To be inline with CMS requirements, practices may request to enable the practice option 'RPM Interactive Communication' which creates a requirement to have a successful RPM call documented in order to generate billing claims for RPM code 99457.

When the practice option is enabled, billing claims for the RPM CPT code 99457 will be restricted from being 'Marked as Submitted' unless a user has logged a successful RPM call with the patient.

To allow the claim to be marked for submission, a user must log a successful interaction with the patient using an 'Interaction Type' that is associated with 'Call Purposes' and then choose an RPM-associated 'Call Purpose' when documenting the interaction.

If a call-related interaction is documented with a successful outcome in the same month as the associated claim, then the 'Mark as Submitted' button will be enabled for users to click and complete their workflow.

To access other helpful ThoroughCare articles in the Knowledge Base or to get help from the ThoroughCare Support team members, click the ‘i’ icon in the top right corner of the software next to the username and use the appropriate link!