Reimbursement
$21.71
Threshold
N/A
2026 Status
Active
What is CPT Code 98975?
CPT 98975 is defined as: Remote therapeutic monitoring (eg, respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment. This represents the administrative and clinical effort to enroll a patient in a therapeutic monitoring program and ensures the patient is proficient in using the device to monitor non-physiologic data.
This code is primarily used for RTM services. It falls under the category of Remote Therapeutic Monitoring (RTM) and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
0
Physician Effort
PE (Non-Fac)
0.65
Practice Expense
Malpractice
0
Risk Factor
Total RVU
0.65
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency shield
Protected from the -2.5% productivity adjustment (Work RVU is 0.0).
fqhc rhc transition
G0511 is sunsetted. FQHCs and RHCs must now itemize and bill 98975 for the initial RTM setup.
specialty benefit
2026 policy continues to support PT/OT/SLP billing of RTM codes, which remain separate from clinical staff-only RPM codes.
Administrative Framework
Place of Service
NCCI Exclusions
Key Modifiers
Operational Requirements
frequency
Once per episode of care
staff type
Clinical staff, physician, or other QHP. Unlike RPM, RTM allows therapists (PT/OT/SLP) to bill directly.
device requirement
Device must be a medical device as defined by the FDA and monitor non-physiologic data (e.g., MSK status, therapy adherence).
documentation link
Must document the specific therapeutic parameter being monitored (e.g., medication adherence, lung function activity).
Compliance Checklist
Audit Defense
device education note
Record specific feedback from the patient: e.g., 'Patient demonstrated proficiency in data syncing and exercise logging'.
parameter validation
Avoid using 98975 for physiologic data (e.g., Blood Pressure); that must be billed as RPM 99453.
2026 Update
Medicare audits focus on ensuring RTM isn't used as a workaround for RPM. Data must be 'therapeutic' (adherence/response), not 'physiologic'.
Common Clinical Scenarios
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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