Reimbursement
$47.06
Threshold
16d
2026 Status
Active
What is CPT Code 98976?
CPT 98976 is defined as: Remote therapeutic monitoring (eg, respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days.
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)
1.41
Practice Expense
Malpractice
0
Risk Factor
Total RVU
1.41
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
short duration fallback
CMS 2026 introduced new codes (e.g., 99XX5) for 2 to 15 days of RTM data. Use 98976 ONLY for 16+ days.
efficiency shield
Protected from the -2.5% productivity adjustment (Work RVU is 0.0).
fqhc rhc transition
FQHCs must now bill 98976 directly instead of using the single flat rate of G0511 for RTM supply.
Administrative Framework
Operational Requirements
minimum data days
16 days of recordings/transmissions within a 30-day period.
frequency
Once every 30 days
system focus
Must be for monitoring the respiratory system.
device type
FDA-cleared medical device required.
automated transmission
Data must be transmitted automatically (e.g., smart inhaler cloud sync).
Compliance Checklist
Audit Defense
respiratory attribution
Ensure for-audit purposes the record clearly distinguishes this as a respiratory device, not a generic physiologic monitor.
no overlap
Cannot be billed concurrently with 98977 (MSK) for the same patient in the same month.
2026 Update
The 16-day rule remains the primary cause of RTM audit recoupments. Automated system checks for day count (16 vs 2-15) are essential.
Common Clinical Scenarios
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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