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RTMBase2026 Compliant

CPT 98979

2026 Billing Guide

RTM Mgmt 10-19 min

Reimbursement

$26.05

Threshold

10m

2026 Status

Active

What is CPT Code 98979?

CPT 98979 is defined as: Remote therapeutic monitoring (RTM) treatment management services provided by a physician or other qualified health care professional (QHP) during a calendar month. This code requires at least 10 minutes but no more than 19 minutes of time spent on the cumulative review and analysis of patient data and the development of a treatment plan. Crucially, at least one interactive communication (e.g., phone or video call) with the patient or caregiver during the month is mandatory.

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)

Standard Formula Applied

Work RVU

0.31

Physician Effort

PE (Non-Fac)

0.44

Practice Expense

Malpractice

0.03

Risk Factor

Total RVU

0.78

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

Strategically exempt from the -2.5% efficiency adjustment. CMS classifies RTM as a 'care management' service, protecting its Work RVU to encourage digital health adoption.

granular management

The 2026 rule emphasizes the use of 98979 as a way to capture clinical effort for patients who are stable but still require monthly professional monitoring.

conversion factor

Utilizes the 2026 Non-QP baseline of $33.40.

Administrative Framework

Place of Service

11 (Office)12 (Home)

NCCI Exclusions

Do not bill with:9898098981994579945899091

Key Modifiers

59Distinct procedural service. Used if RTM management is performed for a completely separate clinical condition from another care management service (rarely allowed).
95Synchronous telemedicine service. Often applied if the interactive communication is via video.

Operational Requirements

time threshold

Requires a minimum of 10 minutes and a maximum of 19 minutes of professional time per calendar month.

interactive communication

At least one synchronous (live) communication with the patient or caregiver is mandatory to bill 98979. Data review alone is insufficient.

provider only

Coded for physician or QHP (NP/PA/PT/OT/SLP) time. Clinical staff time (e.g., MA or RN) does NOT count toward 98979.

frequency

Reported once per calendar month.

Compliance Checklist

Detailed time tracking (cumulative for the month).
Specific clinical decision-making documentation.
Electronic care plan availability and access log.

Audit Defense

No specific audit defense elements defined.

2026 Update

Exempt from the mandatory -2.5% efficiency cut. Interactive communication is a hard requirement.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

Physical TherapyOccupational TherapyPsychiatryOrthopedics

Typical Clinical Indications (ICD-10)

M54.5 (Low back pain)J45.909 (Unspecified asthma, uncomplicated)F41.1 (Generalized anxiety disorder)

Frequently Asked Questions

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