Remote Therapeutic Monitoring Toolkit

Understanding RTM Uses

This toolkit is intended to give a broad overview of Remote Therapeutic Monitoring for both patients and providers. Feel free to contact us at [email protected] with any questions about this toolkit or with any additional questions about RPM. 

Remote Therapeutic Monitoring Basics

What is Remote Therapeutic Monitoring?

Remote Therapeutic Monitoring (RTM) refers to the use of digital technologies to remotely monitor and manage patients' therapeutic activities and adherence to prescribed treatments. RTM encompasses the tracking of non-physiological data, such as medication adherence, therapy adherence, pain levels, and physical activity, often through mobile applications, wearable devices, or other digital platforms. The primary goal of RTM is to enhance patient engagement, improve health outcomes, and provide healthcare providers with real-time insights into patients' therapeutic progress.

Common Uses of RTM

RTM is utilized across various medical disciplines to monitor and support patient care. Common uses include:

• Chronic Disease Management: Monitoring patients with chronic conditions- including diabetes, hypertension, and asthma - to ensure they adhere to prescribed treatment plans and lifestyle modifications.
• Physical Therapy and Rehabilitation: Tracking patient progress in physical therapy or rehabilitation programs, including exercise compliance, pain levels, and functional improvement.
• Mental Health: Monitoring medication adherence, mood, and symptom progression in patients undergoing mental health treatments.
• Post-Surgical Recovery: Assessing recovery progress and adherence to post-operative care plans, such as medication, wound care, and physical activity.
• Medication Management: Ensuring patients follow prescribed medication regimens, track side effects, and adjust dosages as necessary.

Remote Therapeutic Monitoring vs. Remote Patient Monitoring

While Remote Therapeutic Monitoring (RTM) and Remote Patient Monitoring (RPM) both involve the remote collection of patient data, they serve different purposes and focus on distinct aspects of patient care:

RTM: Focuses on non-physiological data related to therapeutic activities, such as adherence to treatment plans, medication management, and behavioral tracking. RTM primarily aims to support therapeutic outcomes and patient engagement.

RPM: Involves the collection of physiological data, such as heart rate, blood pressure, glucose levels, and weight. RPM is primarily used for monitoring clinical indicators and managing chronic conditions, often requiring medical devices and sensors.

Similarities

Healthcare professionals can use both RTM and RPM data to make timely adjustments to the patient’s care plan, such as modifying medication dosages or recommending lifestyle changes. For instance, if a healthcare provider notices that a patient recovering from surgery isn’t reaching their rehabilitation milestones, they can intervene early to provide additional guidance or adjust the prescribed exercises. Both RTM and RPM also allows patients to have regular feedback from their healthcare team without needing to travel to a clinic, improving engagement, reducing costs, and enabling better management of chronic or post-acute conditions. It provides a more personalized, continuous care approach, which helps in early detection of problems and promotes better health outcomes.

Focus on Rural Health

RTM can significantly benefit rural patients by overcoming the challenges associated with limited access to healthcare services. In rural areas, patients often face long travel distances, a shortage of healthcare providers, and delays in receiving timely care. RTM leverages technology to allow healthcare professionals to monitor patients' health conditions, such as medication adherence, physical activity, and symptom progression, from afar. This continuous, data-driven oversight helps in early detection of issues and provides patients with timely interventions, reducing the need for frequent clinic visits. As a result, RTM empowers patients by bringing specialized care to their homes, ensuring more consistent health management, and improving overall outcomes, particularly for those with chronic conditions.

Practical RTM Use

Studies and Articles

According to one study published in 2023, “[t]hese programs have the potential to improve patient outcomes by increasing medication adherence and reducing the risk of adverse drug events.” This study, which specifically looked at the use of RTM for patients with Rheumatic and Musculoskeletal Diseases like arthritis, found that RTM could be used as a complement to telehealth appointments and could reduce the number of in-office appointments and potentially costly interventions needed for patients. 

Another study, this one published in 2024, looked at the use of RPM and RTM in a “hospital at home” setting. This study proposed that RTM could be effectively used when monitoring and treating conditions like “hypertension, heart disease (eg, congestive heart failure), diabetes, chronic obstructive pulmonary disease, asthma, and obstructive sleep apnea” remotely, allowing patients to stay within their communities.

Billing Landscape for RTM

As of 2024, the billing landscape for RTM continues to evolve, with increasing recognition of its value in patient care. Applicable billing codes and short descriptions are below:

Note: RPM and RTM billing codes cannot both be used to bill for the same patient in the same month – only one clinician can submit claims

Sources: https://www.cms.gov/files/document/r11118cp.pdf,  https://www.tenovi.com/rtm-billing-codes-2024/ 

Reimbursement Policies

 Reimbursement rates and policies vary by payer – contact insurers directly for clarification. Billing may face challenges related to the standardization of RTM services, documentation requirements, and patient engagement. Understanding the nuances of billing and reimbursement is crucial for maximizing the benefits of RTM.

The Future of RTM

The future of Remote Therapeutic Monitoring (RTM) is likely to be shaped by advancements in wearable technology, artificial intelligence, and data analytics, paving the way for more personalized and proactive healthcare. As wearable sensors become more sophisticated, they will be able to monitor a broader range of health metrics, providing a more comprehensive understanding of a patient's condition. AI algorithms will further enhance RTM by analyzing vast amounts of health data in real time, identifying subtle trends, and providing predictive insights that enable even earlier interventions. Additionally, integration with electronic health records (EHR) will create a seamless flow of information between patients and healthcare providers, facilitating better coordination and more informed decision-making. In rural and underserved areas, RTM could play a crucial role in bridging healthcare gaps by providing continuous, real-time support that reduces dependence on in-person visits. As healthcare systems adapt, RTM may become a standard tool for managing chronic conditions, reducing hospital readmissions, and ultimately fostering a shift toward more preventive, patient-centered care.

Expanded Use Cases

RTM is expected to expand into new areas of healthcare, including preventive care, wellness programs, and specialized treatments such as oncology and cardiology. As patients become more familiar with digital health tools, engagement with RTM platforms is likely to increase, leading to better adherence to treatment plans and improved health outcomes. It is already in use in pilot programs in “hospital at home” services – depending on outcomes, we may see an expansion in the use of RTM in monitoring acute care patients. 

Regulatory Developments

The proposed CY 2025 Physician Fee Schedule (PFS) included updates to expand the use of Remote Therapeutic Monitoring (RTM) by simplifying billing and increasing reimbursement opportunities for healthcare providers. 

Source: https://www.cchpca.org/resources/proposed-physician-fee-schedule-pfs-cy-2025/

This toolkit is intended to be informational, not to guide care or coverage decisions. For specific questions, we recommend you contact your physician or insurance provider.

Last Updated Sept, 2024