.jpg "Daniel Godla")
While Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) cannot be billed by the same clinician for the same patient in the same month, the two services complement each other.
Here, we explore how RPM and RTM provide different types of patient data as part of high-quality remote clinical care. We’ll also show how RPM or RTM can work concurrently with other Medicare care management programs to provide robust, holistic care for patients with chronic disease or a recent hospitalization.
Remote Patient Monitoring vs. Remote Therapeutic Monitoring
Both RPM and RTM involve remote data collection and monitoring to support patient care, but they differ in the type of data and the purpose of the monitoring.
RPM collects physiological data to monitor health status, detect changes in status, and intervene before deterioration occurs. Physiological data includes vital signs, such as blood pressure, heart rate, blood sugar, weight, and pulse oxygenation.
Patients with any medical condition can enroll in RPM, where a clinician deems it medically necessary. RPM is most often used with diabetes, hypertension, congestive heart failure, chronic kidney disease, and other chronic illnesses.
RTM collects non-physiological data to monitor symptoms and side effects, treatment progress, and adherence to support treatment efficacy.
Non-physiological data can include objective data from digital health devices and subjective data from patient-reported outcomes. For example, these data could consist of pain levels, range of motion, medication, or exercise adherence.
RTM is currently limited to musculoskeletal and respiratory conditions and cognitive behavioral therapy. It’s most often used for osteoarthritis, rheumatoid arthritis, COPD, obesity, anxiety, and depression.
Additionally, RTM can be billed by a wider array of healthcare professionals.
When to use one over the other
While the same provider cannot bill RTM and RPM for the same patient in the same month, patients may transition from one program to the other when clinically appropriate due to changes in their condition.
For example, a patient may undergo heart surgery, and the specialist overseeing their care may enroll them in RPM when they are discharged home. The initial RPM monitoring may look for weight gain, variable heart rate, and pulse oximetry. Once the patient has stable and consistent readings within a desired range, the specialist may stop RPM and enroll them in RTM to monitor their pain levels, medication adherence, and rehabilitation therapy adherence.
Depending on the patient and their stage in the cycle of chronic disease, RPM or RTM may be more suitable. Patients with chronic conditions can benefit from either RPM or RTM at different stages of their condition.
RPM can assist in monitoring physiological parameters, while RTM can offer therapeutic interventions and support for managing the condition. Again, these can be implemented consecutively at various points in treatment according to the data needed for continuous monitoring; however, RPM and RTM cannot be billed concurrently for the same patient within the same 30 days
How RPM and RTM complement other programs
Individually, RPM and RTM can be billed concurrently with other Medicare programs.
These complementary programs include:
- Chronic Care Management (CCM)
- Principal Care Management (PCM)
- Behavioral Health Integration (BHI)
- Transitional Care Management (TCM)
- Advanced Primary Care Management (APCM)
Combining either RPM or RTM with other care management programs synergizes the benefits of care coordination, patient education, and holistic care planning with remote monitoring.
Various patient, clinical, and treatment needs make deploying two programs together applicable.
The table below provides scenarios for using RPM or RTM with another care management program that delivers amplified benefits to support better health outcomes.
Use cases for combining RPM or RTM with other care management programs
Combining either RPM or RTM with other care management programs provides a powerful combination of virtual care and regular patient engagement with remote patient data collection. One informs the other, leading to:
- Opportunities to avoid costly emergency or inpatient care
- Improved self-management
- Treatment and medication adherence
- Slowing disease progression and exacerbation
Here are five scenarios that outline how providers can use combinations of programs to support patient health and create new revenue streams:
Clinical scenarios
A gastroenterologist treats patients with irritable bowel syndrome, a chronic gastrointestinal disorder that can be hard to manage.
Principal Care Management (PCM) provides virtual check-ins and coaching for symptom management. PCM can pair with RTM to document patient symptoms, such as abdominal pain, and track adherence with complex medication regimes.
A primary care physician treats patients with uncontrolled hypertension alongside diabetes or other chronic conditions.
Chronic Care Management (CCM) helps patients learn to self-manage, set SMART goals, and make lifestyle changes. CCM can be paired with RPM to collect vital signs, such as insulin levels, blood pressure, and weight.
A family physician or specialist has a number of patients discharged each month from the hospital to home.
Transitional Care Management (TCM) helps patients transition to home, see their physician quickly, and receive support throughout the month to adapt to new treatments and medication regimes. TCM can pair with RTM to monitor medication adherence or pain levels. Alternatively, RPM could be used to monitor blood pressure and blood oxidation.
A nephrologist or internal medicine physician treats high-risk patients with chronic kidney disease and hypertension.
CCM helps patients manage multiple chronic conditions, set lifestyle goals, and receive support through education and community resources. RPM complements CCM by monitoring blood pressure and weight, alerting the care team when the patient’s results fall outside desired levels.
A physician is treating numerous patients with behavioral health issues, such as depression, anxiety, and bipolar disorder. These may coincide with other conditions, including obesity, hypertension, and diabetes.
Behavioral Health Integration (BHI) provides evidence-based assessment, personalized care planning and goal setting, as well as ongoing support for self-management. RTM complements BHI in collecting symptom data, monitoring behavioral health treatment progress, and medication adherence.
ThoroughCare enables complementary programs
Physicians across specialties and other healthcare providers can tap into the power of Remote Patient Monitoring and Remote Therapeutic Monitoring consecutively or concurrently with other care management programs.
ThoroughCare equips providers and their care teams to carry out all aspects of multiple programs through proven, reliable standards, systems, and workflow.
As an expert in care management, ThoroughCare enables a quick ramp-up of new or existing programs through workflow optimization, compliance and reporting best practices, and a comprehensive software platform to streamline care delivery.
Key questions answered
How can a provider use both Remote Patient Monitoring and Remote Therapeutic Monitoring?
While Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) cannot be billed by the same clinician for the same patient in the same month, the two services complement each other.
More often, providers use either RPM or RTM as a complementary patient monitoring option used concurrently with other care management programs, such as:
- Chronic Care Management (CCM)
- Principal Care Management (PCM)
- Behavioral Health Integration (BHI)
- Transitional Care Management (TCM)
- Advanced Primary Care Management (APCM)