Remote Therapeutic Monitoring (RTM) has become an increasingly important part of modern healthcare delivery, especially since the COVID-19 pandemic highlighted the need for remote care options. If you’re a healthcare provider looking to implement RTM services or just trying to understand the Remote Therapeutic Monitoring billing landscape better, you’re in the right place.
Let’s break down everything you need to know about RTM CPT codes and how they work.
What is Remote Therapeutic Monitoring?
Before we dive into the specific codes, let’s get clear on what RTM actually is. Remote Therapeutic Monitoring refers to the collection and analysis of non-physiological data related to a patient’s health status.
This might include:
- Medication adherence
- Response to therapy
- Exercise adherence
- Pain levels
- Respiratory system status
- Musculoskeletal system status
Unlike Remote Patient Monitoring (RPM), which focuses on physiological data like blood pressure or blood sugar levels, RTM centers on therapeutic data and response to prescribed therapies.
The Core RTM CPT Codes
Device Supply and Setup Codes
CPT 98975
- Initial setup and patient education for RTM device(s)
- One-time billing per episode of care
- Requires medical device as defined by the FDA
- Cannot be reported for software only
- Typical time: 20 minutes
Practice tip: Document the specific device(s) used, setup process, and patient education provided in your notes.
Data Collection and Transmission Codes
CPT 98976
- Device supply with scheduled recordings/programmed alerts
- Specifically for respiratory system monitoring
- Reported once for each 30-day period
- Device must be used for minimum of 16 days to bill
CPT 98977
- Device supply with scheduled recordings/programmed alerts
- Specifically for musculoskeletal system monitoring
- Reported once for each 30-day period
- Device must be used for minimum of 16 days to bill
Practice tip: Ensure your documentation includes the specific system being monitored and the number of days the device was actually used.
Treatment Management Codes
CPT 98980
- First 20 minutes of treatment management services
- Calendar month of provider time
- Interactive communication with patient/caregiver required
- Must document time spent
CPT 98981
- Each additional 20 minutes of treatment management services
- Used in conjunction with 98980
- Maximum of 40 minutes additional time (2 units)
- Must document time spent
Key Billing Requirements and Guidelines
General Requirements for RTM Services
Ordering Requirements
- Valid order from treating provider
- Clear medical necessity documentation
- Specific therapeutic goals identified
Patient Consent
- Written or verbal consent required
- Must be documented in medical record
- Annual renewal recommended
Device Requirements
- Must be FDA-defined medical device
- Capability for daily recordings or programmed alerts
- Data transmission must be automatic (not patient self-recording)
Time Documentation Requirements
When billing for treatment management services (98980, 98981), you must document:
- Total time spent during calendar month
- Nature of interactive communication with patient
- Clinical staff time vs. qualified healthcare professional time
- Summary of management changes or decisions made
Common Clinical Applications
Respiratory Monitoring
- Asthma management
- COPD monitoring
- Sleep apnea therapy adherence
- Inhaler technique and usage tracking
Example scenario: A COPD patient uses a smart inhaler that tracks medication usage patterns and technique. The device transmits data about inhaler use, helping providers adjust therapy based on adherence and effectiveness.
Musculoskeletal Monitoring
- Post-operative recovery tracking
- Physical therapy progress monitoring
- Pain management assessment
- Exercise adherence tracking
Example scenario: A post-knee replacement patient uses a motion sensor device to track exercise adherence and range of motion progress during home therapy.
Medication Adherence
- Therapy response tracking
- Side effect monitoring
- Dosing schedule adherence
- Patient engagement tracking
Reimbursement Considerations
Payment Requirements
Device Supply Codes (98976, 98977)
- 16 days minimum usage per 30-day period
- One unit per 30-day period
- Cannot bill multiple units for multiple devices
Treatment Management Codes (98980, 98981)
- Calendar month billing
- Interactive communication required
- Time-based billing rules apply
- Non-face-to-face services included
Common Reimbursement Challenges
Documentation Gaps
- Insufficient time documentation
- Missing medical necessity
- Incomplete device usage records
Coding Errors
- Incorrect code selection
- Improper time calculations
- Missing required elements
Billing Mistakes
- Wrong date of service
- Incorrect units
- Missing modifiers when required
Best Practices for RTM Implementation
Program Setup
Patient Selection
- Identify appropriate candidates
- Document medical necessity
- Assess technical capabilities
- Evaluate support system
Staff Training
- Device setup and troubleshooting
- Documentation requirements
- Billing procedures
- Patient education protocols
Workflow Integration
- Define roles and responsibilities
Establish monitoring protocols - Create communication procedures
- Develop intervention guidelines
Documentation Excellence
Initial Setup
- Device details and serial numbers
- Patient education provided
- Consent obtained
- Treatment goals established
Ongoing Monitoring
- Data collection dates
- Device usage compliance
- Clinical interventions
- Patient communication
Treatment Management
- Time spent on services
- Clinical decision making
- Care plan modifications
- Patient response
Common Mistakes to Avoid
Billing Errors
- Billing before 16 days of use
- Double-billing device supply
- Incorrect time calculations
- Missing documentation
Clinical Mistakes
- Poor patient selection
- Inadequate training
- Insufficient monitoring
- Delayed interventions
Documentation Failures
- Missing consent
- Incomplete time records
- Poor medical necessity documentation
- Inadequate intervention records
Future of RTM
The landscape of Remote Therapeutic Monitoring is continuously evolving.
Keep an eye on:
Technology Advances
- New device development
- Enhanced data analytics
- Improved patient interfaces
- Better integration capabilities
Regulatory Changes
- Updated coding guidelines
- New coverage policies
- Modified documentation requirements
- Expanded eligible services
Clinical Applications
- New therapeutic areas
- Enhanced monitoring capabilities
- Improved intervention strategies
- Better outcome tracking
RTM Billing Codes FAQ
What is Remote Therapeutic Monitoring and how does it differ from Remote Patient Monitoring?
Remote Therapeutic Monitoring, or RTM, involves collecting and reviewing non-physiological data such as medication adherence, pain levels, and response to therapy. Remote Patient Monitoring instead tracks physiological data like blood pressure or blood sugar. RTM focuses on how a patient responds to a prescribed treatment plan rather than on vital signs.
What does CPT code 98975 cover in RTM billing?
CPT 98975 covers the initial setup and patient education for an RTM device and is billed once per episode of care. It requires use of a device that meets the FDA definition of a medical device, so software alone does not qualify. The typical time associated with this service is 20 minutes, and documentation should describe the device and the education given.
How do CPT codes 98976 and 98977 differ from each other?
CPT 98976 applies to device supply with scheduled recordings or alerts for respiratory system monitoring, while CPT 98977 applies to the same type of monitoring for the musculoskeletal system. Both codes are reported once per 30-day period and require that the device be used for at least 16 days within that period to qualify for billing.
What are the treatment management codes for RTM and what do they require?
CPT 98980 covers the first 20 minutes of treatment management services in a calendar month and requires interactive communication with the patient or caregiver. CPT 98981 is used for each additional 20 minutes, up to a maximum of two additional units, or 40 minutes. Both codes require documentation of the time spent providing the service.
What documentation is required when billing for RTM treatment management time?
Providers must record the total time spent during the calendar month, the nature of the interactive communication with the patient, and whether the time was spent by clinical staff or a qualified healthcare professional. A summary of any management changes or clinical decisions made during that period is also required.
What are the general requirements a provider must meet before billing RTM services?
A valid order from the treating provider is needed, along with documentation of medical necessity and specific therapeutic goals. Patient consent, written or verbal, must be recorded in the medical record and renewed annually. The device used must be FDA-defined, capable of daily recordings or programmed alerts, and must transmit data automatically rather than relying on patient self-entry.
Summary
Remote Therapeutic Monitoring represents a significant opportunity to enhance patient care while maintaining appropriate reimbursement for services.
Success with RTM requires:
- Understanding and proper use of CPT codes
- Thorough documentation practices
- Appropriate patient selection
- Effective program implementation
- Ongoing monitoring and adjustment
Always verify specific requirements with your local Medicare Administrative Contractor (MAC) and commercial payers before implementing new services.
Co-Founder and COO of Medwave, bringing more than 30 years of hands-on experience in healthcare revenue cycle management, payer contracting, and medical credentialing.