RTM program · Neurology

Concussion and mild traumatic brain injury

Recovery is a trajectory across several independent systems, and none of them is a single score.

Concussion is the condition Gathermed was originally built around and it demonstrates the device-agnostic argument better than anything else in the catalog. There is no concussion sensor. There is a camera doing oculomotor tasks, a screen running a luminance staircase, a phone reporting sleep, and a weighted survey, and the clinical value comes from putting those four trajectories on one axis. A platform that only ingests Bluetooth vitals cannot run this program at all.
Concussion and mild traumatic brain injury · 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.

Oculomotor function
Camera-based smooth pursuit, saccades, convergence
Convergence insufficiency and saccadic latency are among the more objective persistent findings and they track recovery rather than plateauing at day three.
Photophobia threshold
Adaptive staircase luminance task with spectral differentiation
Light sensitivity is the most commonly reported and least commonly measured post-concussion symptom.
Symptom burden
Weighted daily inventory
Domain-weighted rather than summed. A headache-dominant and a cognitive-dominant profile at the same total score need different care.
Sleep and activity
Passive from phone or wearable
Sleep disruption maintains symptoms and is the most modifiable variable in the whole picture.
Exertional tolerance
Structured protocol with heart rate
Sub-symptom-threshold aerobic exercise has trial support. Tolerance is the dose.
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.

Symptom burden rising over 72 hours after clearance
ResponsePause progression, clinical review
Convergence near point worsening across two assessments
ResponseVestibular-ocular referral
No improvement in any domain by day 21
ResponseReassess for persistent symptoms pathway
Photophobia threshold flat while symptom score improves
ResponseLikely independent visual pathway, consider targeted treatment

What we will not oversell

The cognitive behavioral therapy device-supply category is the closest listed RTM body system for this program, and the fit is imperfect. Document the therapeutic monitoring rationale explicitly and get a coverage read from your MAC before you build volume assumptions on it.

Program operation

How the month actually runs

Baseline within 72 hours where possible. Baseline is what makes every later measurement interpretable.
Assessment cadence every 48 to 72 hours during the acute phase, weekly after.
Four trajectories on one timeline. Return-to-activity progression gated on trajectory, not on a single day's score.
Symptom exacerbation after a progression step automatically pauses the protocol.
Monthly management time with an interactive communication.
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
S06.0X0AConcussion without loss of consciousness, initial encounter
F07.81Postconcussional syndrome
H53.2Diplopia

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

Thin direct pharmaceutical case today, honestly. No approved pharmacotherapy for concussion recovery, so the sponsored opportunity is trial instrumentation rather than commercial support. That is a real market: objective, remote, repeatable endpoints for neuro trials are scarce and sponsors pay for them. If you are running a TBI or persistent-symptom study, this is an endpoint platform, not a marketing 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

Concussion and mild traumatic brain injury monitoring, answered directly

What is the RTM code for concussion monitoring?
There is no concussion-specific code. Programs generally report the cognitive behavioral therapy device-supply codes, 98978 for 16 or more days and 98986 for 2 to 15 days as of 2026, plus management time. The fit is not exact. Document the rationale and confirm coverage locally.
Can a phone camera really measure eye movement well enough?
For convergence near point and gross saccadic abnormality, in controlled lighting, with the head stabilized, yes, and we publish the constraints. For precise saccade velocity you need instrumentation we do not claim to replace.
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.

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 Multiple sclerosisDisability accrues between visits, and visits are two a year. RTM Neurology 98975 98978 98986 Chronic low back painThe prescribed exercises work. Roughly half of patients do them. RTM Physical therapy, physical medicine and rehabilitation, orthopedics 98975 98977 98985
Start this program All 18 conditions