In January 2022, CMS released new CMT codes that allow therapists to bill for remote therapeutic monitoring (RTM).
The diagram below represents an example workflow demonstrating how your team can use MedBridge to help satisfy the billing requirements for RTM services.
There are two workflows: one for the patient and one for the provider. The flow starts when the provider goes within the MedBridge application and marks the patient episode for RTM.
The provider then proceeds to either create or update a home exercise program, sharing the program with the patient, and educating the patient on how to use the patient portal or app to adhere to their program from home as well as provide feedback to the therapist in between visits.
As the patient interacts within the application or web portal, the system tracks each interaction completed by the patient as well as the clinical team members.
Between the set-up, patient app education, and collection of data transfers, your team will be armed with the data necessary to make clinical decisions around RTM billing and improvement of patient engagement. When the engagement thresholds are met, your providers will be eligible to bill against the engagement-based codes (98975, 989776, and 98977).
As the therapists review adherence and patient feedback within the MedBridge application, they will have the opportunity to document the interactions that they have performed with the patient, such as time spent monitoring or updating a program and remote interactions with the patient, including phone or video calls.
When viewing logged interactions over a month’s time, the therapist can decide what is appropriate to bill for the time based codes (98980/98981 ) as the required thresholds are met.
Step 1 (MEC): Patient identified as RTM eligible and appropriate
To identify which patients agreed to RTM, we added a checkbox that may be marked upon episode creation within the Patient Profile or when an episode is saved for the very first time within the HEP builder. Users may go back to the Patient Profile and click “Edit Episode” to either enable an episode that has been previously made for RTM or to turn off the RTM checkbox by unchecking the box. After one week, the ability to turn off monitoring will be disabled.
Step 1 (non-MEC): Patient identified as RTM eligible and appropriate
To identify which patients agreed to RTM, we’ve added a checkbox that may be marked on an episode level within the Patient Profile. A clinician may return to the patient profile to turn off a checkbox as well; however, after one week, the ability to disable the checkbox will be removed.
Step 2: Clinician logs review of adherence in MB activity log
Once a clinician has marked an episode as RTM, an RTM-enabled chip will display within the episode details panel. Additionally, a new action button will be available called “RTM Activity".
This button will enable your team to log the clinical interactions that occur for the RTM episode. The purpose of this feature is to provide full transparency into the actions taken with this patient when it comes time to bill the codes either after the threshold is met for days of data transfer from the patient to MedBridge or at the end of the month, when tallying the total time spent monitoring the patient.
A clinician will review the adherence for an RTM patient within the patient's profile page. Within the patient profile, therapists will see an Overview of Episode of Care Adherence graph. This graph represents how well a patient is adhering to their prescribed program based on the subjective inputs they have entered from the patient web application.
Details pertaining to the patient's adherence or direct feedback can be found by clicking on the “View Details” page. On this adherence page, the clinician can see all of the exercises performed or skipped by the patient and any direct feedback provided on the exercises. The patient will have the opportunity to indicate pain ratings, reasons for skipping, and ease or difficulty of the exercise performed, as well as send messages or ask questions about a specific exercise.
After the clinician clicks on the “RTM Activity” button, a drawer will open displaying any RTM activity manually logged by a clinician. A new activity can be logged by clicking on the “Log New” button.
To log a new activity, the clinician must enter the provider (defaulted to current user), an interaction type (phone call, video call, monitoring time, or onboarded patient), date (defaults to today’s date with an ability to select any date from when the RTM checkbox was enabled forward), and duration (in minutes).
Upon entering all the fields, the clinician may click “Log Activity,” and the interaction will be added to the Logged Activity Table.
Step 3: Review monitoring dashboard
To assist your clinicians with managing their RTM patients, there will be a new reporting section available in the Patient Engagement sub-navigation panel.
This new dashboard provides a list for that specific clinician user so that they may see all of the patients that they are responsible for monitoring for RTM.
Within this dashboard, we provide some data points that will help the clinician know which patients to view in more detail as well as who might be eligible to bill for the associated RTM codes.
Step 4: Review RTM documentation to bill
With the assistance of the dashboard, a clinician can pull up a patient’s profile to view in detail the interactions that have occured. To do this, the clinician clicks on the “RTM Activity” button and then clicks “Download” within the drawer. 
Clinicians also have the option of downloading RTM documentation in PDF format. By downloading the PDF, the clinician can see a detailed log of both patient and clinical interactions to bill against. Once downloaded, this document may be uploaded into an EMR to provide added documentation support for encounters billed for RTM.
If you would like to learn more about our RTM solution, please contact your organization's Customer Success Manager.