RTM and Medication Adherence Related Articles

Digital health advocates believe remote monitoring—the use of digital technologies to collect and relay patient data to health care professionals—has the potential to transform disease management, health outcomes, and patient care, especially for individuals with multiple chronic conditions who lack convenient access to providers. Medicare, most state Medicaid agencies, and many private health insurance plans cover remote monitoring services.

Remote patient monitoring involves the use of technology to monitor patient health outside of the traditional health care setting, ie, clinics and hospitals. Historically, mental health clinicians (eg, psychiatrists, nurse practitioners, psychologists, social workers) have not been incentivized in the same ways as other clinicians to monitor their patients in between visits. The addition of Current Procedural Terminology (CPT) codes for remote therapeutic monitoring (RTM) presents an opportunity to address this disparity and improve mental health care. However, adoption may be limited by uncertainty in billing and documentation requirements. This Viewpoint explores the development of RTM, as well as the potential challenges to and opportunities for reducing uncertainty and encouraging adoption of this innovative treatment model by mental health care practitioners.

​What Is Remote Therapeutic Monitoring?
RTM is designed for the management of patients under a specific treatment plan using medical devices that collect non-physiological data related to signs, symptoms, and functions of a therapeutic response that provide a functionally integrative representation of patient status.

A recent multijurisdictional CAC meeting held by six of the seven MACs gave stakeholders an initial opportunity to provide feedback on the strength of clinical evidence to support Medicare coverage for RPM and RTM services for non-implantable medical devices. We previewed how this meeting may influence the development of Medicare local coverage determinations in a recent article.

In recent years, the Centers for Medicare & Medicaid Services (CMS) has expanded payment for remote monitoring services in an effort to pay for non-face-to-face services that improve care coordination for Medicare beneficiaries. On November 2, 2023, CMS released the calendar year 2024 final rule for services reimbursed under the Medicare Physician Fee Schedule. In the final rule, CMS clarified certain guidance for remote monitoring services, finalized separate reimbursement for remote monitoring provided by rural health centers and federally qualified health centers, and discussed a recent request for information for digital therapies.