Revenue Model – SmarTrac

Generate A Profitable Revenue Model With SmarTrac

ATTENTION: Physicians and Therapists (PT/OT) can bill for SmarTrac using Remote Therapeutic Monitoring Codes. See corresponding CPT code noted below.

Additionally, DME Providers can bill for SmarTrac using HCPCS code noted below.

CPT Codes for Remote Therapeutic Monitoring (RTM) for Physicians, Physical Therapists, Occupational Therapists

The following General Medicine CPT codes for Remote Therapeutic Monitoring are available to Physicians and Therapists (OT & PT). RTM is billed under General Medicine CPT codes, therefore RTM codes are available to Qualified Health Care Practitioners (“QHCPs”) who are both eligible and not eligible to independently order and bill for Evaluation and Management Services. Therefore, these new CPT codes allow physical therapists and occupational therapists to order and bill the RTM codes subject to state scope of practice and supervision requirements.

98975

Initial Set-up and Patient Education

Remote therapeutic monitoring (e.g., musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment)

98977

Supply of Device for Monitoring Musculoskeletal System

Remote therapeutic monitoring (e.g., musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days)

98980

Monitoring/Treatment Management Services, first 20 minutes

Remote therapeutic monitoring treatment management services, physician/ other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes)

98981

Monitoring/Treatment Management Services, each additional 20 minutes

Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure)

HCPCS Billing

HCPCS Code A9279 – Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified

or just “Monitoring feature/devicenoc” for short.

A9279 can be used (1) whether the monitoring technology is incorporated as part of the base item, (2) supplied as an add-on module (3) or is a stand alone item.

This code can be used by Physicians or Physical Therapy offices that dispenses their own DME products to workers compensation patients.

For more information visit https://hcpcs.codes/a-codes/A9279/

CPT Codes for Remote Patient Monitoring

Many Physicians provide consultation and treatment for Chronic Care Medicare Patients. Arthritis is listed as a chronic care condition by Medicare.

Because SmarTrac is able to monitor heart rate, capture pulse oximeter oxygenation readings, and physical therapy activity on a daily basis, it meets FDA definition of a medical device billed under remote patient monitoring codes.

The following CPT codes are payable for Chronic Care Medicare Patients:

99453

Remote monitoring of physiologic parameter(s); initial set-up and patient education on use of equipment. CPT 99453 offers reimbursement for the work associated with onboarding a new patient onto a remote monitoring service, setting up the equipment and educating the patient on using the equipment.

99457

Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month. Under 99457, CMS will reimburse for clinical staff time that contributes toward monitoring and interactive

99454

Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. CPT 99454 offers reimbursement for providing the patient with a remote monitoring device for a 30-day period. Note that 99454 can be billed each 30 days.

99458

SmarTrac is an FDA approved device.

The FDA considers a product to be a device, and subject to FDA regulation, if it meets the definition of a medical device per Section 201(h) of the Food, Drug, and Cosmetic Act.

Per Section 201(h) of the Food, Drug, and Cosmetic Act, a device is:

An instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is:

recognized in the official National Formulary, or the United States Pharmacopoeia, or any supplement to them,
intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease, in man or other animals, or
intended to affect the structure or any function of the body of man or other animals, and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which does not achieve its primary intended purposes through chemical action within or on the body of man or other animals and which is not dependent upon being metabolized for the achievement of its primary intended purpose. The term “device” does not include software functions excluded pursuant to section 520(0).

Generate A Profitable Revenue Model With SmarTrac

CPT Codes for Remote Therapeutic Monitoring (RTM) for Physicians, Physical Therapists, Occupational Therapists

HCPCS Billing

CPT Codes for Remote Patient Monitoring

SmarTrac is an FDA approved device.

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