How To Use CPT Code 98980

CPT 98980 describes the remote therapeutic monitoring treatment management services provided by a physician or other qualified healthcare professional. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 98980?

CPT 98980 can be used to describe the treatment management services for remote therapeutic monitoring provided by a physician or other qualified healthcare professional. This code is used when the provider spends at least 20 minutes in a calendar month, including at least one interactive communication with the patient or caregiver, to review and monitor data about the patient’s response to therapy and manage their treatment plan.

2. Official Description

The official description of CPT code 98980 is: ‘Remote therapeutic monitoring treatment management services, physician or other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient or caregiver during the calendar month; first 20 minutes.’

3. Procedure

1. The physician or other qualified healthcare professional orders remote therapeutic monitoring (RTM) for the patient, using one or more FDA-approved medical devices for data collection.
2. The provider spends at least 20 minutes in a calendar month reviewing and monitoring the patient’s data, including signs, symptoms, and functions related to the therapy.
3. At least one interactive communication with the patient or caregiver is conducted during the calendar month to discuss the patient’s status and treatment plan.
4. The provider uses the results of the RTM to manage the patient’s treatment plan and make any necessary adjustments.

4. Qualifying circumstances

Patients eligible to receive CPT 98980 services are those who require remote therapeutic monitoring for conditions such as respiratory system status, musculoskeletal system status, or therapy adherence and response. The physician or other qualified healthcare professional must spend at least 20 minutes in a calendar month, including at least one interactive communication with the patient or caregiver, to review and monitor the patient’s data and manage their treatment plan.

5. When to use CPT code 98980

CPT code 98980 should be used when a physician or other qualified healthcare professional spends at least 20 minutes in a calendar month, including at least one interactive communication with the patient or caregiver, to review and monitor the patient’s data and manage their treatment plan. This code should be reported once every 30 days, regardless of the number of therapeutic parameters monitored. It should not be reported for services of less than 20 minutes or in conjunction with certain other codes.

6. Documentation requirements

To support a claim for CPT 98980, the physician or other qualified healthcare professional must document the following information:

• Order for remote therapeutic monitoring
• Date and duration of the 20-minute session
• Details of the interactive communication with the patient or caregiver
• Review and monitoring of the patient’s data, including signs, symptoms, and functions related to the therapy
• Management of the patient’s treatment plan based on the results of the remote therapeutic monitoring

7. Billing guidelines

When billing for CPT 98980, ensure that the service is provided by a physician or other qualified healthcare professional and meets the requirements of at least 20 minutes of provider time in a calendar month, including at least one interactive communication with the patient or caregiver. Do not report CPT 98980 in conjunction with certain other codes or in the same calendar month as specific codes. Additional tips for reporting CPT 98980 may include checking for separate codes for initial setup and device supply.

8. Historical information

CPT 98980 was added to the Current Procedural Terminology system on January 1, 2022. There have been no updates to the code since its addition.

9. Examples

1. A physician spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s respiratory system status through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
2. A qualified healthcare professional spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s musculoskeletal system status through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
3. A physician spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s therapy adherence and response through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
4. A qualified healthcare professional spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s respiratory system status, musculoskeletal system status, or therapy adherence and response through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
5. A physician spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s therapy adherence and response through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
6. A qualified healthcare professional spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s respiratory system status through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.
7. A physician spending at least 20 minutes in a calendar month reviewing and monitoring a patient’s musculoskeletal system status through remote therapeutic monitoring and conducting an interactive communication with the patient or caregiver to manage their treatment plan.