The addition of remote therapeutic monitoring codes in the 2022 Physician Fee Schedule suggests that the transformation in digital health policy took place in response to pandemics starting to have some performance.
In the recent Medicare Physician Fee Schedule, the US Centres for Medicare and Medicaid Services have proposed a state of CPT code. It will help in telehealth and RPM monitoring.
These codes intend to get used to understanding the effectiveness of the patient’s response to the prescribed therapy. CMS usually specifies the system of monitoring for medication adherence can use these codes.
In the US the preventable hospitalizations and emergency department visits connected to medication cost more than $300 billion/ year. The inclusion of medication adherence programs in CMS’s RTM codes can be a major step. It can solve one of the biggest challenges in healthcare. These codes can represent one of the latest advancements to modernize digital health reimbursement.
CMS has opened many opportunities to reimburse providers for non-traditional modes of patient interaction. In such interactions, the patient is remote from the provider.
These efforts are quite confusing due to the technologies and unpredictable utilization. Patients often pay copays for items upon billing. It also has limitations in the number of patients who are willing to participate.
The new categories of digital health reimbursement have become clear. The new RTM codes resemble those for RPM. It also reimburses the providers for the review of psychological data that gets auto transmitted from a device.
The difference between RPM and the new RTM codes is, the RTM codes can get used for monitoring medication adherence. It can also include the instances when a patient self-reports relevant health information. Other advancements include virtual check-ins, where a provider can review a photo or video that a patient has submitted. It also includes e-visits where the patient checks in to provide data with an online portal.
Medications don’t work unless taken properly. Providers can leverage these codes for monitoring and supporting patient medication adherence. RTM can offer more convenient ways for patients to engage with the health system. The available reimbursement codes for virtual care and the RTM codes support efforts to offer the right care to the right patient.
The federal government needs to set policies to align the incentives with outcomes. The inclusion of such codes can also improve the payment policy to catch up with consumer demand and technological advancement.
RTM code also shows that CMS recognizes the therapeutic data and is a very important category in patient information to access remotely.