CPTCodeCalculator
RTMBase2026 Compliant

CPT 98980

2026 Billing Guide

RTM Mgmt 20 min

Reimbursement

$53.77

Threshold

20m

2026 Status

Active

What is CPT Code 98980?

CPT 98980 is defined as: Remote therapeutic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes.

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

0.62

Physician Effort

PE (Non-Fac)

0.94

Practice Expense

Malpractice

0.05

Risk Factor

Total RVU

1.61

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% productivity adjustment (Time-based care management service).

fqhc rhc transition

FQHCs must now itemize and bill 98980 for 20 minutes of professional RTM management following G0511 sunset.

provider parity

Maintains payment parity with RPM management (99457), ensuring equivalent compensation for therapeutic vs physiologic monitoring effort.

Administrative Framework

Place of Service

11 (Office)12 (Home)22 (Outpatient Hospital)

NCCI Exclusions

Do not bill with:99457G0511

Key Modifiers

95Synchronous Telemedicine Service. Mandatory if the interactive communication is performed via audio-visual telehealth.
G2211Applicable to the office visit; 98980 provides the management continuity for therapeutic complexity.

Operational Requirements

minimum time

20 minutes of cumulative clinical time per calendar month.

interactive requirement

Must include at least one synchronous (live) interaction via phone or video with the patient or caregiver.

staff type

Clinical staff, physician, or QHP (including PT/OT/SLP) under general supervision.

billing unit

Once per calendar month.

Compliance Checklist

Timestamped log of clinical time totaling 20+ minutes
Documentation of the date, time, and clinical content of the live interaction
Name and credentials of the provider performing the service

Audit Defense

interaction stamp

A 'review of data' is not sufficient. There must be a specific entry for the 'patient/caregiver synchronous call' to satisfy the CPT definition.

system validation

Ensure 98980 is billed for RTM systems (MSK/Respiratory) and not physiologic RPM systems.

2026 Update

Asynchronous messaging (email/texts) does NOT count toward the interactive requirement without a synchronous live call component.

Common Clinical Scenarios

Physical therapist reviewing MSK exercise logs and calling the patient to adjust home rehab protocol.
Respiratory therapist reviewing inhaler adherence and instructing the patient on better technique.
Clinical staff analyzing therapy response data and coordinating with the physician for treatment modification.

Target Specialties & Utilization

Physical TherapyOrthopedicsPulmonologyPM&R

Typical Clinical Indications (ICD-10)

M54.5 (Low back pain)J44.9 (COPD)M17.11 (Knee osteoarthritis)J45.909 (Asthma)

Frequently Asked Questions

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