While remote physiological monitoring has been around for a while, few of those measurements are useful when treating behavioral health patients. However, the Center for Medicaid Services (CMS) has recently added remote therapeutic monitoring (RTM) codes that enable your practice to bill for many previously unreimbursable practices. Combined with an innovative EHR platform, RTM can be particularly valuable when treating patients in cognitive behavioral therapy (CBT) programs.
The Medicare RTM reimbursement rate changes also reflect an evolving understanding of the context in which therapists and other behavioral health professionals operate. Previously, some licensed clinicians could only furnish RTM services under the general supervision of a physician or other medical clinician, like an advanced nurse practitioner or physician’s assistant. For example, psychologists, social workers, and addiction counselors were unable to provide and bill for RTM services directly. The new rules, however, permit licensed non-medical providers to bill for specific RTM services without direct supervision from medical personnel.
Expanded Reimbursement Codes for Remote Therapeutic Monitoring
Sophisticated EHR technology that incorporates RTM can provide valuable information about patients’ mental health symptoms through assessments and other measurement-based care (MBC) standards.
- Modern EHR platforms can automatically remind CBT patients to complete assessments on a weekly basis. The new device-supply CPT code 98978 covers remote therapeutic monitoring of therapy adherence and response via scheduled alerts like automatic notifications. Practices can bill for this service once every thirty days for each patient receiving CBT.
- Therapists can bill for the time that they spend training their CBT patients to use the mobile app for their assessments using CPT code 98975. Since this code applies to the initial RTM set-up, it is billable only once for any treatment period spanning sixteen or more days.
- At the heart of all MBC, including CBT, is the collaborative effort between treatment teams and their patients. Regular assessments give the provider important information and open the door for discussion with the patient regarding the treatment plan and their progress. The time that therapists spend discussing these assessments with patients is now billable under the new RTM codes. CPT code 98980 is used for the first twenty minutes, and each additional twenty-minute period can be billed using code 98981. The provider must have interacted directly with the patient or their caregiver regarding the RTM assessments at least once for each time billed.
- The reimbursable amount that you can expect varies depending on your exact location. On average, Medicare typically pays around $50 for the first twenty minutes spent discussing patient assessment results (98980) during a thirty-day period. Additional time reviewing assessment results (98981) is usually reimbursed at about $40 per twenty minutes. It’s important to remember that these codes are billable only for full twenty-minute periods; no other increment is allowable.
Altogether, these codes can garner therapists about $100 a month per CBT patient. Most of these steps are already being taken in offices using MBC and now, they are reimbursable. While legislative changes only affect Medicare and Medicaid, commercial insurers usually follow the CMS in paying for new codes. Certain plans through Humana, United Healthcare, Blue Cross, and Cigna are already reimbursing for RTM services.
Using EHR Technology to Get Reimbursed for Remote Therapeutic Monitoring
An innovative behavioral health EHR system streamlines the RTM process, from administration to billing. The incorporation of assessments, records, and billing reduces the chance of human error and can improve your claim rate.
- EHR technology specifically designed for behavioral health applications will provide your practice with a wide range of assessments for patients across a variety of diagnoses. While CBT is the only specific type of psychotherapy eligible for RTM reimbursement at the moment, the CMS has committed to expanding opportunities to increase the availability of remote services for patients. The focus on MBC as justification for reimbursement highlights the importance of assessments to both practitioners and patients.
- Studies show that automatic notifications from your behavioral health EHR platform improve therapy adherence and outcomes. When used as part of CBT, they also ensure that your patients complete the assessments that are crucial to RTM reimbursement. Over time, the assessments give the clinician and the patient a better understanding of the patient’s progress. With a sophisticated EHR system, records of those assessments are easily accessible and make it simple to provide any additional justification for services to payers who request it.
- Behavioral health EHR systems can seamlessly integrate various facets of your practice. When your platform includes an app for patients, such as CarePaths Connect, it ties into your practice management and record-keeping systems. Billing for RTM procedures is a straightforward process that maximizes your claim rate. Being paid the first time that a claim is sent to a payer means less of your practice’s valuable time is spent resubmitting. Â
- Comprehensive behavioral health EHR systems like CarePaths offer training to you and your staff so you can make the most of what’s on offer. Several options are available to get help implementing your new software subscription, including a live information session.
CarePaths Connect will give you access to tools that will transform your practice.
Here at CarePaths, we help therapists work more effectively and improve patient outcomes by empowering them with the data that they need via EHR. To learn more about how we can help you, start your free trial today!
