How To Use CPT Code 98975

CPT 98975 describes the initial setup and patient education for remote therapeutic monitoring (RTM) by a healthcare provider. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 98975?

CPT 98975 can be used to describe the initial setup of equipment for remote therapeutic monitoring (RTM) and the education provided to the patient on how to use the equipment. This code is used when a healthcare provider performs the setup and educates the patient on the proper use of the device used for therapeutic data collection. RTM can include monitoring respiratory system status, musculoskeletal system status, cognitive behavioral therapy, therapy adherence, and therapy response.

2. Official Description

The official description of CPT code 98975 is: ‘Remote therapeutic monitoring (eg, therapy adherence, therapy response); initial set-up and patient education on use of equipment.’

3. Procedure

1. A physician or other qualified healthcare professional orders the remote therapeutic monitoring (RTM) service.
2. A healthcare provider performs the initial setup of the equipment used for RTM.
3. The healthcare provider educates the patient on the proper use of the device used for therapeutic data collection.
4. The device must be a medical device as defined by the Food and Drug Administration (FDA).
5. RTM can include monitoring respiratory system status, musculoskeletal system status, cognitive behavioral therapy, therapy adherence, and therapy response.
6. Report CPT 98975 once per episode of care, which begins when the RTM is initiated and ends when targeted treatment goals are achieved.

4. Qualifying circumstances

Patients eligible to receive CPT 98975 services are those who require remote therapeutic monitoring (RTM) for therapy adherence and therapy response. The healthcare provider must perform the initial setup of the equipment used for RTM and educate the patient on its proper use. The device used for therapeutic data collection must be a medical device as defined by the FDA.

5. When to use CPT code 98975

CPT code 98975 should be used when a healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates the patient on its use. This code should be reported once per episode of care, which begins when the RTM is initiated and ends when targeted treatment goals are achieved.

6. Documentation requirements

To support a claim for CPT 98975, the healthcare provider must document the following information:

• Order for remote therapeutic monitoring (RTM) from a physician or other qualified healthcare professional
• Details of the initial setup of the equipment used for RTM
• Evidence of patient education on the proper use of the device used for therapeutic data collection
• Start and end dates of the episode of care
• Targeted treatment goals and progress made by the patient
• Review and monitoring of data about signs, symptoms, and functions of the patient’s response to therapy

7. Billing guidelines

When billing for CPT 98975, ensure that the healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates the patient on its use. Report this code once per episode of care. Do not report CPT 98975 for monitoring of less than 16 days. Consider using CPT codes 98980 and 98981 for RTM treatment management. Review the specific guidelines for reporting RTM codes to ensure accurate billing.

8. Historical information

CPT 98975 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition. However, on January 1, 2023, the code description was expanded to include monitoring of respiratory system status, musculoskeletal system status, therapy adherence, and therapy response.

9. Examples

1. A healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates a patient with asthma on how to monitor their respiratory system status and therapy adherence.
2. A physician instructs a healthcare provider to perform the initial setup of equipment for remote therapeutic monitoring (RTM) and educate a patient with a musculoskeletal disorder on how to monitor their musculoskeletal system status and therapy response.
3. A healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates a patient undergoing cognitive behavioral therapy on how to monitor their therapy adherence and therapy response.
4. A physician orders a healthcare provider to perform the initial setup of equipment for remote therapeutic monitoring (RTM) and educate a patient on how to monitor their therapy adherence and therapy response to a specific medication.
5. A healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates a patient on how to monitor their therapy adherence and therapy response to a cognitive behavioral therapy program.
6. A physician instructs a healthcare provider to perform the initial setup of equipment for remote therapeutic monitoring (RTM) and educate a patient on how to monitor their therapy adherence and therapy response to a specific treatment plan.
7. A healthcare provider performs the initial setup of equipment for remote therapeutic monitoring (RTM) and educates a patient on how to monitor their therapy adherence and therapy response to a cognitive behavioral therapy program.