RTM program · Neurology

Parkinson's disease

The paper ON-OFF diary is the weakest instrument in modern neurology, and it drives dosing.

Dosing decisions in Parkinson's depend on knowing how much of the day the patient spends OFF, and the standard instrument for that is a paper diary filled in from memory. Continuous motor state classification is a substantial improvement over that baseline, and the bar being low does not make the improvement less valuable. The honest framing is that we are replacing recall with measurement, not replacing examination with an algorithm.

Parkinson's disease · 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.

Motor state

Passive wearable accelerometry classified to ON, OFF, and dyskinetic states

Replaces recall-based diaries with continuous classification. This is the single largest measurement upgrade available in the disease.

Tremor and bradykinesia

Wearable plus screen-based finger tapping

Quantified amplitude and speed rather than a clinician's ordinal rating from a single afternoon.

Medication timing

Logged dose times against the prescribed schedule

Motor fluctuation management is entirely a timing problem, and actual timing rarely matches the prescription.

Gait and falls

Passive gait metrics plus fall events

Freezing episodes and fall frequency, the outcomes that determine independence.

Sleep

Passive

Nocturnal akinesia and REM behavior disorder both affect daytime function and both go unmeasured.

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.

OFF time above 25% of waking hours

ResponseRegimen review

Dyskinesia burden rising

ResponseDose or fractionation review

Any fall event

ResponseSame-week clinical contact and safety review

Dose timing drift above 45 minutes routinely

ResponseAdherence and schedule simplification

What we will not oversell

Algorithmic motor state classification carries real error, particularly distinguishing dyskinesia from voluntary movement in active patients. Gathermed reports classification confidence alongside every summary and will not suppress it to make a chart look cleaner.

Program operation

How the month actually runs

Baseline week of passive collection before any regimen change, so there is something to compare to.

Continuous wearable collection plus weekly active tasks.

Motor state summary reviewed against dose timing before each titration.

Fall events route same-week to a safety review with a named owner.

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
G20	Parkinson's disease
G20.A1	Parkinson's disease without dyskinesia, without fluctuations

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, particularly for continuous delivery systems, adjunct therapies targeting OFF time, and any program with a motor fluctuation endpoint. What a sponsor gets: objective OFF-time and dyskinesia burden at daily resolution, real-world dose timing, and response trajectories that paper diaries cannot produce. This is also a credible trial instrumentation business independent of any commercial program.

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

Parkinson's disease monitoring, answered directly

Is wearable ON-OFF classification accurate enough for dosing decisions?

It is better than a recalled paper diary, which is the actual comparator. It is not a substitute for examination. Use it to decide what to ask about and to see change over time.

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.

Multiple sclerosisDisability accrues between visits, and visits are two a year. RTM Neurology 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

Start this program All 18 conditions