How to Use CPT Code 98981 for Extended RTM Treatment

As remote therapeutic monitoring (RTM) becomes a critical tool in modern healthcare, providers are leveraging digital solutions to track therapy adherence, assess treatment response, and improve patient outcomes. CPT code 98981 is essential for providers managing RTM programs, as it allows for additional time spent on ongoing patient engagement and data-driven care modifications.

For healthcare organizations integrating RTM for musculoskeletal, respiratory, or chronic condition management, understanding CPT 98981’s billing requirements, compliance considerations, and best practices is key to maximizing both patient benefits and financial sustainability. This guide explores how to effectively bill CPT 98981, optimize care delivery, and ensure compliance with Medicare and private payer guidelines.

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

• CPT Code 98976: Remote Respiratory Monitoring Devices

• CPT Code 98977: Maximizing Reimbursement for RTM Devices

• CPT Code 98980: RTM Treatment Management & Provider Guidelines

What Is CPT Code 98981?

CPT 98981 is used to bill for additional time spent on remote therapeutic monitoring beyond the initial 20 minutes covered by CPT 98980. It ensures that providers who dedicate extended time managing RTM data and engaging with patients receive appropriate reimbursement.

Key features of CPT 98981

• Each additional 20 minutes of RTM management per calendar month.

• Covers data review, patient interaction, and treatment plan modifications.

• Supports monitoring of musculoskeletal, respiratory, and other chronic conditions.

• Requires real-time patient communication via phone, video, or secure messaging.

• Billable by physical therapists (PTs), occupational therapists (OTs), speech-language pathologists (SLPs), and other qualified non-physician providers.

Unlike CPT 98975–98977, which cover device setup and transmission, CPT 98981 ensures ongoing engagement and intervention, making it an essential tool for long-term RTM success. As RTM expands, CPT 98981 plays a key role in extended patient management, particularly for musculoskeletal and respiratory conditions, supporting proactive care adjustments based on real-time data.¹

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

Why CPT 98981 Is Important for Value-Based Care

As the healthcare system shifts toward value-based models, CPT 98981 enables providers to proactively manage patient progress and intervene early, preventing complications and improving adherence to therapy.

By leveraging CPT 98981 in RTM programs, providers can:

• Ensure continuous care management beyond the first 20 minutes of patient engagement.

• Identify therapy adherence issues before they impact patient progress.

• Reduce emergency visits and complications by providing real-time treatment adjustments.

• Enhance patient satisfaction by fostering ongoing communication and personalized care.

This level of patient-provider interaction aligns with the goals of remote monitoring—delivering proactive, data-driven healthcare while improving long-term outcomes.

Billing and Reimbursement for CPT Code 98981

To bill CPT 98981, providers must meet the following conditions:

• The patient must be enrolled in an RTM program for a qualifying condition (e.g., musculoskeletal or respiratory therapy monitoring).

• CPT 98980 (the initial 20 minutes of RTM management) must be billed first before 98981 can be added for additional time.

• The provider must spend at least an additional 20 minutes beyond CPT 98980 conducting RTM data review and engaging in real-time patient communication per calendar month.²

• The service must be delivered by a non-physician provider, such as a PT, OT, or SLP.

Medicare reimbursement and payment rates

As of 2024, Medicare reimburses approximately $40–$50 for CPT 98981. However, payment rates vary depending on regional Medicare Administrative Contractors (MACs) and private payer agreements.

To optimize reimbursement for 98981, providers should:

• Monitor CMS Fee Schedules for changes in reimbursement rates.

• Verify private payer policies to identify additional coverage opportunities.

• Maintain clear documentation of RTM interactions and treatment adjustments.

Common Challenges in Implementing CPT 98981 for RTM

While CPT 98981 provides an opportunity to enhance remote monitoring services, providers often face challenges in scaling patient engagement and maintaining compliance.

1. Ensuring patients engage in ongoing RTM sessions

• Many patients disengage from remote monitoring after initial setup, making it difficult to meet the billing criteria for additional RTM management time. 

• Providers should implement automated reminders and structured follow-up schedules to maintain patient engagement.

• Offering multiple communication options (phone, video, secure messaging) improves accessibility and responsiveness.

2. Maintaining proper documentation for compliance

• CMS and private insurers require detailed records of RTM data review, interactive communication, and clinical decision-making.

• Providers should use standardized templates to document treatment adjustments, patient feedback, and adherence monitoring.

• Failure to track time properly can result in claim denials or billing audits.

3. Navigating variability in private insurance reimbursement

• Not all private payers reimburse CPT 98981, requiring providers to negotiate RTM coverage individually.

• Some insurers require specific documentation formats to justify additional RTM time.

• Aligning RTM services with chronic care management programs can increase payer acceptance and reimbursement approval.

Best Practices for Implementing CPT 98981 in RTM Workflows

To maximize CPT 98981’s impact, healthcare providers should adopt structured approaches that support billing accuracy, patient engagement, and care optimization.

1. Develop a consistent patient outreach plan

• Schedule structured follow-ups to ensure patients remain engaged in RTM sessions.

• Offer flexible communication options (phone, video, secure messaging) to fit patient preferences.

• Use automated reminders to improve adherence and participation rates.

2. Ensure accurate time tracking and documentation

• Record all RTM data reviews and patient interactions in electronic health records (EHRs).

• Track how treatment plans are adjusted based on remote monitoring insights.

• Ensure billing records align with CMS and private payer compliance requirements.

3. Identify patients who would benefit from additional RTM management time

• Use predictive analytics to identify patients at risk for therapy non-adherence.

• Adjust treatment plans based on adherence trends and symptom progression.

• Implement self-management resources to empower patients between check-ins.

4. Stay updated on Medicare and private payer policies

• Regularly review Medicare updates and MAC-specific billing guidelines.

• Work with billing specialists to optimize claims and reduce rejections.

• Negotiate private payer contracts to expand RTM reimbursement coverage.

5. Integrate RTM into broader chronic care strategies

• Align RTM services with chronic disease management and rehab programs for holistic care.

• Utilize AI-driven engagement tools to automate therapy tracking.

• Explore hybrid models that combine in-person follow-ups with remote monitoring.

Case Example: Extended RTM Management for Chronic Low Back Pain

A physical therapist is managing a 60-year-old patient with chronic low back pain due to degenerative disc disease. The patient is enrolled in a remote therapeutic monitoring program using a motion tracking device paired with a mobile app to monitor posture, activity levels, and adherence to a prescribed exercise program.

During the initial weeks, the therapist tracks the patient’s data and conducts a live check-in to review progress, billing CPT 98980 for the first 20 minutes of RTM management. However, as the patient’s condition requires additional monitoring and treatment modifications, the therapist spends another 20 minutes analyzing movement patterns, addressing patient concerns, and refining the rehabilitation plan.

A follow-up video consultation reveals that the patient avoids key strengthening exercises due to discomfort. The therapist provides real-time demonstrations of alternative movements, adjusts the intensity of certain exercises, and schedules an additional check-in to ensure adherence. The extended engagement ensures that the patient remains on track, preventing further deterioration and improving long-term outcomes.

Reporting and billing

• Bill one unit of CPT 98980 for the initial 20 minutes of RTM management, including at least one live interactive patient communication.

• Bill one unit of CPT 98981 for each additional 20-minute increment spent reviewing RTM data, modifying the treatment plan, and conducting further patient interaction within the same calendar month.

Leveraging CPT 98981 for Enhanced RTM Management

As remote therapeutic monitoring evolves, CPT 98981 ensures providers are compensated for additional time spent managing patient care beyond the initial engagement.

To fully capitalize on CPT 98981, providers should:

• Implement structured outreach and engagement strategies to maintain patient participation.

• Ensure accurate documentation to support compliance and reimbursement claims.

• Stay informed on private payer policies to maximize coverage opportunities.

• Integrate RTM into long-term chronic disease management models for sustained success.

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 for codes 98980 and 98981. 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. Robeznieks, A. (2022, April 15). As remote patient monitoring expands, so does CPT to describe it. American Medical Association. https://www.ama-assn.org/practice-management/cpt/remote-patient-monitoring-expands-so-does-cpt-describe-it

2. American Speech-Language-Hearing Association. (n.d.). Use of e-visit codes for Medicare Part B services during coronavirus. https://www.asha.org/practice/reimbursement/medicare/use-of-e-visit-codes-for-medicare-part-b-services-during-coronavirus/?srsltid=AfmBOoo_gAXALBvp4RcTcTrd0yWQ6SaG_wbVVj6m1WRsaLafKbZ51DLA