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The CPT® Code 98980 refers to remote therapeutic monitoring treatment management services provided by a physician or other qualified healthcare professional. This service is specifically designed for managing a patient's musculoskeletal or respiratory system status through the use of a remote therapeutic monitoring (RTM) device. The primary objective of this service is to track the patient's adherence to prescribed therapy and evaluate their treatment response over the course of a calendar month. To qualify for this code, the healthcare professional must engage in at least one interactive communication with the patient or caregiver during that month. This interaction is crucial as it allows for real-time feedback and adjustments to the treatment plan based on the patient's progress and experiences. The initial 20 minutes of time spent on these management services is reported using CPT® Code 98980, while additional time can be reported with CPT® Code 98981 for each subsequent 20 minutes. This structured approach to remote monitoring not only enhances patient engagement but also facilitates timely interventions, ultimately aiming to improve patient outcomes.
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The remote therapeutic monitoring treatment management services represented by CPT® Code 98980 are indicated for patients who require ongoing assessment and management of their musculoskeletal or respiratory conditions. These services are particularly beneficial for:
The procedure for remote therapeutic monitoring treatment management services involves several key steps that ensure effective patient management and monitoring. These steps include:
Post-procedure care following the remote therapeutic monitoring treatment management services involves continued engagement between the patient and the healthcare provider. The therapist will monitor the patient's daily progress through the RTM device, ensuring that the patient adheres to the prescribed exercises and therapy regimen. Regular virtual check-ins allow for discussions about the patient's recovery, including any challenges they may face and adjustments that may be needed in their treatment plan. The goal is to support the patient in achieving their therapeutic objectives while providing timely interventions as necessary. This structured follow-up is essential for optimizing recovery outcomes and enhancing the overall effectiveness of the therapeutic regimen.
| Short Descr | REM THER MNTR 1ST 20 MIN | Medium Descr | REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN | Long Descr | Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; first 20 minutes | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Code Not Recognized by OPPS when submitted on Outpatient Hospital Part B Bill Type (12x/13x) | Berenson-Eggers TOS (BETOS) | none | MUE | 1 |
This is a primary code that can be used with these additional add-on codes.
| 98981 | Add-on Code MPFS Status: Active Code APC B Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure) |
| GP | Services delivered under an outpatient physical therapy plan of care | CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant | KX | Requirements specified in the medical policy have been met | GO | Services delivered under an outpatient occupational therapy plan of care | GW | Service not related to the hospice patient's terminal condition | GA | Waiver of liability statement issued as required by payer policy, individual case | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GN | Services delivered under an outpatient speech language pathology plan of care | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) | CG | Policy criteria applied | CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant | GT | Via interactive audio and video telecommunication systems | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | KK | Dmepos item subject to dmepos competitive bidding program number 2 | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2022-01-01 | Added | Code added |
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