How to Bill CPT Code 98976 for Remote Respiratory Monitoring Devices

The expansion of remote therapeutic monitoring (RTM) is transforming patient care, particularly for individuals with chronic respiratory conditions. By enabling continuous monitoring and intervention, RTM helps providers track therapy adherence, device usage, and symptom progression beyond the clinical setting. CPT code 98976 plays a critical role in this model, reimbursing providers for the supply and maintenance of RTM devices specifically designed for respiratory monitoring.

For healthcare organizations implementing RTM for conditions such as asthma, COPD, and post-COVID-19 rehabilitation, understanding CPT 98976’s billing requirements, compliance standards, and best practices is essential. This guide explores how to effectively utilize this code to optimize patient outcomes while ensuring financial sustainability.

• CPT Code 98975: Reimbursement for RTM Device Setup & Patient Education

• CPT Code 98977: Maximizing Reimbursement for RTM Devices

• CPT Code 98980: RTM Treatment Management & Provider Guidelines

• CPT Code 98981: Extended RTM Treatment

What Is CPT Code 98976?

CPT code 98976 is used to bill for the provision and maintenance of remote therapeutic monitoring devices that support respiratory care. Unlike CPT 98977, which focuses on musculoskeletal monitoring, this code is specific to devices that track respiratory conditions.

Remote Therapeutic Monitoring: Your Guide to Successful Billing

Fill out the short form to unlock your free RTM Billing Guide PDF!

Unlock Resource

Thanks for signing up!

You can now download the
resource below.

Download

Key features of CPT 98976

• Covers the supply and maintenance of RTM devices used for respiratory monitoring.

• Applies to FDA-cleared devices that automatically collect and transmit patient data.

• Supports tracking of therapy adherence, inhaler usage, and respiratory function trends.

• Requires data transmission for at least 16 days within a 30-day period.

• Recognized for Medicare reimbursement when billed according to CMS guidelines.

This code ensures that patients have access to the necessary remote monitoring technology, allowing providers to adjust treatment plans in real-time based on respiratory therapy data.

Why CPT 98976 Is Essential for Respiratory Care

Chronic respiratory diseases such as asthma, COPD, and post-viral respiratory syndromes require consistent monitoring to prevent exacerbations and hospitalizations. Traditional care models often lack real-time insights, leading to delayed interventions.

By incorporating CPT 98976 into RTM programs, providers can:

• Monitor therapy adherence by tracking how often patients use prescribed inhalers or other devices.

• Identify early signs of worsening symptoms before they lead to emergency interventions.

• Improve patient education by providing real-time feedback on inhaler technique and respiratory therapy adherence.

• Support value-based care models by reducing avoidable hospital visits and improving long-term disease management.

With Medicare and private insurers increasingly recognizing the role of RTM, CPT 98976 provides a structured reimbursement pathway for providers integrating digital health solutions into respiratory care.

Billing and Reimbursement for CPT Code 98976

To successfully bill for CPT 98976, healthcare providers must ensure they meet the following conditions:

• The patient must be enrolled in an RTM program for a respiratory condition.

• The device must be FDA-cleared and specifically designed for remote respiratory monitoring.

• The device must automatically collect and transmit data (e.g., inhaler usage patterns, lung function trends).

• Data must be collected and transmitted for at least 16 days within a 30-day billing cycle.

• The device must be used for ongoing patient management rather than a one-time assessment.

Initially, CMS prohibited physical therapists from billing RTM codes, stating they were “incident to” services. However, following advocacy from the American Physical Therapy Association (APTA), CMS revised the 2022 Medicare Physician Fee Schedule, officially allowing PTs to bill for these services.¹

Medicare reimbursement and payment rates

As of 2024, Medicare reimburses approximately $50–$55 for CPT 98976. However, payment rates may vary by region, depending on Medicare Administrative Contractors (MACs) and private payer policies.

To maximize reimbursement potential, providers should:

• Regularly check CMS Fee Schedules for updates on payment rates.

• Confirm coverage with private insurers to identify additional reimbursement opportunities.

• Maintain accurate documentation to support billing claims and avoid denials.

Challenges in Implementing CPT 98976 for Respiratory Monitoring

While CPT 98976 provides a reimbursement pathway for respiratory RTM, providers face several obstacles when integrating these programs into patient care workflows.

1. Ensuring patient adherence to RTM devices

• Many patients forget to use their monitoring devices consistently, leading to gaps in transmitted data. 

• Providers must implement reminder systems and automated alerts to encourage consistent device usage.

• Educating patients on how real-time data improves their treatment can increase engagement.

2. Managing compliance and documentation standards

• Medicare requires detailed documentation of device distribution, data transmission records, and ongoing patient monitoring.

• Incomplete documentation can lead to claim rejections and financial losses.

• Providers should establish automated tracking systems to ensure compliance.

3. Navigating reimbursement variability across payers

• Not all private insurers reimburse for CPT 98976, requiring individual contract reviews.

• Providers should stay informed on payer policies and advocate for expanded RTM coverage.

• Aligning respiratory RTM with chronic care management (CCM) initiatives can improve payer acceptance.

Best Practices for Implementing CPT 98976 in RTM Workflows

To successfully integrate CPT 98976 into respiratory care models, providers should adopt structured implementation strategies that support patient engagement, compliance, and reimbursement optimization.

1. Select the proper RTM devices for respiratory monitoring

• Ensure devices are FDA-cleared and capable of automated data transmission.

• Choose platforms that track therapy adherence, lung function, and inhaler technique.

• Verify that devices are compatible with existing EHR and billing systems.

2. Improve patient adherence to monitoring requirements

• Implement patient education sessions to reinforce consistent device usage.

• Use automated text or app-based reminders to encourage daily tracking.

• Provide real-time feedback based on device-reported data to keep patients engaged.

3. Maintain comprehensive documentation for compliance

• Record device distribution, patient education, and data transmission logs.

• Standardize billing documentation workflows to reduce administrative errors.

• Ensure all records meet CMS and private payer compliance standards.

4. Stay updated on Medicare and private payer policies

• Monitor CMS updates and MAC-specific fee schedules for changes in reimbursement.

• Verify private insurance policies to explore additional RTM coverage options.

• Work with billing experts to ensure claims align with evolving regulatory requirements.

5. Align RTM with broader chronic disease management strategies

• Integrate respiratory RTM with asthma and COPD care plans to enhance disease management.

• Utilize predictive analytics to identify high-risk patients needing early intervention.

• Expand RTM adoption within telehealth and hybrid care models for comprehensive patient oversight, as these tools support seamless provider collaboration, reduce medical errors, and enhance overall care coordination.²

Case Example: Remote Monitoring for COPD Management

A respiratory therapist is working with a 68-year-old patient diagnosed with chronic obstructive pulmonary disease (COPD). The patient has a history of exacerbations and frequent hospitalizations due to inconsistent inhaler use and difficulty recognizing early signs of respiratory decline.

To enhance disease management, the therapist prescribes an FDA-approved, Bluetooth-enabled spirometer that automatically records lung function and tracks inhaler adherence. The device syncs with a remote therapeutic monitoring (RTM) platform, allowing the care team to monitor real-time data and intervene when necessary.

The therapist provides the device to the patient and ensures it is properly calibrated and connected to the RTM system. They educate the patient on how to use the spirometer correctly, sync data with their mobile app, and interpret key readings such as peak expiratory flow rate (PEFR). The patient is also guided through automated inhaler tracking, which records usage patterns and alerts both the patient and provider to missed doses. Before concluding the session, the therapist confirms that the patient can operate the device independently.

Over the next 16 days, the spirometer transmits daily lung function data to the RTM platform. The therapist reviews the reports and notices a gradual decline in PEFR, indicating potential airway obstruction. Additionally, data logs reveal inconsistent inhaler use. Concerned about an impending exacerbation, the therapist contacts the patient to discuss symptoms, reinforce inhaler adherence, and recommend adjusting their medication schedule.

After implementing these changes, follow-up monitoring shows improved inhaler compliance and stabilized lung function. With continued RTM support, the therapist ensures that the patient remains engaged in their treatment plan, reducing the risk of emergency interventions and hospital admissions.

Reporting and billing

• Bill one unit of CPT 98976 for the supply and maintenance of the RTM device used for respiratory monitoring.

• Bill only after the device has been used for at least 16 days within a 30-day period, per CMS guidelines.

Leveraging CPT 98976 for Smarter Respiratory Care

As digital health continues to reshape patient care, CPT 98976 provides an essential reimbursement mechanism for respiratory-focused RTM programs.

To maximize the benefits of CPT 98976, healthcare providers should:

• Select appropriate RTM devices that support automated respiratory monitoring.

• Encourage patient adherence through education and automated engagement tools.

• Maintain accurate documentation to ensure billing compliance and claim success.

• Stay informed on payer policies to expand RTM reimbursement opportunities.

With Medbridge Pathways, you can enable RTM for patients and automatically collect patient engagement data as they progress. Pathways has been built from the ground up to support highly engaging and effective digital care, and we are continuously optimizing and experimenting in Pathways to drive higher engagement in those first 30 days.

Pathways also provides a hub for providers to monitor patient progress, get feedback, and document their interactions. Providers can also interact with patients in Pathways via messaging in between visits, which they can use to check on patients status, respond to feedback, and more.

With Pathways, you get a digitally engaging platform for hybrid care that provides a single place to track RTM codes and then easily document it over to the EMR.

Disclaimer: The information contained in this document does not, and is not intended to, constitute legal, billing, or regulatory advice or guidance. All information, content, and material is for general information purposes and independent review and/or counsel should be obtained before making any legal or billing decisions.

References

1. American Physical Therapy Association. (2023, March 8). APTA practice advisory: Remote therapeutic monitoring codes under Medicare. https://www.apta.org/contentassets/95321a10e951408db650e2f19b96699f/apta-practice-advisory-rtm-codes032023.pdf

2. Fitzpatrick P. J. (2023). Improving health literacy using the power of digital communications to achieve better health outcomes for patients and practitioners. Frontiers in digital health, 5, 1264780. https://doi.org/10.3389/fdgth.2023.1264780