2025 CPT code 98981
(Active) Effective Date: N/A Medicine - Non-Face-to-Face Nonphysician Services Feed
Remote therapeutic monitoring (RTM) treatment management services, physician or other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure).
Appropriate modifiers may be used with 98981 to indicate specific circumstances of the service, as per general modifier guidelines.
Medical necessity for 98981 must be supported by documentation showing that the additional 20 minutes of RTM treatment management, beyond the initial 20 minutes (98980), were necessary for effective management of the patient's condition. The documentation should clearly link the RTM to the patient's diagnosis, treatment plan, and progress.
After the initial 20 minutes of RTM treatment management in a calendar month (reported with 98980), the physician or other qualified healthcare professional provides an additional 20 minutes of treatment management using remote monitoring data. This must include at least one interactive communication with the patient or caregiver. The provider orders the RTM, which involves collecting therapeutic data using one or more FDA-approved medical devices. The provider reviews and monitors the data, including signs, symptoms, and functions related to the patient's response to therapy, to manage the patient according to a specific treatment plan.
In simple words: This code covers the doctor's time spent managing your treatment remotely using special monitoring devices, like those used for breathing or muscle problems. It's for every 20 minutes they spend after the first 20 minutes in a month, and they need to talk to you or your caregiver at least once during that month.
This code reports an additional 20 minutes of provider time in a calendar month spent on remote therapeutic monitoring treatment management services, after the initial 20 minutes reported by code 98980.It requires at least one interactive communication with the patient or caregiver during the calendar month. The RTM involves using FDA-defined medical devices for therapeutic data collection, which the provider reviews and monitors to manage the patient's treatment plan. Examples of RTM include monitoring respiratory system status, musculoskeletal system status, and therapy (medication) adherence and response.
Example 1: A patient with chronic obstructive pulmonary disease (COPD) uses a spirometer at home to measure lung function. The data is transmitted to the physician's office, and after the initial 20 minutes of review and communication, the physician spends an additional 20 minutes adjusting the patient's medication dosage based on the data and communicates the change to the patient., A patient recovering from knee surgery uses a wearable sensor to track range of motion exercises at home. The data is transmitted to a physical therapist who, after the initial 20 minutes of review, spends another 20 minutes communicating with the patient via telehealth to adjust the exercise program based on the data., A patient with hypertension uses a remote blood pressure monitor. The physician reviews the data and, following the initial 20 minutes of service in the month, spends an additional 20 minutes communicating with the patient to discuss lifestyle modifications and medication adherence, and to answer patient's questions, based on the transmitted data.
Documentation should include the date and time of all interactive communication with the patient or caregiver, the total time spent on RTM treatment management for the additional 20-minute increment, the specific device(s) used for monitoring, the data collected, how the data was interpreted, and any changes made to the treatment plan based on the data. The medical necessity for the RTM should also be documented, including the patient's diagnosis and the specific goals of the monitoring.
** Remote therapeutic monitoring (RTM) is a relatively new technology and coding guidelines might evolve. Stay updated on current guidelines from CMS and other relevant organizations. As of December 1, 2024, this information is current.
- Payment Status: Active
- Specialties:Specialties that might use this code include, but are not limited to, cardiology, pulmonology, orthopedics, physical medicine and rehabilitation, and primary care.
- Place of Service:Office, Home, Inpatient Hospital, Outpatient Hospital, Skilled Nursing Facility, Nursing Facility, and other places where RTM is appropriate.