CPT-98981

Remote therapeutic monitoring treatment management services, physician or other qualified health care 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)

CODE TYPE

Timed code
Each additional 20 mins

ADD-ON CODE

98980

CPT CODE 98981 INTRODUCTION

Physicians or other Qualified Health Professionals (QHPs) remotely provide treatment management services to patients as part of an individualized treatment plan. This service uses telemedicine monitoring results ordered by a physician or QHP. This requires at least one two-way communication with the patient or the patient’s caregiver.

CODE DESCRIPTION

CPT Code 98981 is reported for every additional 20 minutes for management services. After the reporting of CPT 98980 for the first 20 minutes spent by a Physician or QHP in a calendar month.

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 98981 can be reported three times and billed up to 80 min.
At least 20 minutes of total time must be completed for billing CPT 98981.
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 98981 permits for a reimbursement of $40.84

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CPT-98981

CATEGORY

CODE TYPE

ADD-ON CODE

CPT CODE 98981 INTRODUCTION

CODE DESCRIPTION

CODING CRITERIA

BILLING CRITERIA

DOCUMENTATION CRITERIA

REIMBURSEMENT CRITERIA

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