Remote Therapeutic Monitoring: CPT Codes 98980-98981
Last week, I published an article titled “Remote Therapeutic Monitoring: CPT Codes 98976-98978“. The previous week, I published an article titled “Remote Therapeutic Monitoring: CPT Code 98975 FAQs“. In this week’s article, I will answer the following questions I have been receiving about CPT codes 98980 – 98981:
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If patients are traveling out of state or outside the country, is there limitation on continued RTM during that time if the therapist is licensed in the state where the patient lives full-time? I know for telehealth, licensing requirements are based on the location of the patient at the time, but I’m not sure if this would be the same for asynchronous communication like RTM.
Please read this article as there is a FAQ regarding licensure.
Can 98980 and 98981 be provided by a therapist who is not located in the outpatient clinic or facility. For instances if the provider was working from their own home?
Yes, since some PTs in private practice see patient’s in their home as outpatients and do not have a physical clinic.
Apologies – I meant that as a question clarifying that section. Does this mean where the patient “resides” as a resident or where they are at the time the RTM is occurring. I know for telehealth it is based on their location at the time of the visit, but not sure if that is the same for RTM since it is asynchronous.
You must be licensed in the state the patient is located in and receiving RTM services.
Two Questions:
1) Must a patient pay for or be billed for an evaluation to be eligible for RTM through their insurance (say they were given a free screen)?
2)Does 98980 and 980981 require any 16 days of data to be billed as well or can that be billed at any time (say they started with 7 days left in the month, but you had 40 min of communication with them)? Can they be billed separately from 98975 and 98977?
Patient must be under a therapy plan of care so that would require an evaluation to establish the plan of care. It’s possible to bill 98980 and 98981 prior to being able to bill 98975 and 98977.
Do you need to have a second two way communication to bill 98981 for the month?
We are seeking clarification from the American Medical Association regarding this question since the way the codes are written would indicate that a separate interactive communication would be required for each additional 20 minutes..
Are these 2 codes (98980 and 98981) able to be submitted on a UB-04?
Yes