2025 CPT code 98976
(Active) Effective Date: N/A Revision Date: N/A Medicine Services and Procedures - Remote Therapeutic Monitoring Services Medicine Feed
Device supply for remote therapeutic monitoring of the respiratory system; reported once per 30 days, including scheduled recordings and/or programmed alert transmission.
Modifiers may be applicable depending on circumstances. Consult the AMA CPT manual for guidance.
Medical necessity for 98976 is established by the physician's order based on the patient's respiratory condition and the need for ongoing monitoring to manage their treatment effectively. Documentation must support the need for RTM and demonstrate clinical appropriateness.
The provider's responsibility is to supply the necessary FDA-approved device(s) for respiratory system RTM, ensuring proper setup and patient education (if not covered by code 98975), and the collection and review of the patient data.Direct supervision is required.
In simple words: This code covers providing devices for remotely tracking a patient's breathing.The devices send information to the doctor regularly.This is billed once every 30 days and requires at least 16 days of data collected.
This CPT code encompasses the provision of one or more devices for remote therapeutic monitoring (RTM) of the respiratory system.The service includes scheduled recordings and/or programmed alert transmission and is reported once per 30-day period, requiring a minimum of 16 days of monitoring.The devices must be FDA-approved medical devices. The clinical responsibility includes supplying the device(s) after a physician or qualified healthcare professional orders the service. The RTM process involves reviewing and monitoring data regarding patient signs, symptoms, and functional responses to therapy to assess patient status. Data may be objective (device-generated) or subjective (patient-reported).
Example 1: A patient with COPD uses a connected spirometer to record peak expiratory flow daily. The provider bills 98976 for the 30-day supply of the device and its data transmission., A patient with asthma uses a wearable device that tracks respiratory rate and oxygen saturation.The provider bills 98976 for the device and data transmission for the 30-day period., A patient recovering from pneumonia uses a pulse oximeter and a respiratory rate monitor. The provider bills 98976 for providing the devices and transmitting the data for a 30-day monitoring period.
Documentation should include the order for RTM services, details of the supplied device(s) (including manufacturer, model, and FDA approval), the dates of monitoring, and a record of the transmitted data.Patient education records should also be documented if not separately billed with code 98975.
** This code requires at least 16 days of data collection within the 30-day billing period.The data can be patient-self reported or objective data from a connected device.
- Revenue Code: M5D (Specialist - Other)
- RVU: The relative value units (RVUs) for this code vary depending on the payer and geographic location.Consult the relevant fee schedule for specific values.
- Global Days: This code is reported once per 30-day period with a minimum of 16 days of monitoring data collection.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier does not apply to this code.
- Fee Schedule: Historical fee schedules will vary by payer and location.Consult past fee schedules for specific reimbursement rates.
- Specialties:Pulmonology, Respiratory Therapy, Internal Medicine, Family Medicine
- Place of Service:Office, Home, Telehealth Provided in Patient’s Home, Telehealth Provided Other than in Patient’s Home