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CPT 98980
Description, Billing Rules, and Use Cases

CPT 98980 is used to report treatment management services performed under a Remote Therapeutic Monitoring (RTM) program. This code covers 20 minutes of provider time in a calendar month and requires at least one interactive communication with the patient or caregiver.

 

It applies to musculoskeletal, respiratory, or therapy adherence monitoring and supports digital care programs across a wide range of specialties.

What is CPT Code 98980?

CPT 98980 is a time-based billing code that reflects the clinical management of an RTM episode. It is reported when a physician or qualified healthcare professional (QHP) provides at least 20 minutes of treatment management during a calendar month, including one or more interactive communications (e.g., phone, video, or secure platform conversation).

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This code is used when:

  • RTM data has been generated from one or more supplied and compliant devices

  • The provider reviews data related to symptoms, adherence, or therapy outcomes

  • The provider makes clinical decisions or adjustments to a care plan

  • The service is clearly documented, including patient communication and time spent

 

CPT 98980 may not be billed:

  • If fewer than 20 minutes of clinical management occur

  • Without at least one live patient or caregiver interaction

  • In the same month as codes that conflict with RTM treatment management (e.g., 99457, 99091)

CPT 98980 Billing Requirements and Eligibility

CPT 98980 is used to report treatment management services provided under a Remote Therapeutic Monitoring (RTM) program. This code applies when a provider actively engages in managing the patient’s care based on data collected from an approved RTM device — such as for musculoskeletal recovery, respiratory tracking, or therapy adherence.

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It may only be billed once per calendar month and must meet the following requirements:

Patient Eligibility Criteria

To bill CPT 98980, the patient must be:

  • Enrolled in an active RTM program

  • Using a device that captures relevant data (musculoskeletal, respiratory, or therapy-related)

  • Receiving ongoing therapeutic care that requires clinical oversight or adjustment

 

Patients must also:

  • Provide consent to participate in RTM

  • Be reachable for interactive communication with their provider or care team

Device and Setup Requirements

While CPT 98980 does not cover device setup or supply directly, it requires that the patient is enrolled in an RTM program that includes a qualifying device. These devices must:

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  • Meet the FDA definition of a medical device

  • Be capable of recording and/or transmitting therapeutic data

  • Be used to monitor:

    • Musculoskeletal status

    • Respiratory function

    • Adherence to therapy or medication protocols

 

The device must be:

  • Assigned to the patient as part of the RTM episode

  • Set up and activated either in person or remotely

  • Already in use during the same calendar month that 98980 is billed

 

While setup and patient education are reported separately under CPT 98975, ongoing use of the device and access to the data it generates are prerequisites for billing 98980.

Service and Time Requirements

To meet criteria for billing:

  • The provider must perform at least 20 minutes of treatment management activity in a calendar month

  • There must be one or more interactive communications (live phone or video — not automated messaging)

  • The time must be spent on clinical tasks such as:

    • Reviewing device data

    • Modifying treatment plans

    • Documenting findings or progress

    • Coordinating care across a team

 

If less than 20 minutes is spent or no interactive communication occurs, CPT 98980 cannot be billed.

Who Can Bill CPT 98980

CPT 98980 may be billed by:

  • Physicians

  • Nurse Practitioners (NPs)

  • Physician Assistants (PAs)

  • Other Qualified Healthcare Professionals (QHPs)

 

This code is not intended for clinical staff billing under general supervision. It must reflect time and activity performed by a licensed provider who can make clinical decisions.

CPT 98980 Billing Documentation Checklist

To support compliant billing of CPT 98980, include the following in the patient’s chart:

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  • A signed order from a physician or QHP initiating RTM treatment management

  • Description of the RTM device(s) in use:

    • Meets FDA definition of a medical device

    • Assigned specifically to the patient

    • Used to monitor musculoskeletal, respiratory, or therapy adherence data

  • Documentation that the device was supplied and activated prior to or during the billing period

  • Evidence of treatment management activities totaling at least 20 minutes during the calendar month:

    • Reviewing patient-generated RTM data

    • Assessing symptoms or therapy adherence

    • Adjusting the treatment plan based on findings

    • Coordinating care with other providers or disciplines

  • Documentation of at least one interactive communication with the patient or caregiver:

    • Includes date, format (e.g., phone, video), and brief summary

  • Confirmation that the billing provider:

    • Personally performed the service

    • Is a physician, NP, PA, or other QHP

  • Time tracking:

    • Start/stop times or cumulative log for the 20 minutes of treatment management

  • Verification that no conflicting time-based management codes were billed in the same calendar month:

    • Codes to avoid include 99091, 99457, 99458, 99473, 99474, and 93264

CPT 98980 Time Thresholds and Code Combinations

CPT 98980 is used to report treatment management services delivered by a physician or qualified healthcare professional as part of a Remote Therapeutic Monitoring (RTM) episode. This code is billed once per calendar month, and several conditions must be met to ensure compliance.

Table showing billing conditions for CPT 98980 based on time thresholds, communication requirements, provider qualifications, and code conflicts.

Important to Note:

CPT 98980 may be billed once per month if the following are true:

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  • A valid RTM device is already in use and collecting data

  • The provider performs at least 20 minutes of treatment management activity

  • At least one interactive communication occurs with the patient or caregiver

  • The provider is a physician or QHP, not clinical staff under general supervision

  • No conflicting care management or time-based monitoring codes are reported in the same month

When to Use CPT 98980:
Common Scenarios and Use Cases

CPT 98980 is used when a physician or qualified healthcare professional actively manages care for a patient enrolled in Remote Therapeutic Monitoring (RTM). This includes reviewing data, adjusting plans, and directly engaging with the patient, provided the 20-minute threshold and communication requirements are met.

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Here are examples of how CPT 98980 is used in practice:

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  • Managing Home Rehab for a Knee Replacement Patient
    An orthopedic physician:

    • Reviews range-of-motion data from an RTM rehab sensor

    • Identifies gaps in adherence and adjusts the home exercise protocol

    • Calls the patient to confirm progress and reinforce care plan
      Billing: 98980 (for 20+ minutes of RTM treatment management)

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  • Therapy Adherence Monitoring for a COPD Patient
    A pulmonology NP:

    • Analyzes daily oximeter trends and inhaler use

    • Updates treatment goals based on symptom tracking

    • Conducts a secure video consult to discuss inhaler technique and expectations
      Billing: 98980 (to capture provider-led RTM review and communication)

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  • Remote Support for Chronic Back Pain with Exercise Data
    A pain management provider:

    • Reviews a wearable RTM device showing limited mobility and poor adherence

    • Coordinates with the care team to schedule additional PT visits

    • Speaks with the patient to troubleshoot device use and reinforce motivation
      Billing: 98980 (once per month when treatment management conditions are met)

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  • Behavioral Therapy Plan Oversight Using RTM Metrics
    A primary care physician:

    • Reviews patient check-in data from a CBT tracking app paired with a compliant RTM device

    • Confirms progress against behavioral therapy milestones

    • Documents a phone call reviewing emotional response patterns and adjusting strategies
      Billing: 98980 (monthly for therapy-related RTM treatment management)

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Common CPT 98980 Billing Mistakes
(and How to Avoid Them)

CPT 98980 is a high-value RTM management code, but it comes with strict criteria. Below are common mistakes that lead to denials or compliance issues — and how to avoid them:

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  • ❌ Billing Without 20 Full Minutes of Treatment Management
    CPT 98980 cannot be reported if the provider spends less than 20 minutes on care management activities. Track cumulative time accurately using start/stop or time logs.
     

  • ❌ Missing Interactive Communication
    At least one interactive conversation (e.g., phone or video) with the patient or caregiver must occur during the billing month. This cannot be passive data review or automated messaging.
     

  • ❌ Claiming Time Spent by Clinical Staff Only
    Only physicians or qualified healthcare professionals (QHPs) may bill CPT 98980. Time spent by RNs, MAs, or administrative staff cannot count toward the 20-minute threshold.​​
     

  • ❌ Overlapping Time-Based Codes
    Do not bill CPT 98980 in the same month as codes like 99457, 99091, 93264, 99473, or 99474, as they conflict with RTM treatment management billing.
     

  • ❌ Inadequate Documentation of Activities and Communication
    You must document what the provider did during the 20 minutes (e.g., data review, care planning) and include the date and content of the interactive communication.

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