Remote peak flow monitoring is commonly used to monitor asthma and COPD. Patients enrolled in a remote therapeutic monitoring (RTM) program will use an FDA-cleared peak flow meter device. The service is covered under Medicare and eligible for reimbursement. This article summarizes the proper procedures for billing for remote therapeutic monitoring services according to the Centers for Medicaid and Medicare Services (CMS) guidelines.
Remote Peak Flow Monitoring Overview
Digital RTM spirometers and peak flow meters are handheld remote therapeutic monitoring devices that measure peak expiratory flow using Bluetooth or cellular connections. When patient measurement is captured by the remote peak flow monitoring medical device, it is transmitted securely to a clinician’s software portal. Many RTM devices are easy-to-use tools that help engage active participation in care management.
Medicare Reimbursement
Healthcare organizations must follow CMS remote therapeutic monitoring billing guidelines to ensure proper reimbursement. Medicare covers remote monitoring services for chronic care populations and patients not close to medical professionals due to geographic location. Remote peak flow monitoring uses the CPT codes listed below. These are the same CPT codes used for remote therapeutic monitoring services that utilize spirometers, smart pillboxes, and inhaler usage tracking devices.
RTM Billing
The Center for Medicaid and Medicare (CMS) uses 5 RTM billing codes to help track patients respiratory data at home and allows physicians to bill for respiratory therapy. RTM codes are general management codes that qualified healthcare professionals, like respiratory therapists, can use to bill for their services, unlike RPM codes. The RTM CPT codes, descriptions, payment rates, and billing frequency are listed below.
98975
This code covers initial setup and patient education on the use of equipment. It can be billed once by one practitioner only when at least 16 days of data have been collected on at least one medical device. The average national payment rate for CPT 98975 is $22.00.
98976
Billing CPT code 98976 pays for respiratory devices supplied with daily scheduled recordings and programmed alerts and transmission for monitoring the respiratory system. The code can be used every 30 days by one practitioner only when at least 16-30 days of data have been collected on at least one medical device. The average national payment rate for CPT code 98976 is $52.00.
98984
Billing CPT code 98984 pays for respiratory devices supplied with daily scheduled recordings and programmed alerts and transmission for monitoring the respiratory system. The code can be used every 30 days by one practitioner only when at least 2-15 days of data have been collected on at least one medical device. The average national payment rate for CPT code 98984 is $52.00.
98979
CPT 98979 bills for the initial 10-19 minutes of treatment time per calendar month. Time must include at least one interactive communication via phone or video with the patient during the month. The average national payment rate for CPT code 98979 is $26.00.
98980
CPT 98980 bills for the initial 20 minutes of treatment time per calendar month. Time must include at least one interactive communication via phone or video with the patient during the month. The average national payment rate for CPT 98980 is $54.00.
98981
CPT 98981 covers each additional 20 minutes of treatment time per calendar month. The average national payment rate for CPT 98981 is $41.00.
Medicaid Reimbursement for Remote Peak Flow Monitoring
Medicaid coverage varies from state to state. For example, some state Medicaid programs limit the types of facilities allowed to claim reimbursements and the kind of device that can be used. When initiating remote peak flow monitoring, it is important to check your states Medicaid policy. The Center for Connected Health Policy (CCHP) tracks and compiles telehealth-related laws and regulations across all 50 states, the District of Columbia, and the federal level. The CCHP website has up-to-date information for Medicaid reimbursement in your state.
Remote Peak Flow Monitoring for Chronic Care Companies
Remote monitoring is used to manage a host of common respiratory diseases. Today, effective telehealth and remote monitoring programs play a vital role in chronic respiratory disease management. Schedule a complimentary demo to learn how Tenovi remote respiratory monitoring solutions benefit patients, chronic care companies, and clinicians.
