Understanding the New Remote Therapeutic Monitoring CPT Codes

January 3, 2022
 / 
Rick Gawenda
 / 

Effective January 1, 2022, there were 5 new CPT codes to describe remote therapeutic monitoring (RTM). In this article, I will answer the following questions I have been receiving about these new CPT codes.

  1. What are the new CPT codes that describe RTM and what is the description of each of the new RTM CPT codes?
  2. What is the difference between the new Remote Therapeutic Monitoring (RTM) codes and the existing Remote Physiological Monitoring (RPM) codes?
  3. Can physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) bill the RTM codes to Medicare and other insurance carriers and be reimbursed for them?
  4. What types of practices and organizations will be able to bill the RTM codes?
  5. Will the Annual Therapy Threshold and Multiple Procedure Payment Reduction Policy apply to the RTM codes?
  6. If the RTM codes are provided in whole or in part by a physical therapist assistant (PTA) or an occupational therapy assistant (OTA), will the codes require the CQ/CO modifier and therefore, 15% reduction apply?
  7. How much will CMS reimburse for each of the new remote therapeutic monitoring CPT codes?
  8. What CPT codes can be the same day as the RTM codes?
  9. What type of device can I use in order to bill CPT codes 98975, 98976 and/or 98977?
  10. I see that CPT codes 98976 and 98977 at the end of their description each state “each 30 days”. Must I do the remote therapeutic monitoring for the entire 30 days to bill CPT codes 98976 and/or 98977?
  11. I see that CPT code 98980 states “first 20 minutes”. Can I bill this code if I spend less than 20 minutes in a calendar month?
  12. I see that CPT code 98981 states “each additional 20 minutes”. Can I bill this code if I spend less than an additional 20 minutes in a calendar month?
  13. Will Medicare Advantage plans and commercial insurance carriers reimburse the RTM codes if provided and billed by physical therapists, occupational therapists and speech-language pathologists?
  14. Will Medicare Advantage plans and commercial insurance carriers have a patient cost-sharing responsibility on the RTM codes (e.g., co-pay or co-insurance)?
  15. In order to bill CPT codes 98976 and/or 98977, must I supply the medical device that captures the recordings and/or programmed alert(s) transmission to monitor the respiratory system or musculoskeletal system?

Let’s Begin!

Question #1
What are the new CPT codes that describe RTM and what is the description of each of the new RTM CPT codes?

Answer #1

The content here is for members only log in here or sign up.

Question #2
What is the difference between the new Remote Therapeutic Monitoring (RTM) codes and the existing Remote Physiological Monitoring (RPM) codes?

Answer #2

The content here is for members only log in here or sign up.

Question #3
Can physical therapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) bill the RTM codes to Medicare and other insurance carriers and be reimbursed for them?

Answer #3

The content here is for members only log in here or sign up.

Question #4
What types of practices and organizations will be able to bill the RTM codes?

Answer #4

The content here is for members only log in here or sign up.

Question #5
Will the Annual Therapy Threshold and Multiple Procedure Payment Reduction Policy apply to the RTM codes?

Answer #5

The content here is for members only log in here or sign up.

Question #6
If the RTM codes are provided in whole or in part by a physical therapist assistant (PTA) or an occupational therapy assistant (OTA), will the codes require the CQ/CO modifier and therefore, 15% reduction apply?

Answer #6

The content here is for members only log in here or sign up.

Question #7
How much will CMS reimburse for each of the new remote therapeutic monitoring CPT codes?

Answer #7

The content here is for members only log in here or sign up.

Question #8
What CPT codes can be the same day as the RTM codes?

Answer #8

The content here is for members only log in here or sign up.

Question #9
What type of device can I use in order to bill CPT codes 98975, 98976 and/or 98977?

Answer #9

The content here is for members only log in here or sign up.

Question #10
I see that CPT codes 98976 and 98977 at the end of their description each state “each 30 days”. Must I do the remote therapeutic monitoring for the entire 30 days to bill CPT codes 98976 and/or 98977?

Answer #10

The content here is for members only log in here or sign up.

Question #11
I see that CPT code 98980 states “first 20 minutes”. Can I bill this code if I spend less than 20 minutes in a calendar month?

Answer #11

The content here is for members only log in here or sign up.

Question #12
I see that CPT code 98981 states “each additional 20 minutes”. Can I bill this code if I spend less than an additional 20 minutes in a calendar month?

Answer #12

The content here is for members only log in here or sign up.

Question #13
Will Medicare Advantage plans and commercial insurance carriers reimburse the RTM codes if provided and billed by physical therapists, occupational therapists and speech-language pathologists?

Answer #13

The content here is for members only log in here or sign up.

Question #14
Will Medicare Advantage plans and commercial insurance carriers have a patient cost-sharing responsibility on the RTM codes (e.g., co-pay or co-insurance)?

Answer #14

The content here is for members only log in here or sign up.

Question #15
In order to bill CPT codes 98976 and/or 98977, must I supply the medical device that captures the recordings and/or programmed alert(s) transmission to monitor the respiratory system or musculoskeletal system?

Answer #15

The content here is for members only log in here or sign up.

I hope you found this article to be informative. Thank you for being a Gold Member!

All material posted on our website is intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.




All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

  1. Thank you Rick! This resource is super valuable.
    How does Medicare define monitoring for at least 16 days out of the 30 days per month to bill for 98976?
    What is required to show 16 days of monitoring? Thank you !

  2. Can these codes be used in place of telehealth or are they in conjunction with telehealth. I’m trying to find specific examples of how we would bill 98980 and 98981.

  3. In the incident to practice if the PT uses RTM can it still be billed by the physician under the practice?
    On the commercial side if a patient is receiving RTM services is the patient still liable for a copay or since it’s remote over time, the copay doesn’t apply?
    Thank you in advance.

    1. Any questions regarding a patient copay, you would need to contact the insurance carrier. Medicare allows incident-to-billing. Regarding your other insurance carriers, you would need to check if allowed.

  4. Hi Rick
    Is it safe to say that you can bill RTM codes as well as other CPT codes? Meaning you can still see the patient in the clinic for manual and send home with HEP that can be monitored?
    Thank you
    Gerriann