MedBridge can easily help you generate reports on patients who are eligible to be billed for the RTM billing codes.
To get started, navigate to the RTM reporting page, and select “Monthly Reports.” On this dashboard, you’ll see three different tables - one for each of the RTM Code categories. Use these tables to determine which patients are eligible for reimbursement for each of the CPT codes.
- Device Set Up (CPT Code 98975)
- Device Supply (CPT Codes 98976 and 98977)
- Treatment Minutes (CPT Codes 98980 and 98981)
- Generating Activity Reports
How to use these reports
In order to generate a billing report, you’ll first need to filter the data to fit your needs.
- Start by filtering the appropriate subset of patients using the primary clinician, clinic, and region filters at the top of the page. Enabling one of these filters will apply to all tables on this page.
- Scroll to the table you would like to reference and select the month you would like to review.
- Filter to Access or Activity based on your organization’s billing policy for the given code.
- Once you have identified patients who are eligible for reimbursement, you will need to generate an activity report by navigating to the patient profile. This report will need to be added to your EMR in order to bill for this patient.
Once you have filtered your data, you can download an Excel or CSV of any of the data on this page by selecting the “Download” button at the top of the page.
Data Definitions
In order to understand and use these reports, there are a few terms that will be important for you to understand. For more information about any of this data, refer to the “Data Definitions” tab in the reporting dashboard.
For the Device Set Up (989875) and Device Supply (98976, and 98977) codes, your organization can choose to use one of two data points to determine eligibility:
- Access Days: The number of days since the patient first logged into their program.
- Activity Days: The number of days a patient has recorded an activity, such as logging an exercise, reading or responding to a message, and logging in. See the data definitions tab for a detailed list of all tracked events.
When using this dashboard, make sure to filter the Device Set Up and Device Supply tables based on the data point your organization chooses to use.
Activation: An RTM episode is considered active when a patient has logged into their program via MedBridge GO or the Patient Portal at least once after RTM is enabled by the care team.
Episode Status: This is a general episode status in MedBridge meaning the following:
- Active: The episode has not been ended or archived.
- Ended: The provider has selected “End Episode” in the patient profile and archived the episode.
Note: When an episode has ended, the patient will still have access to their most recent program in the MedBridge GO app or Patient Portal, however, the patient will not be able to message, report pain/difficulty, or log activity. It’s best practice to end a patient’s episode in MedBridge when you discharge the patient from your care. This helps you reduce noise in the RTM reporting and ensures you do not receive patient feedback on an episode you are not actively monitoring.
Interval: In our RTM reporting dashboard, we use 30-day consecutive intervals to measure, track, and report on patient activity. This is because device supply can only be billed every 30 days. The first interval starts on the day a patient activates their program by logging in (also referred to as activation). After 30 days, the first interval ends and the second interval begins. This continues until a patient’s episode is ended by the clinician. The monthly reports filter to the interval end dates rather than calendar dates due to the 30-day billing criteria for the device-related codes.
Device Set Up (CPT Code 98975)
Use this table to determine if patients have met the requirements for the Device Set Up code, 98975. When you navigate to this page, you will see all patients with an interval that ends in the current month.
To identify eligible patients, you will need to first identify the appropriate time period by using the“First RTM Interval End Date” filter. Then, you will need to select the appropriate metric for your organization - Access or Activity. Refer to your organization’s billing policy to determine which data point you should use.
How do I identify patients who are eligible for reimbursement under 98975?
- Use the “First RTM Interval End Date” dropdown to filter the data to the appropriate time period.
- Select the “Access or Activity” filter to “Access Met” or “Activity Met,” depending on your organization’s billing policy.
The table now shows all patients with an interval ending in the selected month who have met the selected billing milestone. You can now generate an activity report for each of these patients in order to bill for them.
You can also identify patients who have already met their access or activity milestone for intervals ending next month. For example, if a patient has an interval that starts in early February, their interval won't end until March, but they may achieve 16 days of access or activity before the end of February.
To identify patients who have achieved the Access or Activity milestone for an interval that ends next month, change the “First RTM Interval End Date” filter to “next month.”
Device Supply (CPT Codes 98976 and 98977)
Use this table to determine if patients have at least 16 days of activity recorded and have met the requirements for the Device Supply codes, 98976 and 98977.
To identify eligible patients, you will need to first identify the appropriate time period by using the “Interval End Date” filter. Then, you will need to select the appropriate metric for your organization - Access or Activity. Refer to your organization’s billing policy to determine which data point you should use.
How do I identify patients who are eligible for reimbursement under 98976 or 98977?
- Use the “Interval End Date” dropdown to identify intervals ending in the selected time period.
- Select the “Access or Activity” filter to “Access Met” or “Activity Met,” depending on your organization’s billing policy.
The table now shows all patients who have met the billing milestone you’ve selected for the time period you’ve selected. You can now generate an activity report for each of these patients in order to bill for them.
Treatment Minutes (CPT Codes 98980 and 98981)
This table shows any patients for whom at least 20 minutes of treatment activity and one interactive communication have been documented in a calendar month and are eligible for billing under codes 98980 and 98981.
Note that while the other reports on this page focus on 30-day intervals, this report focuses on a calendar month; the patient’s RTM interval does not impact their eligibility for 98980 or 98981.
To identify eligible patients, you will need to first identify the appropriate time period by using the “Treatment Date” filter. Then, to identify patients with at least 20 minutes of treatment activity and an interactive communication, set the “Minimum Treatment Met” filter to “Y”
You can now see all patients with at least 20 total minutes of logged treatment activity in a month and one interactive communication. These patients may be eligible to be reimbursed for CPT Code 98980. For each additional 20 minutes, they may be eligible to be reimbursed for CPT Code 98981.
On the right side of the table, you can see how many minutes were recorded sorted by clinician discipline, so you can easily determine if your reimbursement will be subject to the PTA/COTA payment differential.
How do I identify patients who are eligible for reimbursement under 98980 and 98981?
- Set the “minimum treatment met” filter to “Y.” This will filter out any patients who have not had 20 minutes of activity or who have not had an interactive communication.
- If necessary, change the “Treatment Date” filter to a different month.
The table now shows all patients who have met the treatment milestone for the time period you’ve selected. You can now generate an activity report for each of these patients in order to bill for them.
You can also filter to include patients who have not met that milestone by setting “Minimum Treatment Met” to “N.” This gives you another way to identify patients who may need a follow-up.
Generating Activity Report
Once you’ve identified a patient who is eligible for reimbursement with one of the RTM codes, you can generate an activity report from the patient’s profile. Learn how to generate an RTM activity report.