Remote Therapy Monitoring (RTM)

Leverage the Medesto Health Enterprise Platform to digitally track specific patient conditions and bill for RTM services.

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New guidelines taking effect January 1, 2022

New guidelines established by the Center for Medicare and Medicaid Services (CMS) that take effect January 1, 2022, allows qualified health care professionals monetary reimbursement for Remote Therapy Monitoring (RTM), for monitoring medication adherence, and therapy response through an approved medical device.

These new RTM codes are limited to patients with respiratory and musculoskeletal conditions. However, CMS recognizes the national epidemic of non-adherence and the billions of dollars it costs our healthcare system each year. Therefore, CMS has enacted these new guidelines to incentivize the medical community to monitor the medication adherence.

The RTM codes expand the use of medication reimbursement beyond Remote Patient Monitoring. The creation of these new RTM codes, validate the necessity of improving medication adherence.

RTM is intended for the management and monitoring of patients using an FDA approved medical device. Monitoring patients outside of conventional clinical settings, such as in the home or in a remote area, increases access to care and decreases healthcare delivery costs.

The Medesto Health Enterprise Platform, developed by Perigon Health 360, utilizes an FDA approved Class 1 medical device that digitally tracks medication doses and provides access to a customized HIPAA compliant practitioner dashboard that allows physicians to track medication adherence in real-time. Medesto also provides predictive analytics data to determine when a patient might stop therapy, notice any medication trends, collects feedback assessment data relative to therapy response, side effects and much more.

RTM data can also be self-reported by the patient if the data is submitted manually into a covered device, or digitally uploaded via the device.

Under these new CMS regulations, qualified health care professionals treating respiratory and musculoskeletal conditions can now bill Medicare/Medicaid for additional compensation for their RTM services.

CPT# 98975

$18.82 / month

Descriptor: Initial set-up and patient education on use of equipment

CPT# 98976

$54.10 / month

Descriptor: Device(s) supply with scheduled (e.g. daily) recording(s) and/or programmed alert(s) and monthly data transmission to monitor respiratory system, each 30 days

CPT# 98977

$54.10 / month

Descriptor: Device(s) supply with scheduled (e.g. daily) recording(s) and/or programmed alert(s) and monthly transmission to monitor musculoskeletal system, each 30 days

CPT# 98980

$48.75 / month

Descriptor: Treatment management services physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes

CPT# 98981

$39.65 / month

Descriptor: Treatment, physician/other qualified health care professional time in a calendar month with the patient/caregiver during the calendar month; each additional 20 minutes

*16 day minimum of medication adherence every month                                                                                                                                                                  **Minimum reimbursement estimates

 

Perigon Health 360 is the only digital health company that monitors and modifies human behavior by using digitally generated data to create scalable, but personable communication pathways and provides prescription medication through our pharmacy. The result is improved medication adherence, side effect management that generates greater clinical outcomes for our patients.