RTM program · Neurology

Multiple sclerosis

Disability accrues between visits, and visits are two a year.

MS is managed on a schedule that does not match the disease. Two visits a year and an annual MRI cannot detect the slow functional drift that becomes permanent disability, and they certainly cannot detect a patient who quietly stopped their therapy in March. Continuous functional measurement is not a replacement for imaging. It is the thing that tells you when to look.

Multiple sclerosis · observed transmission profile Representative, not best case

Day 1Day 15Day 30

Transmitted days 0 / 30

Device supply code —

Start this program Model the economics

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.

Gait and mobility

Passive phone-based gait cadence and variability, plus timed walk

Gait variability shifts before a patient reports a change. Passive collection avoids asking a fatigued person to perform tasks.

Manual dexterity

Screen-based tapping and tracing tasks, weekly

A remote analogue of the nine-hole peg concept. Sensitive to upper-limb progression.

Fatigue and cognition

Weighted weekly inventory plus processing speed task

Fatigue is the most disabling symptom by patient report and the least captured in the record.

Therapy adherence

Structured logging by route, oral or injectable or infusion schedule

Persistence on disease-modifying therapy is the primary determinant of long-term disability and drops off silently.

Relapse self-report

Structured, event-triggered

Time from symptom onset to clinical contact is the modifiable variable in relapse management.

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.

New focal symptom reported

ResponseSame-day contact, relapse pathway

Gait variability rising across 14 days

ResponseClinical review

Two or more missed oral doses in a week

ResponseAdherence contact

Processing speed decline across two assessments

ResponseCognitive review

What we will not oversell

Remote functional measures are not validated disability scales. Gathermed reports them as within-patient trajectories and explicitly does not output an EDSS estimate. Do not let a sponsor talk you into implying otherwise.

Program operation

How the month actually runs

Baseline functional battery at enrollment, ideally at a stable visit rather than post-relapse.

Passive gait collection continuously, active tasks weekly, inventories weekly.

Trajectory review before each scheduled visit so the visit starts with data rather than recall.

Relapse self-report routes same-day with a defined steroid decision pathway.

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.

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

Diagnosis anchors

ICD-10-CM	Description
G35	Multiple sclerosis

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 strong sponsored case with an unusually direct commercial logic. Disease-modifying therapy persistence is the core commercial metric in MS and current visibility is limited to refill data. A program yields persistence curves with structured stop reasons, functional trajectory on therapy at a resolution no registry achieves, and relapse timing relative to adherence gaps. Relevant to every DMT class and to any program trying to demonstrate a progression benefit outside of imaging endpoints.

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

Multiple sclerosis monitoring, answered directly

Can remote monitoring replace the neurology visit?

No, and a program that markets itself that way will fail clinically and commercially. It changes what the visit is for, from reconstructing six months by memory to deciding what to do about a trajectory everyone can see.

Adjacent programs

Conditions that travel with this one

Comorbidity is the norm. One episode, one billing clinician, one device-supply line per 30 days, even when the patient has four diagnoses.

Parkinson's diseaseThe paper ON-OFF diary is the weakest instrument in modern neurology, and it drives dosing. RTM Neurology, movement disorders 98975 98978 98986 Concussion and mild traumatic brain injuryRecovery is a trajectory across several independent systems, and none of them is a single score. RTM Neurology, sports medicine, concussion clinic, physical medicine 98975 98978 98986 Depression and anxiety treatment monitoringMeasurement-based care works and almost nobody does it. The measurement is the intervention. RTM Psychiatry, behavioral health, primary care 98975 98978 98986

Start this program All 18 conditions