There are six CPT® codes used by providers for Remote Therapeutic Monitoring (RTM), four of which are relevant to musculoskeletal (MSK) conditions. Furthermore, the RTM CPT codes are broken down into two basic types: service codes and treatment management codes.
In this blog, we’ll explore RTM CPT Code 98981, highlighting its focus on patient monitoring well as the billing and documentation requirements
Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; additional 20 minutes.
Interactive Communication for RTM can include a phone call or two-way audiovisual communication. Any communication tools should be evaluated for HIPAA compliance. Text messaging and e-mail do not qualify.
Treatment Management Code
According to the Centers for Medicare & Medicaid Services (CMS), the CPT® codes for RTM can be billed by “physicians and other eligible qualified healthcare professionals.” This includes the following clinicians:
The 2024 CMS Final Rule brought clarification to the rules of General Supervision. This important provision allows Physical Therapists and Occupational Therapists in private practice to provide general supervision for RTM services furnished by their PTAs and OTAs, respectively. This supports RTM management services to be performed outside of the clinic, which is instrumental to providing comprehensive at-home support for patients.
Only one practitioner can bill RTM CPT codes 98980 and 98981 in a 30-day period, even if the patient has been provided multiple medical devices from multiple practitioners.
In all cases, providers must practice in accordance with applicable state and scope of practice laws.
If CPT codes 98975, 98980, and/or 98981 are provided in whole or in part by a physical therapist assistant (PTA) or an occupational therapy assistant (COTA), you will need to append the CQ or CO modifier respectively to those codes on the claim form. The CQ or CO modifier does not apply to 98976, 98977, or 98978.
RTM CPT code 98981 may be billed after the reporting of 98980, at the end of the calendar month
In the 2024 Final Rule, CMS clarified the 16-day data requirement does NOT apply to RTM treatment & management services
A Physical Therapist Assistant (PTA) dedicates time to analyzing and interpreting the patient's submitted data, both subjective and objective. They provide email updates to the patient’s in-clinic therapist regarding progress and engage directly with the patient through texts, emails, and a phone call to address questions about their home exercise program. The total time spent for these activities in this calendar month was 45 minutes and included at least one interactive communication with the patient. The provider is able to bill CPT Code 98981 after they have billed 98980, for the additional 20 minutes of their efforts.
Created alongside clinicians and experts in billing and compliance, Limber Health's RTM Billing & Coding Guide offers an in-depth look at all of the Remote Therapeutic Monitoring CPT codes, best practices for billing and documentation and answers your frequently asked questions. Click the button below to download your free copy of the guide.
The information provided here about the Remote Therapeutic Monitoring CPT Codes is for informational purposes only and does not constitute billing or legal advice.
