The Centers for Medicare & Medicaid Services (CMS) continues to expand Remote Patient Monitoring (RPM) coverage, recognizing the growing role of digital health technologies in improving patient outcomes and chronic disease management. The 2022 Physician Fee Schedule (PFS) introduced new Remote Therapeutic Monitoring (RTM) codes, expanding Medicare reimbursement for monitoring therapy adherence, treatment response, and other non-physiological data. While these updates represent significant progress, healthcare providers continue to seek greater alignment between RPM and RTM billing policies.
What Is Remote Patient Monitoring (RPM)?
Remote Patient Monitoring (RPM) allows healthcare providers to monitor patients outside traditional clinical settings using connected medical devices, telehealth platforms, and digital health technologies.
RPM helps providers:
- Monitor vital signs remotely
- Improve chronic disease management
- Reduce hospital readmissions
- Detect health issues earlier
- Enhance patient engagement
- Support long-term care management
The widespread adoption of telehealth during the COVID-19 pandemic accelerated the use of RPM across healthcare organizations.
CMS Continues to Expand Medicare Coverage
CMS first introduced Medicare reimbursement for RPM services in 2019 through CPT codes covering remote physiological monitoring.
For 2022, CMS expanded coverage by introducing Remote Therapeutic Monitoring (RTM) services, allowing providers to monitor non-physiological data, including therapy adherence, medication response, and pain levels.
New Remote Therapeutic Monitoring (RTM) CPT Codes
The 2022 Physician Fee Schedule added five new RTM CPT codes:
| CPT Code | Description |
|---|---|
| 98975 | Initial setup and patient education |
| 98976 | Device supply for respiratory system monitoring (30 days) |
| 98977 | Device supply for musculoskeletal system monitoring (30 days) |
| 98980 | RTM treatment management (first 20 minutes per month) |
| 98981 | Each additional 20 minutes of RTM management |
These codes support reimbursement for remote therapeutic monitoring services performed by physicians and other qualified healthcare professionals.
Benefits of the New RTM Codes
The addition of RTM codes offers several advantages for healthcare providers:
- Expands Medicare reimbursement opportunities
- Supports therapy adherence monitoring
- Improves chronic condition management
- Encourages digital health adoption
- Allows more healthcare professionals to participate in remote monitoring
- Promotes proactive patient care
The expansion reflects CMS’s continued commitment to integrating remote care into routine clinical practice.
Challenges with RTM Reimbursement
Despite the progress, industry experts believe the RTM framework still has limitations.
Limited Device Coverage
Current RTM device supply codes apply only to:
- Respiratory system monitoring
- Musculoskeletal system monitoring
Many stakeholders recommend expanding reimbursement to include additional specialties such as neurology, cardiology, endocrinology, vascular medicine, and gastroenterology.
Differences Between RPM and RTM
RPM and RTM have different billing requirements.
Key differences include:
- RPM codes are classified as Evaluation and Management (E/M) services.
- RTM codes are classified as General Medicine services.
- RTM generally requires direct involvement by the billing provider.
- RPM allows greater use of clinical staff under physician supervision.
These differences can create confusion for healthcare organizations implementing remote monitoring programs.
Expanded Eligibility for Healthcare Professionals
CMS broadened access to RTM billing by allowing additional qualified healthcare professionals to report these services.
Eligible providers include:
- Physical therapists
- Occupational therapists
- Speech-language pathologists
- Nurse practitioners
- Physician assistants
- Clinical social workers
- Psychiatrists
This expansion increases opportunities for interdisciplinary care management.
Patient-Reported Data Now Accepted
Unlike traditional RPM services, RTM allows the use of patient self-reported data, provided the information is collected through an FDA-recognized medical device or Software as a Medical Device (SaMD).
This flexibility supports broader patient participation while expanding remote care options.
Future of Remote Monitoring
Industry experts believe CMS is moving in the right direction but recommend greater integration between RPM and RTM reimbursement policies.
Future improvements may include:
- Broader device eligibility
- Additional monitoring categories
- Better alignment between RPM and RTM billing rules
- Expanded reimbursement opportunities
- Simplified coding requirements
CMS has indicated it will continue working with stakeholders to refine remote monitoring policies in future rulemaking cycles.
Best Practices for Healthcare Providers
Healthcare organizations implementing RPM and RTM should:
- Review current Medicare billing guidelines.
- Train providers on new RTM CPT codes.
- Verify documentation supports medical necessity.
- Use FDA-approved monitoring devices.
- Monitor payer reimbursement policies.
- Ensure patient education is documented.
- Audit remote monitoring claims regularly.
- Stay informed about future CMS updates.
Conclusion
The expansion of Remote Patient Monitoring Medicare coverage marks another important step toward modernizing healthcare delivery. The introduction of Remote Therapeutic Monitoring (RTM) codes broadens reimbursement opportunities and supports more personalized, technology-enabled patient care. While differences between RPM and RTM billing remain, healthcare providers that understand the new coding requirements and documentation standards will be better positioned to improve patient outcomes, enhance care coordination, and maximize Medicare reimbursement.
