Exploring CPT Code 98981: Additional 20 Minutes of Remote Monitoring

Remote Therapeutic Monitoring (RTM) for Managing Musculoskeletal (MSK) Conditions

Remote Therapeutic Monitoring (RTM) is a simple, app-based solution designed to help healthcare providers manage musculoskeletal (MSK) conditions. With RTM apps, providers can track patient progress, encourage adherence to home exercise programs (HEPs), and provide personalized care between in-person visits. Patients can log their exercises, pain levels, and other important data, which is then shared with providers in real time. This allows healthcare providers to offer continuous support and make adjustments to care plans as needed, even when they aren’t meeting the patient in person.

Key RTM CPT Codes for MSK Care

There are six CPT codes related to RTM, divided into service and treatment management categories. Four of these codes are particularly relevant to MSK care:

• CPT Code 98975: RTM App Setup and Patient Education
• CPT Code 98977: RTM App Supply for Monitoring Patient Condition
• CPT Code 98980: Initial 20 Minutes of Monitoring and Treatment Management
• CPT Code 98981: Additional 20 Minutes of Monitoring and Treatment Management

What Does CPT Code 98981 Cover?

CPT Code 98981 covers an additional 20 minutes of RTM treatment management services provided during a calendar month. This includes:

• Monitoring patient progress
• Reviewing key metrics, such as pain levels and exercise compliance
• Conducting interactive communication (e.g., phone call or video call) with the patient or caregiver

Providers can bill CPT Code 98981 when they exceed the initial 20 minutes covered by CPT Code 98980 and provide an additional 20 minutes of treatment management.

Who Can Bill CPT Code 98981?

CPT Code 98981 can be billed by the following healthcare professionals:

• Physicians
• Physical Therapists
• Occupational Therapists
• Other qualified healthcare providers involved in RTM services

Billing Frequency for CPT Code 98981

CPT Code 98981 is billed in 20-minute increments. Providers can bill this code multiple times within a calendar month as long as each additional 20-minute increment of RTM management services is provided.

Real-World Example

Let’s look at a real-world example: A physical therapist uses an RTM app to track a patient's recovery after knee surgery. Over the course of the month, the therapist spends:

• 15 minutes reviewing the patient’s logged exercises and pain data
• 5 minutes on a follow-up phone call with the patient, reviewing progress and updating the home exercise program

Since this additional 20 minutes of treatment management happens over the month, the therapist can bill CPT Code 98981.

Documentation Requirements for CPT Code 98981

To properly bill CPT Code 98981, providers must document the following:

• Time spent: Ensure at least 20 minutes of additional RTM management services are provided during the calendar month.
• Interactive communication: Record the date, time, and method of patient interaction (e.g., phone or video call).
• Services provided: Document the data reviewed, decisions made based on the data and any changes to the treatment plan.

Accurate documentation is crucial to comply with billing guidelines and avoid potential audits.

Need Help with RTM CPT Codes?

Navigating RTM billing and compliance can be tricky, but PhyxUp Health makes it easy. Our intuitive RTM app helps providers deliver high-quality care while simplifying billing and ensuring compliance. With features like real-time progress tracking, interactive communication tools, and automated documentation, we make managing RTM easier than ever. PhyxUp Health lets you focus on patient care while streamlining the billing process.

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