The number of doctors using digital health tools is increasing, and so is the framework that helps ensure they are appropriately compensated for their work. As a result of increased demand, the Current Procedural Terminology (CPT®) code set, commonly referred to as “the language of medicine,” is being expanded.
Leslie Prellwitz, in charge of CPT content management and development for the AMA, said that the CPT code set continues to change and keeps up with changes in the medical field.
While speaking at a recent American Medical Association (AMA) webinar on telehealth and other digital health tools and CPT coding, Prellwitz remarked, “When you look at digital medicine, the areas with high physician interest, confidence, utility, and patient care also have a lot of CPT code representation.”
The employment of digital tools has dramatically increased among physicians of all genders, specialties, and ages, according to the most recent data from an American Medical Association physician survey (PDF), which was used as a foundation for the webinar. The two main factors influencing adoption are better clinical results and increased productivity.
The American Medical Association’s Recovery Plan for America’s Physicians includes the funding and promotion of telehealth as a vital component. In addition, the AMA continues to take the lead in pushing for a vigorous expansion of telehealth legislation, research, and resources to ensure the sustainability of medical practices and equitable compensation. Telehealth is essential to the future of health care for this reason.
The significant change in telehealth
According to Meg Barron, vice president of digital health innovations at the AMA, the most progress has been made in adopting remote-care tools. These tools include televisits, telehealth, and remote monitoring.
Given the increased consumption during the pandemic, Barron continued, “This isn’t a tremendous surprise.” But when you consider it, telehealth use has increased threefold since 2019—a significant shift.
Beyond telemedicine and remote monitoring, digital health includes many solutions, including wearables, applications, and more. However, Televisits (57%) and remote monitoring tools (53% each) are the two digital health solutions that excite doctors the most.
The CPT code set categorizes the latter applications as either tool for remote physiologic monitoring (RPM) or remote therapeutic monitoring to ensure proper payment (RPT).
RPM CPT codes were made in 2019, and they cover setting up the device, teaching the patient how to use it, getting the device, and managing the patient’s treatment.
The RPM codes are meant to keep track of things like a patient’s weight, blood pressure, pulse oximetry, or respiratory flow rate.
This year, the RTM CPT codes were made available. They are used to teach patients how to use the devices, set them up, get them, and track patient adherence and therapeutic response.
According to Prellwitz, “therapeutic monitoring” is “the ability to look at the effects of a certain treatment regimen.”
While significant growth is anticipated, the present RTM codes concentrate on the status of the musculoskeletal and respiratory systems, cognitive behavioral treatment, therapy adherence, and therapy response, as well as the examination and monitoring of data about the therapeutic response.
The following codes are related:
- 98975 is the report number for the initial patient education and setup, as well as the use of the equipment.
- 98976 and 98977 to report a device supply with planned recordings or program alert transmission to monitor the musculoskeletal or respiratory system every month.
The use of digital therapies is modest (11%), but a more significant proportion of physicians (40%) aim to implement the technology within the next year than for any other new digital health tool.
Barron stated that despite the development in RPM, it is still the solution utilized the least out of all of the ones we questioned. “This only elucidates the market-share opportunity that we already have at our disposal—as well as the part that technology may play in assisting with the treatment of chronic disease.”
She says that digital health technologies can help reduce stress and burnout is a big reason why people are using them.
Revised health care digital codes for the year 2023
Remote therapeutic monitoring and treatment management services are a new CPT code category introduced this year. The following codes are recorded for time spent each month on various services:
- The 98980 code describes the initial 20 minutes of treatment management services.
- The 98981 code records each extra 20-minute interval of treatment management services.
The AMA Board of Trustees gave the CPT Editorial Panel permission to revise, update, and change CPT codes, descriptors, rules, and guidelines. Last year, the CPT Editorial Panel adopted a taxonomy to describe health services or procedures delivered through augmented intelligence (AI), often called “artificial intelligence.” The document’s instructions became effective in January and are found in Appendix S of the CPT code set.
2023 will see the addition of the following codes for digital ophthalmology services:
- 0704T–0706T cover the delivery of the device, technical support, interpretation, and report for the remote treatment of amblyopia utilizing an eye-tracking system.
Additionally, in 2023, CPT codes that allow pathologists to conduct remote examinations or work with AI algorithms will be included.
- Digitalization of glass microscope slides is covered in 0751T–0763T, allowing a pathologist to examine them remotely or in collaboration with AI algorithms.
“There are numerous codes in that region,” according to Prellwitz. “That’s quite new, and advancements of that magnitude don’t happen frequently.”
The AMA Ed HubTM, an online learning platform that offers CME and education, provides a particular section dedicated to CPT education that includes a module series presenting an overview of CPT coding fundamentals and other subjects. For trustworthy CPT coding advice, consult the CPT Network.