practices

For successful billing of both RTM and RPM providers should:

• Charting in Detail: Note every patient encounter, data review and management time.
• Check Payer Policies: RTM codes are not uniformly payable by all payers—review guidelines.
• Use Technology: Look for platforms that integrate with EHRs to automatically collect data and submit claims.
• Educate Patients: Patients need to be trained in the proper use of devices/apps for data reliability.
• Don’t Double Dip: In case a patient is entitled to both RTM and RPM services, ensure that the services are distinct as well as reported correctly.

Final Thoughts

Remote Therapeutic Monitoring (RTM) and Remote Patient Monitoring (RPM ) are transforming the delivery of healthcare. Both RPM and RTM are on-the-go technologies to watch patients’ biometric data using FDA-cleared devices; however, RTM allows for the monitoring of treatment outcome and patient-reported data. One of the main points that differentiates providers is the way the expenses are dealt with. The billing codes of remote therapeutic monitoring (98975–98981) refer to the situations when therapists and other health professionals are involved in the treatment of musculoskeletal or respiratory problems. In contrast, remote patient monitoring services (99453–99458) are designed for doctors and nurse practitioners who manage chronic diseases only.

An understanding of these differences will enable healthcare providers to optimize reimbursement, improve patient engagement and provide customized care.

FAQs

 Is it possible for the same patient to be qualified for both RTM and RPM services?

The answer is yes, provided that the services are different. The data that are RPM are tracked, whereas RTM is dedicated to therapeutic progress and completion of the activities. The usage of proper codes is the only way to ensure that there will be no duplications.

Are FDA-approved devices required for RTM?

No. RTM can use digital apps or patient self-reports, whereas RPM requires FDA-approved medical devices for physiological monitoring.

Who is entitled to bill RTM and not Remote Patient Monitoring (RPM)?

Therapists, occupational therapists, and other non-physician providers are allowed to bill through RTM; on the contrary, physicians, nurse practitioners, and physician assistants are the only ones who can do so for RPM.

What are the diseases that can be managed better by RTM or RPM?

RTM can be used effectively for the management of musculoskeletal or respiratory therapy problems, while RPM is mainly used for diseases like hypertension, diabetes, or heart failure.