One Provider to Bill RPM or RTM Only One Time Per Patient
Rheumatology CPT codes 98977, 98980 and 98981 for RTM can be billed by only one provider in a 30-day period only one time per patient (episode of care, not a calendar month). However, other services, such as chronic care management (CCM), transition care management (TCM), principal care management (PCM) and chronic pain management (CPM), can be billed concurrently with either RPM or RTM.
General Information
RPM and RTM treatment management codes were created to report services that are provided when clinical staff utilize the results of remote monitoring devices to manage a patient under a specific treatment plan. These services are a general telehealth option classified under E/M services to collect and analyze patient vitals on an ongoing basis between regular office visits and can be furnished only by a physician, other qualified healthcare professional or clinical staff under the general supervision of a physician eligible to bill for Medicare E/M services. These services are part of a monthly billable program and track patients’ health issues/status. They must:
- Be for an established patient, one with whom the physician has had a prior new patient E/M service (which may have been done via telehealth); and
- Allow for both chronic and acute conditions.
Review the full overview of the RPM and RTM definition here.
RPM and RTM service updates are ongoing, so it is imperative that rheumatology practices remain up to date on all coding guidelines to ensure proper reimbursement. For questions and additional coding guidance for these services, contact the ACR Practice Management Department at [email protected].
