RTM Billing and Documentation Playbook Therapy Practices

Remote Therapeutic Monitoring (RTM) can be a game-changer in patient care. But it’s not always easy for therapy providers to know how to bill for time spent monitoring data with digital apps. To make the most of RTM, providers need to feel confident about billing practices so they can stay compliant. 

When handled properly, RTM billing can be low-stress, and providers can focus on offering patients the best level of care. In the guide that follows, we’ll discuss the best strategies for therapy practices overseeing RTM billing and documentation. 

Understanding Remote Therapeutic Monitoring

Remote Therapeutic Monitoring is a way for providers to track a patient’s responses to a treatment plan. Using an app or other digital tool, the provider can look at anything from how well a patient is sticking to a medication plan to how much pain a patient feels. 

Between visits, RTM can be an excellent tool to monitor recovery progress. RTM can help determine if a patient is gaining back mobility following a surgery, for instance. 

Providers can use the information gathered to help tweak treatment plans. They can also determine how to motivate patients to stick with recommended exercises or medications. Physical therapists and other rehabilitative providers find RTM especially useful as patients continue treatment plans at home. 

Reviewing Billing Codes

Billing codes are a critical piece of the puzzle when it comes to overseeing RTM services. Five-digit codes are used to cover RTM processes, and staff members at therapy practices need to know them. 

Further, practices need to be mindful of documenting all services carefully to ensure they meet insurance expectations for given codes. Without the right details, insurance could deny a claim.

Common codes cover RTM patient education. The patient needs to know how to use the system and how frequently they need to provide updates. After a long hospital stay, for instance, the patient may need a little extra guidance to ensure a smooth transition to at-home treatment. 

There will also be an RTM device code for the platform that collects patient information. This code is applicable when the tool is used for at least half the month. 

Providers will need to dedicate time to looking over patient data reports, perhaps calling or messaging them to communicate updates. And they may need to revise the treatment plan if the data doesn’t point to improvements. Since these efforts take time, data review is also covered by RTM codes.

Focusing on Documentation

For providers to get reimbursed, details are critical. Without complete documentation that shows a clear rationale for RTM, the claim may not be approved. It’s best to err on the side of recording too much information. 

Practices should document evidence of patient consent to be part of RTM services. Providers should record consent in patient records as well as details on what will be monitored. Having a clear plan of care can help insurers see that the RTM treatment connects logically to larger goals for the patient’s recovery. 

Additionally, providers should outline key information about the digital platform to be used. The best remote therapeutic monitoring plans can ensure clearer results and encourage stronger patient adherence.

Providers should note all key data, plus the dates when it was collected. And they should document how much time they spend looking at data and following up with patients. 

Stick with a Structured Approach

RTM programs work best when there’s consistency with documentation. Creating a standardized workflow within a practice can help avoid costly problems.

The workflow should begin with the patient agreeing to enroll in the RTM program. From there, the provider works with the patient to understand how to use the app and collect information related to progress or symptoms.

Other steps include provider communication with the patient and documentation of data reviews. Ultimately, these steps are coded and submitted to insurance as part of the billing process. 

When every staff member in a practice knows their role in an RTM workflow, the chance of claim denials and other problems goes down. Staff members should know how to enroll patients and explain their responsibilities to them. 

Everyone from the front desk staff to the providers and assistants should be an encouraging presence for patients. When patients feel supported, they’ll be more likely to commit to logging their treatment exercises and health details in the system.  

Don’t Overlook Compliance

RTM claims tend to be reviewed very carefully by insurance companies. And there are several complicating factors that can impact RTM claims. 

Remote Patient Monitoring (RPM) and RTM cannot be billed simultaneously for one patient, for instance. And monthly interactive communication is a must between the provider and patient. Consequently, practices need to stay on top of requirements.

It’s smart to do internal audits to verify that documentation is thorough. Documentation should include timestamps and specifics on the diagnosis and relevance of the treatment. Practices should try to have a designated staff member in charge of RTM compliance. 

Staff members should also follow up with patients regularly to make sure they’re engaged with the RTM. Simple voice message reminders and a simple software interface can improve engagement. And more consistent work on exercises can contribute to more positive outcomes. 

Track Key Performance Indicators

Practices shouldn’t stop at introducing RTM to their patients. They should monitor progress to see if RTM programs are worth the effort. 

Looking at patient participation and health outcomes can be a strong indication of efficacy. Providers should see how much time they’re investing in reading data and communicating with patients. And front desk staff should review how well patients are sticking with follow-up appointments. 

Done well, RTM programs can help patients feel positive about their prospects for improvement. With weeks or months between in-person appointments, RTM programs provide a critical bridge.

Make RTM a Key Part of Your Therapy Practice

Therapy practices and their patients stand to gain a lot from RTM programs. But it’s best to introduce RTM gradually with a handful of patients. Staff members can adapt to the new workflow, learn how to document treatment details, and support patients new to the monitoring software. 

When staff members are careful with billing details, RTM can be a helpful and lucrative component of therapy.