Our Remote Therapeutic Monitoring Solution is only available for organizations with Enterprise subscriptions using HEP. To turn this feature on or upgrade your organization's subscription, please contact your Customer Success Manager or request a demo.
As you prepare to bill for the Remote Treatment codes (CPT Code 98980 and 98981), MedBridge can help you easily collect the information you need.
For your reference, CPT Code 98980/81 is defined as follows. For more information on the RTM billing codes, please refer to this article: What are the new RTM CPT codes?
Remote Treatment (CPT Code 98980 and 98981)
What CPT code 98980 covers: Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes.
What CPT code 98981 covers: Remote therapeutic monitoring treatment management services, physician/other qualified healthcare professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month, each additional 20 minutes. List separately in addition to code for primary procedure.
How to use CPT code 98980 & 98981: 98980 is used to report the first 20-minute increment of time spent reviewing and integrating the data collected during remote monitoring to inform treatment goals; monitor the patient’s progress and adherence to the treatment plan; and provide clinical feedback to the patient/caregiver. 98981 is used to report each subsequent 20-minute increment.
Count cumulative time spent in data review and patient/caregiver interaction in a calendar month (not each 30 days). Report the base and add-on codes together on the claim, based on total time, at the end of each calendar month. The base code (98980) may only be reported once per calendar month.
Don’t report CPT code 98980 unless a full 20 minutes of monitoring has occurred, don’t report CPT code 98981 unless a full additional 20 minutes of monitoring has occurred. Note that CPT code 98980 must be billed if CPT code 98981 is being billed.
What to document: Document the data gathered from the device, the date and time of the patient and/or caregiver interaction, and any decisions made that impact the treatment and plan of care as a result of the monitoring.
Determining Patient Eligibility
First, you will need to determine which patients are eligible for billing under this code.
- Select RTM Reporting from the top of the HEP page. This page will show you all your patients with RTM enabled.
- Next select the “Treatment Minutes” tab.
- If necessary, you can use filters to select all patients within your organization, or select a different clinician under the “Primary Clinician” filter.
- Make sure the “Patient Activated RTM filter is set to “Y” to only show patients who have activated and engaged with their program.
- Next, filter this data to the specific month you want to review. For example, if you’re billing at the end of November, you’ll set this filter to November to see all the logged treatment time that month.
- In order for a patient to be eligible for billing under 98980/81, two criteria need to be met:
Total time spent in the calendar month needs to be 20 minutes or more. For each additional 20 minutes, you can also bill 98981.
One interactive communication per calendar month. In addition to the time spent updating and monitoring that patient data, there needs to be at least one interactive communication, such as a phone call or telehealth visit, between the patient/caregiver/family and the clinician in the calendar month.
Once these two milestones have been met within a calendar month, you can bill for 98980. For each additional 20 minutes beyond the initial 98980 code time, you may report 98981. This code (98981) may be reported multiple times in a calendar month. An additional interactive communication is not required to bill for 98981; as long as that requirement was met for 98980, you can bill 98981 for each additional 20 minutes of treatment time.
In this example, because 59 minutes of activity have been recorded, 98980 and 98981 could each be billed once.
Generating Activity Report
Once you have identified a patient who is eligible for reimbursement under 98980/81, you can generate an activity report using MedBridge.
- From the RTM Reporting page, select the patient’s name and click the “Patient Profile” link.
- Select RTM Activity.
- Select RTM Activity report.
- Uncheck the patient activity box to filter to just the provider activity and change the date to the appropriate month.
- You now have a report that’s filtered to the information you need. You can now download this as a PDF or copy it to your clipboard to paste into your EMR.