RTM Billing & Reporting Overview

This article explains how the RTM Billing Dashboard evaluates and displays billing codes, and covers the key concepts behind billing cadence and monitoring intervals. It is intended for clinicians, care coordinators, and billing teams responsible for evaluating RTM activity and completing monthly billing workflows.

Billing Cadence vs. Activity Monitoring Interval

Although both are based on a 30-day concept, billing cadence and activity monitoring intervals serve different purposes.

Remote Treatment Codes (Care Management)

Remote treatment codes reflect time-based RTM services for clinical treatment and care management, billed on a calendar-month basis.

• Remote treatment codes are evaluated using calendar months, not activity monitoring intervals
• All qualifying treatment minutes provided during the month are summed within that calendar month
• These codes appear on the billing report for the month in which the treatment time occurred
• Treatment time does not roll forward into future months

How the Platform Evaluates and Displays RTM Billing Codes

The platform evaluates RTM code thresholds on a monthly basis and displays billing information up to the current reporting month. Code visibility in the billing report is determined by how each RTM code is defined and when its evaluation period ends.

• 98975 appears in the month the setup requirement is met, since it is not tied to an ongoing monitoring interval.
• 98985 and 98977 are patient activity-based codes and appear in the month the monitoring interval being evaluated ends, rather than the month the activity threshold is first achieved.

This approach ensures RTM activity is evaluated consistently within defined monitoring periods and aligns billing visibility with the appropriate evaluation timeframe. The RTM Billing Dashboard brings these evaluations together and clearly shows which RTM codes met their thresholds for each patient episode and billing month.

Billing Overview (3-Month Trend)

At the top of the Billing tab, a summary chart shows RTM billing activity over the last three months. Use this view to understand overall code achievement, track trends over time, identify changes in volume or code mix, and spot early signals of workflow, engagement, or activation issues.

The Billing Detail Report

Below the trend chart, the Billing Detail Report serves as both a monthly billing workspace and a historical record of RTM activity across all patient episodes. The report includes one row per RTM-enabled patient episode per billing month, with rows shown regardless of whether any codes were met. Each row clearly indicates which codes met thresholds, how many units were achieved, and whether the episode was billable that month.

CMS Compliance

While the platform provides interval-based reporting and billing guidance, CMS compliance ultimately rests with the organization submitting the claim. Actively monitoring billing cadence ensures that:

• No RTM code is billed more than once within the same 30-day period for a patient
• Each claim corresponds to a clearly documented, non-overlapping 30-day monitoring interval
• Claims are submitted only after monitoring intervals are fully complete and reviewed
• Audit readiness is maintained