Remote Therapeutic Monitoring (RTM) helps providers track a patient’s treatment between office visits. It also helps improve patient care without frequent appointments.
The demand for remote patient care is getting popular in the United States. Between 2019 and 2023, Medicare paid for more than 13.5 million remote monitoring services, totaling over $664 million in reimbursements.
To receive payment, providers must use the correct billing code and follow payer rules. CPT code 98980 is used for the first 20 minutes of treatment management during one calendar month. This guide explains the code, billing rules, documentation, and reimbursement in simple English.
2026 UPDATE: CPT 98980 remains an active RTM treatment-management code. Effective January 1, 2026, CPT 98979 was added for qualifying treatment management requiring at least 10 minutes during a calendar month. CMS also introduced new respiratory and musculoskeletal device-supply codes, 98984 and 98985.
98980 CPT Code Description
The 98980 CPT code description covers the first 20 minutes of RTM treatment management services. The provider reviews the patient’s health data and communicates with the patient or caregiver. This discussion can be by phone or video call. The provider uses the collected information to support the patient’s treatment.
The 98980 cpt code description requires qualifying treatment-management services during the calendar month. Providers must document at least 20 minutes of eligible time and at least one real-time interactive communication with the patient or caregiver. The required communication does not mean all 20 minutes must be spent talking.
Who Can Bill CPT 98980?
Many healthcare providers can bill CPT 98980 when they meet payer rules. They must also follow state laws and billing requirements. The provider should be qualified to deliver RTM treatment management services.
Physicians
Physicians can bill this code after meeting all billing requirements. They must provide and document the required treatment management services.
Nurse Practitioners
Nurse Practitioners can also bill CPT 98980. They must follow payer rules and complete all required documentation.
Physician Assistants
Physician Assistants may bill this code when allowed. They should meet all state and payer requirements before billing.
Physical Therapists
Physical Therapists can report this code for eligible RTM services. They must provide qualified treatment management during the month.
Occupational Therapists
Occupational Therapists may also bill this service when allowed. They should keep complete and accurate patient records.
Speech-Language Pathologists
Speech-Language Pathologists can bill CPT 98980 for eligible patients. They must meet all billing and documentation requirements.
Follow State and Payer Rules
Not every provider can bill this code in every situation. State laws and insurance rules may be different. Providers should check these rules before submitting claims. Following the correct requirements helps prevent claim denials and payment delays.
Provider eligibility depends on the applicable payer, professional qualifications, state laws, and enrollment requirements. The 2026 CMS therapy code list identifies certain RTM services as therapy services. Therapists must follow applicable therapy-plan and modifier rules.
Billing Requirements for CPT Code 98980
Providers must meet all billing rules before using CPT code 98980, to get faster payments and avoid claim denials.
Use an RTM Device
The patient must use an approved RTM device. It collects treatment data every day. This data helps the provider check the patient’s progress. The provider should use an approved device only.
Providers should verify that the technology meets applicable medical-device requirements. A general wellness application does not automatically qualify for RTM billing. The device-supply code may also depend on the body system and number of monitoring days.
Spend 20 Minutes
The provider must spend at least 20 minutes each month. This time is for managing the patient’s treatment. All time should be recorded correctly. Guessing the time is not allowed.
The cpt 98980 requirements include at least 20 minutes of qualifying treatment-management time in one calendar month. CPT 98979 may apply when eligible management time reaches at least 10 minutes but remains below 20 minutes. Providers should confirm the correct code before submitting a claim.
Review Patient Data
Healthcare experts must review the patient’s treatment data. This data shows how the patient is doing. The provider should use this information during treatment. Every review should be recorded.
Documentation should connect the reviewed information with patient management. Providers should record relevant findings, clinical decisions, follow-up actions, and treatment changes when applicable.
Talk With the Patient
Coordinate with the patient or caregiver. This talk must happen during the same month. A phone call or video call is accepted. Text messages alone are not enough.
At least one qualifying real-time interactive communication must occur during the calendar month. Record the date, participants, and relevant discussion. Asynchronous messages alone do not replace the required interaction.
Keep Good Records
The provider should keep clear and complete records. Write the total time spent with the patient. Record every phone or video call. Also write any treatment changes made. Good records help support the claim.
Check Insurance Rules
Every insurance company may have different billing rules. Providers should check those rules before billing. This helps avoid billing mistakes. It also improves the chance of getting paid.
Medicare and commercial insurers may apply different coverage and documentation requirements. Check current CMS guidance, Medicare contractor instructions, and the patient’s insurance policy before submitting a claim.
CPT 98980 Reimbursement Factors
CPT 98980 reimbursement depends on several billing factors. The allowed amount can vary between Medicare and commercial payers. Provider contracts can also affect the final reimbursement amount.
The reported service must meet applicable coding requirements. Documentation should support the reported RTM treatment-management service. Missing documentation can create claim review problems.
Providers should also verify current payer policies. Some plans may apply additional coverage requirements. State rules can also affect which providers may furnish services.
Billing teams should avoid using outdated reimbursement information. Fee schedules can change between calendar years. Current payer sources provide the most reliable reimbursement information.
For 2026, verify the applicable Medicare Physician Fee Schedule before quoting a rate. The amount may vary by locality, service setting, and applicable payment rules. Commercial insurance contracts may use different rates.
When checking 98980 reimbursement, confirm the fee-schedule year and the applicable locality. Do not treat an unofficial national estimate as a guaranteed reimbursement amount.
Common CPT 98980 Denial Reasons
Incomplete documentation can create problems with 98980 claims. Missing interactive communication is another common issue. Providers must document qualifying communication during the month.
Insufficient treatment-management time can also affect claims. The provider must complete the required 20-minute threshold. Partial time does not support reporting 98980.
Another issue involves incorrect device requirements. The technology must support the applicable RTM service. Providers should confirm device eligibility before starting billing.
Duplicate time reporting can also create billing problems. RTM minutes should not overlap with other billed services. Separate records can help prevent accidental double counting.
Finally, incorrect code selection can cause claim denials. Billing teams should review 98980 and 98981 carefully. Current payer guidance should guide final claim submission.
CPT 98981 is an add-on code for each additional qualifying 20 minutes of RTM treatment management. CPT 98979 applies to qualifying shorter-duration management services. Providers should review current code-pair restrictions before billing related services in the same month.
98980 Billing Checklist for Providers
A simple checklist can help providers review every 98980 claim. First, confirm that RTM is medically necessary. Next, verify the patient’s treatment and monitoring plan.
Confirm that the device meets applicable requirements. Review the total treatment-management time for the month. Then confirm at least one interactive communication occurred.
Check the provider’s eligibility before submitting the claim. Review payer-specific billing and coverage requirements. Make sure documentation supports the reported service.
Finally, check for overlapping time with other services. Remove any time already reported under another code. This final review can reduce avoidable billing errors.
Using a consistent checklist helps billing teams stay organized. It also makes internal claim audits easier to complete.
Before submitting a claim, confirm the monthly time threshold, qualifying communication, device eligibility, provider qualifications, complete documentation, and payer coverage rules. Check applicable modifiers and remove duplicate time.
CPT Code 98980 Billing Guidelines
Following 98980 billing guidelines helps providers submit correct claims. It also lowers the risk of claim denials and payment delays.
Complete the Required Time
Bill the service after completing 20 minutes. Count the time during one calendar month. Do not bill before reaching the required time. Keep accurate time records for every patient.
Count the Right Time
Count only time spent managing the patient’s treatment. Do not count unrelated work or office tasks. Include only services allowed under billing rules.
Record Monthly Time
Write the total time for the month. Keep clear records for every patient visit. Make sure the recorded time is correct. Missing time may cause claim problems.
Document Every Communication
Record every phone or video call. Write the date of each conversation. Include the topics discussed with the patient. Keep these records in the patient’s file.
Avoid Incorrect Billing
Do not bill services that cannot be billed together. Check payer rules before submitting the claim. Using the wrong codes may delay payment. Correct coding helps prevent billing errors.
Review Before Submission
Review the claim before sending it. Check all records for missing information. Make sure every billing rule is met. Good documentation supports every claim.
For applicable Medicare therapy services, GP, GO, or GN modifiers may be required depending on the therapy discipline and plan of care. CQ or CO may apply under the relevant assistant-service rules.
Final Thoughts
Understanding CPT code 98980 helps providers bill RTM services correctly. Following documentation rules and billing requirements can reduce claim denials and improve reimbursement. Regular claim reviews also help keep billing accurate.
Mediremote helps healthcare providers manage medical billing, improve claim accuracy, and receive faster reimbursements so they can focus more on patient care.
Providers should review the 2026 RTM code changes, current fee schedules, and applicable payer policies before submitting claims. Accurate time records, qualifying patient communication, and complete clinical documentation help support compliant billing and reimbursement.
FAQs
What is CPT code 98980 used for?
It is used for the first 20 minutes of RTM treatment management during one calendar month.
Does CPT 98980 require patient communication?
Yes. The provider must have live communication with the patient or caregiver.
Who can bill CPT 98980?
Qualified physicians and other approved healthcare providers can bill this code.
How does 98980 reimbursement work?
Payment depends on Medicare, insurance rules, provider contracts, and service location.
What documentation is needed for CPT 98980?
Records should include treatment time, patient communication, reviewed data, and provider notes.
What are the main 98980 billing guidelines?
Providers must complete 20 minutes, document the service, and communicate with the patient before billing.
