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)
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
Key Modifiers
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
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
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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