Billing for RTM Device Supply (CPT Code 98976 and 98977)

As you prepare to bill for RTM Device Supply (CPT Code 98976 and 98977), MedBridge can help you easily collect the information you need.

For your reference, CPT Codes 98976 and CPT Code 98977 are defined as follows. For more information on the RTM billing codes, please refer to this article: RTM Billing Codes and Best Practices for Success

Device Supply (CPT Code 98976 and CPT Code 98977)

What CPT code 98976 covers: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response), device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days.

What CPT Code 98977 covers: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response), device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days.

How to use these codes: Report 98976 only if monitoring a patient’s respiratory system and report 98977 only if monitoring a patient’s musculoskeletal system. With both codes, only report if the 16 days of data collection has occurred in a 30-day period.

What to document: The name and description of the device provided for monitoring of the respiratory or musculoskeletal system along with the dates covered. 

It’s recommended to bill for this milestone once per month, but remember that this code looks at any 30 day period, so that doesn’t necessarily need to occur at the end of the month. You can use Medbridge to pull a report of the patient’s activity.

Determining Patient Eligibility

First, you will need to determine which patients are eligible for billing under this code.

1. Select RTM Reporting from the top of the HEP page. This page will show you all your patients with RTM enabled.
   
   • If necessary, you can use filters to select all patients within your organization, or select a different clinician under the “Primary Clinician” filter.
2. Then, change the “Patient Activated RTM” filter to “Y.” You’ll now see only the patients who have activated and engaged with their program.
   
3. Now, you’ll need to determine if your patients have at least 16 days of activity data. Based on your organization’s policy, you will use one of the following three filters to determine activity data:
   • Days Since First RTM Login: The total number of days since the patient first logged in after RTM was enabled for the episode of care.
   • Patient Login Days: The total number of days where a patient login occurred after RTM was enabled for the episode. If a patient logs in multiple times on a single day, that day will only be counted one time.
   • Patient Activity Days: The total number of days that the patient completed an activity, as defined below, after RTM was enabled for the episode. If a patient completes multiple activities on a single day, that day will only be counted one day.
     
     • Patient Activities: logged adherence, engaged with education resources, messaged clinician, read message, loaded an exercise or education video, completed a survey.
4. Locate the appropriate filter, and change the left value to 16. Now you can see which patients have been monitored for at least 16 days.

Generating Activity Report

Once you’ve identified a patient with at least 16 days of monitoring, you need to determine if those 16 days occurred within a 30 day period.

1. From the RTM Reporting page, select the patient’s name and click the “Patient Profile” link.
2. Select RTM Activity.
3. Select RTM Activity report.
4. Uncheck the provider activity box to filter to just patient activity.
5. Review the patient activity and determine if 16 activities occurred within 30 days.
6. Change the Start and End Dates to the start and end of the 30 day period.
7. You now have a report that’s filtered to the information you need. You can now download this as a PDF or copy it to your clipboard to paste into your EMR.