98979 CPT Code indicates remote therapeutic monitoring services given to the patient. The time limit ranges between 10-19 minutes, spent by a physician or an expert healthcare professional. In the 2026 Physician Fee Schedule, CMS added 98979 as a “sometimes therapy” RTM code for eligible therapy services. This reflects Medicare’s continued expansion of Remote Therapeutic Monitoring
In simple words, providers can now accurately record rtm management minutes each month. The shorter time treatment encourages scalable digital healthcare models and streamline the reimbursements.
98979 cpt code Overview
98979 CPT Code is a part of the RTM Codes family and covers tracking non-physiologic information. It includes therapy adherence, symptoms and the current health status of the patient. Moreover, this code is used in various settings such as behavioural therapy, occupational therapy and physical therapy.
Before that 98980 code was used to bill at least 20 minutes spent with patients in a calendar month. Which was causing a limitation in RTM reimbursements. Healthcare experts regularly check patient data, and prepare a care plan, the work gets unreimbursed if the time spent was 19 minutes.
98979 RTM Billing Requirements
Understanding the 98979 CPT Code billing requirements are crucial to get timely reimbursement. Even a slight mistake can lead to denials and revenue loss.
Time and Communication: Every provider should spend at least 10-19 minutes with patients during a 30-day period. As per the CMS. a live interaction such as phone call or video call between provider and patient or caregiver is a must. However, emails, sms or chats do not qualify for this code as per the rules.
Healthcare providers can only bill this code once a month. In case the patient care time increases beyond the given range, code 98980 will be assigned.
Documentations: Physicians must clearly include all the elements of remote therapeutic monitoring when documenting the information.
- It includes complete RTM data such as the patient`s therapy routine and current health status.
- Time, date and the medium of communication such as phone call or a video call.
- Any update such as change in patient health, care plan, new suggested treatments like walk, exercise or therapy.
- Total time a provider spent on offering remote therapeutic management services to the patient.
- Patient consent regarding the RTM services, every episode of care should be recorded.
RTM Management Minutes
To bill 98979 CPT Code, providers must complete at least 10-19 management minutes each month. The time must support the patient’s treatment plan and documented RTM data. Activities may include reviewing therapy data, assessing patient progress, and updating care plans.
Providers may also contact patients to discuss results or treatment changes. Only qualified management work counts toward the monthly total. Administrative tasks and scheduling do not count as billable time.
Accurate time tracking helps support every billed service. Record the date, total minutes, and completed activities. Notes should explain why each action was medically necessary. Good documentation also reduces claim delays and audit risks.
Meeting these Remote therapeutic monitoring time requirements helps providers bill correctly. It also shows that patient care continued throughout the monitoring period. Clear records make reimbursement reviews easier and support compliance with payer guidelines.
98979 Reimbursement Rate
Average Medicare Reimbursement
The 98979 reimbursement rate depends on the current Medicare Physician Fee Schedule. Medicare updates the rates each year. Most providers receive reimbursement only after meeting all billing requirements.
These include completed management minutes, proper documentation, and correct claim submission. Missing any requirement may reduce payment or cause claim denial. Always verify the latest Medicare rates before submitting claims.
Factors That Affect Payment
Medicare applies local payment adjustments across different regions. Provider documentation also affects claim approval.
Records should clearly show completed management work and medical necessity. Incorrect coding or missing time logs may delay reimbursement. Payer rules and contract terms can also influence payment.
Commercial Payer Differences
Commercial insurance plans may not follow Medicare reimbursement policies. Some payers adopt Medicare guidelines with minor changes. Others create their own billing rules and payment schedules. Prior authorization may also be required for some plans.
Coverage policies, documentation standards, and reimbursement amounts often vary between insurers. Providers should review each payer’s policy before billing 98979 CPT Code.
Why Reimbursement Varies
No single reimbursement amount applies to every provider. Annual Medicare updates may change payment rates. Geographic adjustments also affect the final allowed amount. Commercial insurers negotiate different reimbursement contracts with healthcare organizations.
Claim accuracy plays an important role in successful payment. Complete documentation and accurate coding improve reimbursement outcomes. Following Remote therapeutic monitoring time requirements also supports compliant billing and reduces the risk of denied claims.
98979 VS 98980
| Feature | 98979 | 98980 |
| Purpose | Bills the first 10–19 minutes of RTM treatment management with required patient communication. | Bills the first 20 minutes of RTM treatment management with required patient communication. |
| Required time | 10–19 minutes per calendar month | First 20 minutes per calendar month |
| Service type | Remote Therapeutic Monitoring (RTM) treatment management | Remote Therapeutic Monitoring (RTM) treatment management |
| Billing frequency | Once per calendar month when requirements are met | Once per calendar month when requirements are met |
| Typical use | For shorter monthly management time that does not reach 20 minutes. | For standard monthly RTM management lasting at least 20 minutes. |
Although both codes are used for Remote Therapeutic Monitoring (RTM) treatment management. They apply to different monthly time thresholds. 98979 covers 10–19 minutes of eligible management time, while 98980 is used for the first 20 minutes.
Both codes require at least one interactive communication with the patient or caregiver. The table below highlights the key differences between these two RTM codes.
Time Log
Every 98979 CPT Code claim should include a complete monthly time log. Record the date, total minutes, and completed management activities. Only qualified RTM management work should appear in the record. Accurate logs support claim reviews and reduce billing errors.
Patient Communication
Documentation should include meaningful patient communication during the monitoring period. Record phone calls or other interactive discussions when required. Notes should explain the patient’s concerns and provider recommendations. Communication records help demonstrate active patient management and ongoing clinical involvement.
Clinical Decisions
Providers should document every important clinical decision made from RTM data. Notes should explain how monitoring results influenced patient care. Include findings that required further evaluation or follow-up. Clear clinical reasoning strengthens medical necessity and supports compliant billing.
Treatment Adjustments
Any treatment changes should appear in the patient’s medical record. Document medication updates, therapy modifications, or exercise plan changes. Explain why each adjustment was necessary. Link every change to the patient’s monitored therapeutic data whenever possible.
Medical Necessity
Medical necessity is essential for accurate 98979 CPT Code billing. Documentation should explain why RTM management was clinically appropriate. It should also connect monitoring data with ongoing treatment decisions.
Records should clearly show:
- The patient’s condition required continued RTM management.
- Monitoring results supported clinical decision-making.
- Treatment changes matched the patient’s current needs.
- Ongoing management improved patient care and treatment goals.
Complete documentation supports Remote therapeutic monitoring time requirements and stronger reimbursement claims. It also reduces denials, supports audits, and demonstrates compliant billing practices.
Conclusion
Accurate billing for 98979 CPT Code depends on proper documentation, correct time tracking, and payer compliance. Providers should record every billable management activity and meet all RTM requirements before submitting claims.
Staying updated with Medicare and commercial payer policies also helps reduce denials and improve reimbursement. A structured billing process saves time and supports better patient care.
MediRemote helps healthcare organizations simplify RTM billing with accurate coding, compliant documentation, reimbursement support, and experienced billing professionals who help maximize revenue while reducing administrative workload.
Frequently Asked Questions
Is 98979 billed every month?
Yes. 98979 CPT Code is typically billed once per calendar month. Providers must complete all required RTM management services and documentation before submitting the monthly claim.
Does 98979 require exactly 20 minutes?
Yes. Providers must complete at least 20 minutes of qualified RTM management activities. Less than 20 minutes does not meet the billing requirement.
Can 98979 and 98980 be billed together?
No. These CPT codes represent different RTM management services. Providers should bill the code that correctly matches the documented service and time requirements.
Does Medicare reimburse 98979?
Yes. Medicare generally reimburses 98979 CPT Code when billing requirements, documentation standards, and medical necessity are fully met according to current payer guidelines.
What documentation is required for 98979?
Documentation should include time logs, patient communication, clinical decisions, treatment changes, and medical necessity. Complete records help support compliant billing and reimbursement.
Who can bill 98979?
Qualified healthcare providers who meet payer requirements and deliver eligible RTM management services may bill 98979 CPT Code when all documentation requirements are satisfied.
