Complete Guide to RTM Billing and CPT Codes for 2025

Remote Therapeutic Monitoring uses five primary CPT codes that healthcare providers can bill in 2025. Each code serves a specific function in the RTM billing process and has distinct requirements.

Current RTM CPT Codes for 2025 - What Each Code Covers

RTM CPT Code 98975: Device Setup and Patient Education

What it covers: Initial setup and patient education for RTM device(s) and software
Requirements: First-time device configuration, patient training, consent documentation
Billing frequency: Once per device per patient (one-time setup)
Average reimbursement: $19.46 (Medicare non-facility rate)
Who can bill: Physician or qualified healthcare professional (PT, OT, SLP under scope of practice)

RTM CPT Code 98976: Respiratory System Monitoring (Device Supply)

What it covers: Supply of device for 30 days of respiratory system monitoring data collection
Requirements: 16 days of data collection within 30-day period minimum
Data types: Peak flow, spirometry readings, inhaler usage, breathing exercises
Average reimbursement: $55.63 (Medicare non-facility rate)
Medical necessity: Must document respiratory condition requiring monitoring

RTM CPT Code 98977: Musculoskeletal System Monitoring (Device Supply)

What it covers: Supply of device for 30 days of musculoskeletal system monitoring data collection
Requirements: 16 days of data collection within 30-day period minimum
Data types: Range of motion, exercise adherence, pain scores, functional assessments
Average reimbursement: $55.63 (Medicare non-facility rate)
Medical necessity: Must document musculoskeletal condition requiring therapeutic monitoring

RTM CPT Code 98980: Treatment Management Services (First 20 Minutes)

What it covers: First 20 minutes of RTM treatment management services per calendar month
Requirements: Interactive communication with patient/caregiver during the month
Activities included: Data review, care plan adjustments, patient consultation, clinical management
Average reimbursement: $49.78 (Medicare non-facility rate)
Documentation: Must log time distribution and clinical activities

RTM CPT Code 98981: Additional Treatment Management (Each Additional 20 Minutes)

What it covers: Each additional 20 minutes beyond the first 20 minutes (98980)
Requirements: Same as 98980, billed for extended monitoring time
Maximum billing: No monthly limit established by CMS
Average reimbursement: $39.14 (Medicare non-facility rate)
Documentation: Detailed time logs required for each 20-minute increment

RTM vs RPM: Key Billing Differences You Must Know

Provider Eligibility: Who Can Bill RTM Codes?

Qualified Healthcare Professionals for RTM Billing:

Physicians (MDs, DOs) - All RTM codes
Physical Therapists (PTs) - All RTM codes within scope of practice
Occupational Therapists (OTs) - All RTM codes within scope of practice
Speech-Language Pathologists (SLPs) - All RTM codes within scope of practice
Nurse Practitioners (NPs) - All RTM codes
Physician Assistants (PAs) - All RTM codes
Clinical Social Workers - RTM codes within scope of practice

Important Billing Limitations:

One practitioner rule: Only one practitioner can bill RTM codes per patient per 30-day period
Supervision requirements: Therapy assistants must work under general supervision (effective January 2024)
Scope of practice: All services must align with state and professional scope of practice laws
Personal furnishing: RTM services must be personally furnished by the billing practitioner

Required Documentation for RTM Billing Success

Medical Necessity Documentation Checklist:

Initial evaluation documenting condition requiring RTM
Treatment plan specifying therapeutic goals and monitoring parameters
Medical condition documentation (musculoskeletal, respiratory, or CBT-appropriate condition)
Clinical rationale for remote monitoring vs. traditional care
Expected outcomes and monitoring frequency justification

Patient Consent Requirements:

Informed consent for RTM services (written documentation required)
Technology consent for data collection and transmission
Privacy acknowledgment for HIPAA-compliant data handling
Communication preferences (how patient wants to be contacted)
Consent timing - obtained before or at time of service initiation

Device Setup Documentation (98975):

Device type and FDA medical device classification
Patient education provided (specific training topics)
Setup completion date and verification of device functionality
Patient demonstration of proper device use
Troubleshooting guidance provided to patient

Treatment Management Documentation (98980/98981):

Time logs with start/stop times for each clinical activity
Data review notes analyzing patient-submitted information
Interactive communication records (date, duration, content)
Clinical decision-making based on RTM data
Care plan modifications resulting from monitoring insights

Codes Requiring 16 Days of Data:

98976 (Respiratory device supply) - 16 days required
98977 (Musculoskeletal device supply) - 16 days required

Codes NOT Requiring 16 Days of Data:

98975 (Device setup) - No data requirement
98980 (First 20 minutes treatment) - No data requirement
98981 (Additional 20 minutes treatment) - No data requirement

2026 Changes Coming

The AMA CPT Editorial Panel approved new codes effective January 2026 that will include a device code covering 2 to 15 days of data transmission, expanding from the 16 days currently required. This will provide more flexibility for short-term monitoring scenarios.

Data Collection Best Practices:

Track data collection dates meticulously
Document data gaps and patient communication about missing days
Use automated systems to monitor compliance with 16-day requirement
Maintain audit trail of all data transmission records