In 2022, the Centers for Medicare and Medicaid Services (CMS) introduced remote therapeutic monitoring (RTM) codes for treatment management. RTM is designed to manage patients using remote therapeutic monitoring devices that collect non-physiological data for certain medical conditions.
This article provides an overview of 7 common remote therapeutic monitoring devices and their use in RTM.
Differences in RPM and RTM Devices
To track chronic conditions, remote patient monitoring typically involves physiological monitoring, such as heart rate, blood pressure, and glucose levels. RPM collects data from medical devices that measure a patient’s physiological parameters. Devices like blood pressure monitors, glucometers, and pulse oximeters are generally classified as RPM devices because they track physiological parameters outside RTM’s primary focus on therapy adherence and response.
Remote therapeutic monitoring encompasses non-physiological data and tracks adherence to treatment plans and health status. RTM can only be used for musculoskeletal, respiratory, or therapy-driven conditions. This category is more about patient adherence to prescribed therapeutic activities and includes devices that measure “non-physiologic” metrics like therapy adherence, pain levels, or respiratory status.
Which Remote Therapeutic Monitoring Devices Are Used in RTM?
RTM requires the use of a medical device that meets FDA standards. Remote therapeutic monitoring devices include Software as a Medical Device, which is “software intended to be used for one or more medical purposes that perform these purposes without being part of a hardware medical device.” This makes RTM that much more accessible.
Remote therapeutic monitoring devices that align with Medicare’s description of RTM for therapeutic adherence and therapeutic response tracking:
Musculoskeletal Activity Trackers
Remote therapeutic monitoring devices are can be used for physical therapy or recovery from injuries. These RTM devices measure adherence to prescribed physical exercises. Some can track range of motion, pain levels, and activity patterns, helping providers optimize treatment plans. By remotely monitoring patient activity, qualified healthcare professionals can see if a patient is adhering to their care plan.
1.) Smart Watch
Activity tracking can also help support the self-management of patients with respiratory conditions s. For example, the Tenovi Smart Watch is a cellular-connected device that encourages an active lifestyle. It tracks steps, heart rate hourly, and sleep duration daily.
Activity trackers can be used to encourage physical activity in those with respiratory conditions. In addition, it can improve remote assessment of overall mobility in patients with with conditions such as rheumatoid arthritis. Interventions using activity trackers have shown improvements in health metrics across a wide range of populations.
Motion Trackers
Motion tracking systems qualify as remote therapeutic monitoring devices. The integration of computer vision for motion tracking enabled precise assessment of joint movements, but it does not require patients to wear physical sensors.
2.) Digital MSK Platforms
Platforms like IncludeHealth use computer vision technology to analyze a patient’s movements directly through a device’s camera. This software allows for remote assessment and personalized feedback for enhanced quality of care and greater patient engagement.
Inhaler Usage Trackers
Smart inhalers are remote therapeutic monitoring devices used for patients with respiratory conditions like asthma or COPD. These trackers monitor inhaler usage and adherence, helping providers assess the effectiveness of prescribed respiratory therapy.
3.) Hailie® Sensors
For example, Adherium Hailie® Sensors track medication usage to reduce the number of asthma and COPD attacks, drive better outcomes and reduce costs. These FDA-cleared sensors cover the 10 most common inhaled medications.
Medication Adherence Tracking
For patients with specific therapeutic regimens where adherence directly impacts the efficacy of the treatment (e.g., medications for mental health or pain management). These remote therapeutic monitoring devices track adherence. Some RTM devices send reminders to the patient and alerts to providers for missed doses.
4.) Smart Pill Bottle Cap
One example of a remote therapeutic monitoring devices that can be used for medication adherence tracking is PatchRx. This is a smart, universally-fitting pill bottle cap that allows patients to track one or two critical medications. It monitors both opening and closing events.
5.) Smart Pillbox
The Tenovi Pillbox is a smart pillbox that is identical to a standard 7-day morning and evening pillbox. Only, it features built-in sensors that automatically detect when pill compartments are opened or refilled. The event data is transmitted to care teams for prompt evaluation.
Respiratory Monitoring Devices
Remote therapeutic monitoring devices that track coughing frequency, wheezing, or other respiratory symptoms rather than physiological metrics like oxygen levels. These are particularly useful for respiratory therapy adherence.
6.) Peak Flow Meter
A peak flow meter (PFM) for asthma is an example of an RTM device that measures peak expiratory flow (PEF) and forced expiratory volume in 1-second (FEV1). When the date is sent to a provider it allows for swift assessment of patient lung function.
7.) Spirometer
Spirometers are another RTM device that is used to monitor respiratory conditions such as asthma, COPD, and cystic fibrosis. A remote spirometer enables patients to measure forced expiratory volume (FEV) from home.
Remote Therapeutic Monitoring Devices and Billing
RTM codes can be used by physicians, physical therapists, occupational therapists, speech-language pathologists, physician assistants, nurse practitioners, and clinical social workers. These codes allow physical therapists who can’t bill for remote patient monitoring (RPM) to offer services for respiratory system and musculoskeletal system status.
Remote therapeutic monitoring reimbursement codes include CPT 98975 for setup. Data transmission is allowable under CPT 98976 and 98977), as w the two time-based codes, CPT 98980 and CPT 98981, in increments of 20 minutes per month. Remote therapeutic monitoring is specific to patients with musculoskeletal and respiratory conditions using a digital app [i.e., Software as a Medical Device (SaMD)] and does not require a physiologic biosensor device.
Advances in Remote Therapeutic Monitoring Devices
As we explore innovative studies in remote therapeutic monitoring devices, the research on exoskeleton training opens new possibilities for integrating medically necessary devices into the care and rehabilitation of SCI patients. Both studies highlight the evolving landscape of remote therapeutic devices and solutions, emphasizing the potential for improving independence, mobility, and overall well-being.
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