Issued on July 13, 2020, the Centers for Medicare and Medicaid Services (CMS) released an update to the Medicare Physician Fee Schedule proposal (the “Proposed MPFS/Rule”) that aims to formalize Remote Therapeutics Monitoring (RTM).
Until now, RTM has largely acted as an addition to the more well-established Remote Physiological Monitoring (RPM) system from the regulatory framework perspective. Now, with the addition of five CPT codes – a uniform coding practice for medical services and procedures to streamline reporting, and insurance claims -, RTM will stand on its own as a formal medical service.
So. what does this mean for organizations in the telehealth and mHealth space? Opportunity. And with this new opportunity, comes a sizeable uptick in new applications and services being brought to the market to capitalize on RTM early. As a San Diego-based app development firm, we too have seen a substantial upswing in the volume of requests around this growing healthcare niche.
What is Remote Therapeutics Monitoring?
From a perspective of care, Remote therapeutics monitoring is the practice of using medical technology to monitor health conditions including, but not limited to, the cardiatric system, the musculoskeletal system, respiratory system, therapy adherence, therapy response, and other biological systems in patients. And although the name suggests otherwise, RTM supports a variety of other remote monitoring services that differ from the physiological categories.
In fact, RTM can account for remote medical services including physical therapy, clinical psychology, speech-language pathology and occupational therapy. With the rise in remote-based medical services, those close to the telehealth and mHealth industry believe this branch of services will account for a majority of the insurance billings under the new RTM codes.
Regulatory Considerations for Remote Therapeutics Monitoring
From a regulatory standpoint, some interesting aspects of the newly proposed codes influence how businesses can approach innovating in the RTM space. The CPT codes released from the CMS closely resemble Remote Patient Monitoring (RPM) codes from a regulatory perspective; however, the slight differences in how these codes are defined make all the difference for organizations looking to bring RTM services to the market.
In short, the new set of codes are designed to be illustrative rather than exhaustive regarding what is considered a remote therapeutics monitoring technology or service.
Another major regulatory win for businesses in the telehealth and mHealth space is how clinicians can bill for RTM services. With the introduction of the new codes, remote clinicians such as therapists, psychologists and physical therapists can bill insurance for these services. Previously, the umbrella RPM codes limited these services to nurses and doctors, making it very hard for remote clinicians or technologies supporting remote clinicians to bill insurance.
This regulatory framework proposed by the CMS has a profound influence on how businesses in the telehealth or mHealth space can bring RTM products to market. Knowing there is a broader regulatory framework regarding RTM gives businesses the confidence that their solution will be protected under the CMS and likely covered by insurance agencies.
A Call to Action for Business
For those in the telehealth and mHealth space, now is the time to take action. With broader regulatory coverage, innovators in the telehealth and mHealth field have an opening. By introducing new technologies into the telehealth and mHealth industry that overlap with the adoption of remote therapeutics monitoring, a business can enter the market early and gain an early advantage over competitors in the space.
About Dogtown Media
Dogtown Media is a mobile media development company headquartered in Venice Beach, California with a presence in San Francisco, New York City, and London. Since 2011, our team of hardened techies has launched over 200 apps, and counting. Our team is experienced in creating solutions for a wide range of platforms, including iOS, Android, HTML5 Web Apps and more. We offer specialized packages to satisfy a range of needs and budgets, from rapid prototyping for startups to full-featured interfaces for international enterprises.
If you’re interested in learning how Dogtown Media can help introduce your next telehealth or mHelath app to the market contact us. We’d love to help!