RTM Consent: What You Need Before You Bill

Consent is the quiet gate that stops more RTM revenue than any coding error. The data can be perfect, the call documented, the thresholds met — but if there's no consent on file, the month isn't billable. It's also one of the easiest gates to clear, as long as you do it at the right time.

Why consent gates billing

RTM bills for monitoring a patient's data, so Medicare expects the patient to have agreed to be monitored. That agreement — consent — has to exist before the service is billed. No documented consent means no billable RTM, regardless of how complete everything else is.

What consent should cover

• That the patient is enrolling in remote therapeutic monitoring of their recovery.
• That their logged data may be reviewed by their provider and used to support billing to Medicare or their insurer.
• That they may decline or withdraw at any time, without affecting their care.
• Standard cost-sharing context — RTM, like most Part B services, may carry patient cost-sharing.

Consent isn't a waiver you bury — it's a clear yes to being monitored, captured before the monitoring is billed.

When to obtain it

Up front. The clean pattern is to capture consent at enrollment, as part of onboarding the patient into the program — the same moment you set up their monitoring. Retroactive consent at month-end is the thing to avoid; it invites exactly the gap auditors look for.

Keeping it documented (and current)

Record that consent was obtained, when, and the version of what the patient agreed to. If a patient withdraws, note it — monitoring after withdrawal isn't billable. The goal is that, for any month you bill, you can point to active consent that predates the service.

In BoneArc, consent is captured at onboarding and tracked as a billing gate, so a patient without active consent simply doesn't show as billable — the system won't let the gap slip through.