Virtual Physical Therapy (PT) rehab coding inquiry

[Michele]

Received the following from a user who couldn't figure out how to start a new post.  Wanted to make this public.


Here is my question:
The new CPT RPM codes had been released, I just don't know how to apply them
in the case of virtual physical therapy (PT).

The new codes (as you can see, they don't contain any procedure information.

CPT 99453 (Remote monitoring of physiologic parameter(s) (eg, weight, blood
pressure, pulse oximetry, respiratory flow rate), initial; set-up and
patient education on use of equipment) CPT 99454 (Remote monitoring of
physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry,
respiratory flow rate), initial; device(s) supply with daily recording(s) or
programmed alert(s) transmission, each 30 days) CPT 99457 (Remote
physiologic monitoring treatment management services, 20 minutes or more of
clinical staff/physician/other qualified health care professional time in a
calendar month requiring interactive communication with the
patient/caregiver during the month); .....

For the traditional face-to-face PT, e.g., (CPT 97110 Therapeutic Exercise
for face to face visit, 15 minutes/unit); (CPT 97112 Neuromuscular Re-ed,
15 minutes/unit). They are specific and contain the exercise/treatment info.


So, when we code for virtual physical therapy, are we supposed to use two
CPT codes together?
E g., On going virtual PT for therapeutic exercise is CPT 97110 and CPT
99457?
Or, on going virtual PT for Neuromuscular Re-ed   is CPT  97112  and CPT
99457?

In summary, my question is how to code the virtual PT? Can anyone
demonstrate with detailed examples, please?

Looking forward to your assistance.

[Michele]

The new CPT codes for virtual PT are different than the CPT codes used for in person therapy.  So if you are doing remote PT on a patient but walking them thru the exercises as if they were there in person, I would use the in person codes.  For example if you do 30 minutes of therapeutic exercise virtually, but as if they were in person I would bill 97110 with 2 units.  The 99457 is a "monthly billing code for RPM patients requires 20 minutes of interactive virtual care during the calendar month that a qualified healthcare provider or care manager gives to the patient. This code is billable once a month regardless of the RPM patient's conditions."  That is very different then doing a virtual session with a patient where the patient is performing exercises and the therapist is instructing and monitoring the exercises as they are being completed.

I hope this helps!