Billing RTM for Medicare Patients

When billing Remote Therapeutic Monitoring (RTM) codes for Medicare patients, it’s crucial to include the GY and GP modifiers all the time.

• GY Modifier: This indicates that the service is not covered by Medicare, helping clarify that the item or service is not deemed medically necessary under Medicare guidelines.

• GP Modifier: This shows that the service is part of a physical therapy plan of care, which is crucial for RTM services related to rehabilitation.

Why Use These Modifiers?

1. Accuracy: They provide necessary context for the services billed thus eliminating being prompted of a validation error when billing.
2. Compliance: Using the correct modifiers helps ensure adherence to Medicare guidelines.
3. Reimbursement: Proper application can prevent claim denials and facilitate timely payment.

Always add the GY and GP modifiers when billing RTM codes for Medicare patients. This small step can help streamline the billing process and ensure you receive appropriate reimbursement for your services.