Understanding CPT 98975: Setup for Remote Therapeutic Monitoring

There are six CPT® codes used by providers for Remote Therapeutic Monitoring (RTM), four of which are relevant to musculoskeletal (MSK) conditions. Furthermore, the RTM CPT codes are broken down into two basic types: service codes and treatment management codes.

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• CPT Code 98975: Initial Set-up and Patient Education
• CPT Code 98977: Supply of Device for Monitoring Musculoskeletal System
• CPT Code 98980: Monitoring/Treatment Management Services, first 20 minutes
• CPT Code 98981: Monitoring/Treatment Management Services, each additional 20 minutes

In this blog, we'll take a look at RTM CPT Code 98975, including billing and documentation requirements.

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Remote Therapeutic Monitoring CPT® Code 98975: Initial Set-up and Patient Education

Remote therapeutic monitoring (eg, respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment.

• By definition, an episode of care begins when the RTM service starts, and ends when established treatment goals are met. 
• Providers must obtain consent, set-up and educate the patient on the use of the platform and create the patient's home exercise program.
• The patient has been active on the RTM platform for at least 16 days of the next 30 day (rolling) period. Depending on the RTM platform, this may be automatically calculated or manually calculated by the provider.

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Type of CPT Code

Service Code

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Who Can Bill CPT Code 98975?

According to the Centers for Medicare & Medicaid Services (CMS), the CPT® codes for RTM can be billed by “physicians and other eligible qualified healthcare professionals.” This includes the following clinicians:

• Physicians
• Physical Therapists
• Occupational Therapists
• Speech Language Pathologists

The 2024 CMS Final Rule brought clarification to the rules of General Supervision. This important provision allows Physical Therapists and Occupational Therapists in private practice to provide general supervision for RTM services furnished by their PTAs and OTAs, respectively. This supports RTM management services to be performed outside of the clinic, which is instrumental to providing comprehensive at-home support for patients.

In all cases, providers must practice in accordance with applicable state and scope of practice laws.

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Billing Frequency for 98975:

CPT code 98975 may be billed once per episode of care at the initial RTM enrollment.

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Clinical Example:

A Physical Therapist evaluates a patient and creates an individualized plan of care that includes a home exercise program. Based on the patient's plan of care, the provider believes the patient will benefit from a Remote Therapeutic Monitoring program and plans to enroll the patient into their RTM platform. The PT provides consent for RTM, reviews the HEP and educates the patient on how to use the medical device. At the end of the patients first 30-day period, they've been engaged on the Limber platform for 22 of those 30 days. They've completed their exercises 16 out of those 30 days, logged a daily pain rating 22 out of 30 days, and responded to a PROMIS-10 outcome measure. The provider bills 98975 at the end of the episode of care.

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Required Documentation for 98975:

• Document consent for RTM​​
• Document set-up and education of the RTM device
• Document at least 16 days of data transmitted by the patient’s medical device in a 30-day period

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RTM CPT Code Questions?

Created alongside clinicians and experts in billing and compliance, Limber Health’s RTM Billing & Coding Guide offers an in-depth look at all of the Remote Therapeutic Monitoring CPT codes, best practices for billing and documentation and answers your frequently asked questions. Click the button below to download your free copy of the guide.

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The information provided here about the Remote Therapeutic Monitoring CPT Codes is for informational purposes only and does not constitute billing or legal advice.

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