CPT-98980

REMOTE THERAPEUTIC MONITORING

RTM uses medical equipment to collect non-physiological data in order to manage patients. Data on indicators includes therapy/medication adherence, therapy/medication response, and pain level. On the other hand, RPM codes can only be used in conjunction with monitoring physiologic data (e.g., heart rate, blood pressure, and blood sugar levels).

RTM codes may be used by clinical social workers, physician assistants, occupational therapists, speech-language pathologists, physical therapists, and occupational therapists.

The patient may self-report RTM data or may upload it digitally using the gadget. RTM codes still call for the use of equipment that satisfies the FDA’s definition of a medical device, but according to CMS, self-reported RTM data submitted through a smartphone app or online platform that falls under the category of Software as a Medical Device may be eligible for reimbursement.

CODE DESCRIPTION

CPT Code 98980 requires a minimum of 20 minutes per month for remote patient therapy monitoring and treatment. During the month, this period must also include at least one interactive communication (e.g. phone call or video) with the patient/caregiver.

CODING CRITERIA

• Do not report these codes for services that take less than 20 minutes.
• Basic Code 98980 and Add-on Code 98981 are reported together on the invoice based on the total hours after the end of the calendar month.
• These codes cannot be reported on the same day as E/M service by the same doctor or other qualified medical professional.
• Remote treatment monitoring may be reported in the same month as care management (99439, 99487, 99489-99491), transitional care management (99495-99496), primary care management (99424-99427), or behavioral health integration (99484, 99492-99494) but not at the same time.

BILLING CRITERIA

• All RTM services should be provided as part of the treatment plan.
• CPT 98980 is reported once regardless of the number of monitoring modalities performed.
• At least 20 minutes of total time must be completed for billing CPT 98980.
• Time spent for this service doesn’t include clinical staff time required for data collection.
• At least one two-way communication with the patient or caregiver is required during the calendar month.

DOCUMENTATION CRITERIA

• At least one interactive communication with the patient or caregiver should be documented.
• Time spent can be viewed as part of the accumulated documented time for the month.
• A patient’s specific treatment plan should be documented.
• Devices used must be tabulated and meet the FDA definition of a medical device.

REIMBURSEMENT CRITERIA

CPT code 98980 permits for a one-time reimbursement of $50.18.