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RTMBase2026 Compliant

CPT 98985

2026 Billing Guide

RTM Device MSK 2-15 Days

Reimbursement

$39.75

Threshold

2d

2026 Status

Active

What is CPT Code 98985?

CPT 98985 is defined as: Remote therapeutic monitoring (RTM) of the musculoskeletal system status (e.g., therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission, for a period of 2 to 15 days of data transmission within a 30-day period.

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

Physician Effort

PE (Non-Fac)

1.19

Practice Expense

Malpractice

0

Risk Factor

Total RVU

1.19

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

2026 CMS Policy Intelligence

revenue safety net

98985 is a critical 2026 policy addition that prevents 'all-or-nothing' revenue loss. It ensures that the costs of providing the device and technical support are partially reimbursed even if the 16-day rule is not met.

work rvu exemption

As a PE-only code, it is not affected by the -2.5% efficiency adjustment applied to physician work.

conversion factor

Utilizes the 2026 Non-QP rate of $33.40.

Administrative Framework

Place of Service

11 (Office)12 (Home)

NCCI Exclusions

Do not bill with:98977 (mutually exclusive per month)9898499454

Key Modifiers

N/ATechnical component code.

Operational Requirements

transmission threshold

Requires a minimum of 2 days and a maximum of 15 days of data transmission within a 30-day period. This is the 'short-duration' counterpart to CPT 98977.

device type

The device must be an FDA-defined medical device used to monitor musculoskeletal status (e.g., ROM sensors, smart braces).

billing interval

Reported once every 30 days only if the 16-day threshold of the primary code (98977) is not met.

musculoskeletal focus

Restricted to monitoring the MSK system (e.g., joint recovery, back pain progression).

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

NEW 2026 CODE. Use this for low-compliance MSK monitoring months to secure compliant reimbursement.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

Physical TherapyOrthopedicsPain Management

Typical Clinical Indications (ICD-10)

M54.5 (Low back pain)M17.1 (Osteoarthritis of knee)M75.1 (Rotator cuff syndrome)

Frequently Asked Questions

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