RTM Billing Guide

What is Remote Therapeutic Monitoring (RTM) ?

Remote Therapeutic Monitoring (RTM) is a family of five codes created by the CPT Editorial Panel in October 2020 and valued by the RUC at its January 2021 meeting — Remote Therapeutic Monitoring/Treatment Management CPT codes 98975, 98976, 98977, 98980, and 98981.

Components of Implementing RTM

Patient Consents & Initial Setup

Acquire consent from patient to be remotely monitor (verbal or written)

Daily Recordings and Data Transmission

Patient syncs health data remotely using telehealth equipment

Monitoring Data and Billing

Interactive communication with patient/caregiver during a calendar month.

The Workflow

01

Plan

Create an RTM work-flow, establish documentation, and RTM billing procedure

02

Train

Train qualified clinical staff to help remotely monitor patients' vitals.

03

Consent

Acquire consent from the patient to be remotely monitored.

04

Educate

Educate patients on how to measure oxygen and blood pressure health data using Connect+ to collect health data.

05

Sync

Patient sync and health data remotely monitor by physician/clinical staff.

06

Submit

Submit eligible patients for billing and get reimbursed for monthly monitoring.

RTM CPT Billing Code Guide

CPT 98975

Patient Set Up & Training
$ 19 Once per Episode Of Care
  • Remote therapeutic monitoring (e.g. respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment. Patient must give consent for RTM services

CPT 98976

Device supply that allows data transmission for Respiratory Condition
$ 54 Monthly
  • Remote therapeutic monitoring (e.g. respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g. daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days

CPT 98977

Device supply that allows data transmission for Respiratory Condition
$ 54 Once per Episode Of Care
  • Remote therapeutic monitoring (e.g. respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g. daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days

CPT 98980

Initial Remote Monitoring
$ 49 Once per Episode Of Care
  • Remote therapeutic monitoring treatment, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/care- giver during the calendar month; first 20 minutes

CPT 98981

Additional Remote Patient Monitoring
$ 31 Once per Episode Of Care
  • Remote therapeutic monitoring treatment, 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; each additional 20 minutes

Frequently Ask Questions

CPT codes 98975, 98976, and 98977 require the RTM device to monitor at least 16 days of data per each 30-day period, in total.

Yes. RTM is designed for the management of patients using medical devices that collect non-physiological data. Data around indicators such as therapy/medication adherence, therapy/medication response, and pain level can be collected and billed under the new RTM codes.

Yes, the clinical use cases eligible for device supply reimbursement under RTM are limited. The two RTM device supply codes (98976, and 98977) are similar to the RPM device supply code (99454), but not identical.

No. Because the two RTM treatment management codes (CPT codes 98980 and 98981) are not E/M codes, they cannot be designated as care management services. This means a physician could not order and bill for RTM services while having remote-based non-physician practitioners perform the work under general supervision.

RTM requires the use of a medical device as defined under the federal Food, Drug, and Cosmetics Act (i.e., not merely a wellness device).