98985 Code: RTM Data Transmission Overview

98985 - RTM Data Transmission

"Remote therapeutic monitoring (e.g., therapy adherence, therapy response, digital therapeutic intervention); device(s) supply for data access or data transmissions to support monitoring of musculoskeletal system, 2 to 15 days in a 30-day period."

The requirements for billing 98985 code are automatically tracked and can be analyzed on the RTM Dashboard.

Requirements:

• Code 98985 is eligible to be billed once the patient:
  • Has at least 2 days of data collection, and
  • It becomes mathematically impossible for them to reach 16 days of data within that 30-day window.

When to bill for code 98977 or 98985?

Example Patient Scenario 1:

• Device Setup: (Day 1):  Patient Jane is discharged from her initial post-operative care and begins Physical Therapy. Dr. K, her Physical Therapist, determines that Patient Jane would benefit from RTM to ensure adherence to her home exercise program and monitor her recovery progress.
• Monitoring Period (Days 1–30): Patient Jane uses the Engage app for her prescribed exercises. She transmits data from the device on 22 days out of the 30-day period.
• Billing decision: As soon as the 16 data points within the 30-day period have been met, Dr. K confirms that Patient Jane met the requirement for code 98977 and should bill for code 98977.

Example Patient Scenario 2:

• Device Setup: (Day 1):  Patient Jane is discharged from her initial post-operative care and begins Physical Therapy. Dr. K, her Physical Therapist, determines that Patient Jane would benefit from RTM to ensure adherence to her home exercise program and monitor her recovery progress.

• Monitoring Period (Days 1–30):

  At Day 25: Patient Jane uses the Engage app for her prescribed exercises. She transmits data from the device for only 10 days out of the 30-day period and since there are only 5 days left in the 30-day period, meaning the patient can no longer meet the 16 days with data points requirement - then 98985 becomes eligible.

• Billing decision: As soon as it is no longer possible to hit 16 days of data points within a 30 day period - though 2+ data points have been met - Dr. K confirms that Patient Jane did not meet the minimum requirement for code 98977 and should be billed for code 98985.

Frequency:

• 1x per 30 day period