RTM program · Psychiatry

Depression and anxiety treatment monitoring

Measurement-based care works and almost nobody does it. The measurement is the intervention.

Measurement-based care means adjusting treatment against a repeated standardized score instead of against clinical impression. The evidence supports it, the collaborative care model is built on it, and adoption is low because administering and tracking instruments manually is a burden nobody has capacity for. Automating the instrument is most of the intervention. That is an unglamorous claim and it happens to be true.
Depression and anxiety treatment monitoring · observed transmission profile Representative, not best case
Day 1Day 15Day 30
Transmitted days 0 / 30
Device supply code
Signal stack

What gets measured, from where, and why it earns its place

Every source is tagged at ingest as billable or context-only. Context-only data is clinically valuable and never enters a device-supply line.

Symptom severity
PHQ-9 and GAD-7 on a defined schedule
Every two weeks during titration, monthly when stable. Measurement-based care has solid evidence and dismal uptake, largely for workflow reasons this solves.
Medication adherence
Structured daily or weekly logging
Early discontinuation in the first eight weeks is the dominant failure mode in antidepressant treatment.
Side effect burden
Structured, weekly during titration
The specific reason people stop, and it is knowable two weeks before they do.
Sleep and activity
Passive
Objective correlates that move earlier than self-reported mood, and useful when self-report is unreliable.
Therapy engagement
Session attendance and between-session assignment completion
Where psychotherapy is part of the plan, engagement is a measurable therapeutic signal.
Escalation design

Thresholds, and who has to do something about them

Red marks a same-day or immediate pathway. Amber marks a review within the stated window. Each one is assigned to a named clinician with a response clock, not to a queue.

PHQ-9 item 9 above zero
ResponseImmediate safety protocol with a named clinician
PHQ-9 unchanged after 6 weeks at therapeutic dose
ResponseTreatment change review
Side effect burden rising in week 1 to 2
ResponseContact before discontinuation happens
Two or more missed doses per week
ResponseAdherence contact

What we will not oversell

Any program in this population must have a tested crisis escalation pathway with a named clinician before the first patient enrolls. Gathermed will not activate risk-item thresholds until an escalation contact is configured and verified, and no sponsored program receives identifiable risk-item data under any configuration.

Program operation

How the month actually runs

Safety protocol configured and tested before enrollment. This is not optional in this population.
Instrument schedule set at enrollment: every two weeks during titration, monthly when stable.
Item 9 and any risk response routes immediately to a named clinician with a response clock, never to a queue.
Treatment changes recorded against the score trajectory that justified them.
Management time and interactive communication monthly.
Code path · CY2026

What this program can bill

Rates are national non-facility averages, rounded, for orientation. They vary by locality and payer. Verify against your fee schedule before you model revenue on them.

CodeWhat it coversNational avgCadence
98975Setup and patient education
One-time setup and education on use of the monitoring equipment.
$21.71once per episode
98978Device supply, cognitive behavioral therapy, 16-30 days
Device supply for cognitive behavioral therapy monitoring, 16 or more days of data in 30.
$39.75per 30 days
98986new 2026Device supply, cognitive behavioral therapy, 2-15 days
New for 2026. Short-duration CBT device supply. Mutually exclusive with 98978.
$39.75per 30 days
98980Treatment management, first 20 min
20 minutes of QHP management time with at least one interactive communication.
$53.77per calendar month
98979new 2026Treatment management, first 10 min
New for 2026. 10 to 19 minutes of management time with at least one interactive communication. Mutually exclusive with 98980.
$26.05per calendar month
98981Treatment management, each additional 20 min
Add-on to 98980. Reported per additional 20 minutes in the month.
$41.8per additional 20 min

Diagnosis anchors

ICD-10-CMDescription
F32.1Major depressive disorder, single episode, moderate
F33.1Major depressive disorder, recurrent, moderate
F41.1Generalized anxiety disorder

Illustrative anchors only. Code to the documented clinical picture, not to a list on a vendor website.

The rules that break programs

One billing clinician per 30-day episode. RPM and RTM are not additive in the same calendar month. Duration codes are mutually exclusive. Management time requires at least one real-time interactive communication. Medical necessity precedes enrollment.

Full rule set and calculator

Sponsor view

If you are a manufacturer looking at this condition

A real sponsored case with unusually heavy structural constraints. Antidepressant and novel-mechanism programs need real-world time-to-response, discontinuation timing, and side-effect-driven stop reasons. The population is vulnerable, the data is among the most sensitive categories in health care, and a program here needs consent design and privacy architecture well beyond the baseline. If you are not prepared for that, choose a different condition.

Read this before you fund anything

Sponsor-funded monitoring that produces billable revenue for prescribers is remuneration to referral sources under the federal Anti-Kickback Statute. The structures that survive scrutiny keep the sponsor's data interest and the provider's billing interest completely separate. The three structures we will build, and the one we will not.

Questions

Depression and anxiety treatment monitoring monitoring, answered directly

Can collaborative care codes and RTM be billed together?
They are separate families with separate requirements and the time cannot be double counted. Many practices run behavioral health integration codes instead of RTM here. Model both before choosing.
How is suicide risk handled?
Risk items route immediately to a named clinician with a response clock, not to a shared queue. The pathway is configured and tested before enrollment, and the platform refuses to activate the program without it.