Refer to AMA guidelines, not Medicare, for approved RTM billing

Why This Topic Matters

RTM billing is an active area where CPT and Medicare guidance may not align neatly, so understanding the correct source of authority helps practices avoid reporting errors and apply payer rules appropriately.

Article Sections

1. Question

   Introduces a billing question about RTM services and whether certain services may be performed by clinical staff or must be reported by a physician or other qualified health care professional.

2. Answer

   Summarizes the article’s discussion of AMA CPT guidance, related CPT Assistant commentary, and Medicare’s treatment of the RTM code family. It also addresses the relationship between CPT guidance and payer-specific policy.