CPT code 98975 – Remote therapeutic monitoring setup guide

Key takeaways

CPT Code 98975 covers RTM device setup and patient education, billed once per episode of care with no minimum time.

Under 2026 CPT guidance, 98975 is reported once the patient has at least 2 days of monitoring data in a 30-day period.

Physicians, nurse practitioners, physician assistants, physical and occupational therapists, and speech-language pathologists can bill RTM. Clinical staff can furnish it under general supervision.

RTM is not a Medicare telehealth service, so 98975 takes no 95 or GT modifier.

Two avoidable denials come from billing 98975 twice in one episode or before the data threshold is met.

CPT Code 98975: official descriptor and what it covers

CPT Code 98975 is the initial setup and patient education code for remote therapeutic monitoring (RTM), billed once per episode of care. The AMA’s CPT code set reads: Remote therapeutic monitoring (eg, therapy adherence, therapy response); initial set-up and patient education on use of equipment.

The code has no time threshold, so you do not need to record start and stop times. It pays for supplying the device, setting it up, and teaching the patient to use it. The 20-minute wording often quoted for RTM belongs to the treatment management codes 98980 and 98981.

Under the 2026 CPT guidance, you report 98975 once the patient has transmitted at least 2 days of data in a 30-day period. Before 2026 the minimum was 16 days. After setup, monthly device supply is billed with 98976, 98977, or 98978, and clinician time with 98979, 98980, and 98981.

Who can bill RTM setup under Medicare

Medicare lets physicians, nurse practitioners, physician assistants, physical therapists, occupational therapists, and speech-language pathologists bill CPT Code 98975. Since 2023, physicians and non-physician practitioners (NPPs) can bill RTM that clinical staff furnish incident-to under general supervision.

• Physicians and other qualified health care professionals: May bill under their own NPI in any care setting
• NPs and PAs: May bill under their own NPI, or bill staff-furnished RTM incident-to under general supervision
• Physical therapists: May bill under Medicare Part B, and since 2025 may generally supervise PTAs furnishing RTM in private practice
• Occupational therapists: May bill under Medicare Part B, with the same general supervision rule for OTAs in private practice
• Speech-language pathologists: May bill RTM for conditions within their scope of practice

Scope-of-practice rules vary by state. Some states restrict which conditions a PT or OT can treat without a physician referral. Check your state practice act and your payer policies before billing 98975.

CPT Code 98975 vs 98977: when to use each code

CPT Code 98975 and 98977 serve different stages of the RTM workflow. 98975 is the one-time setup code, and 98977 is the recurring musculoskeletal device supply code.

RTM vs RPM: how CPT Code 98975 differs from remote patient monitoring

RTM (the 98975 code family) and RPM (the 99453/99454 code family) are frequently confused because both involve devices and remote data collection. The difference lies in what the device measures and who can bill it.

Billing RPM codes for what is functionally an RTM service is a coding error. If your device tracks pain scores or exercise adherence rather than blood pressure or weight, the 98975 family applies, not the 99454 family.

2026 Medicare reimbursement rate for CPT Code 98975

The 2026 Medicare national unadjusted payment rate for CPT Code 98975 is published in the CMS Physician Fee Schedule lookup tool. Rates vary between facility and non-facility settings. The non-facility rate, typical for office-based PT or OT practices, is higher because it includes practice expense. Apply your locality’s geographic practice cost index (GPCI) to get your local payment.

Commercial payer rates are not governed by the Medicare Physician Fee Schedule. Many commercial insurers have not adopted RTM codes or apply different coverage criteria. Verify coverage before you enroll patients in an RTM program billed to a commercial plan.

How to bill the setup code in six steps

Billing CPT Code 98975 correctly comes down to six steps, completed in order before the claim goes out.

1. Verify patient eligibility and coverage. Confirm the patient has active Medicare Part B, or that the commercial plan covers RTM. Run the eligibility check before the setup appointment.
2. Obtain and document patient consent. Record consent before the first RTM service. Note the date, the method (verbal or written), and who obtained it.
3. Supply the RTM device and document it. Record the device make, model, and any serial or software version identifier in the patient record. Not every wellness app or consumer wearable meets the FDA definition of a medical device.
4. Conduct and document the education session. Record who delivered the education, the date, and what you covered: device use, data transmission, and how to report symptoms. CPT sets no minimum duration, so no start or stop times are needed.
5. Confirm the data threshold. Hold the claim until the patient has at least 2 days of monitoring data in the 30-day period. Bill 98975 only once per episode of care.
6. Submit the claim with the correct ICD-10 code and place of service. RTM is not a Medicare telehealth service, so do not append modifier 95 or GT. Report the place of service where you would normally furnish care, such as POS 11 for an office. Review every field for a clean claim submission.

What the setup note must document

The medical record must contain each of the following to support a 98975 claim. A missing element is grounds for denial or post-payment recoupment during an audit. Good medical billing compliance treats this list as a pre-billing checklist.

• Patient consent: date obtained, method (verbal or written), and the name and role of the staff member who obtained it
• Device details: make, model, and software version or serial number of the RTM device supplied
• Monitoring start: the date monitoring began and the data days that support the 2-day threshold
• Provider identity: name and credential of the clinician who conducted the setup session
• Clinical rationale: the condition being monitored and why RTM is appropriate for this patient
• Topics covered: a brief description of the education provided, such as device use, data transmission, and symptom reporting

Common denial reasons and how to fix them

Most 98975 denials trace back to a short list of preventable errors. Systematic denial management workflows catch these before the claim leaves the practice.

ICD-10 codes that commonly support RTM setup

Every 98975 claim needs a supporting ICD-10-CM diagnosis code that justifies RTM. The table below covers common pairings by clinical category. M54.5 (low back pain) was retired on October 1, 2021, so use M54.50, M54.51, or M54.59 instead.

Verify active status for every code against the CMS ICD-10 code files before submitting. Your MAC’s local coverage policies may further restrict which diagnoses support RTM claims in your region. For full descriptors and Excludes notes on any pairing, search our ICD-10-CM codes library.

Revenue cycle management for RTM practices

RTM adds a new billing layer to PT, OT, and SLP practices. A one-time setup code, a monthly device supply code, and a monthly treatment management code can each generate claims independently. A disorganized revenue cycle management process misses billing windows, duplicates codes, or links the setup claim to the wrong episode of care. The map below shows which code fires when, and on what threshold.

Four RTM habits keep denials down across the code family:

• Episode tracking: Record the date 98975 was billed for each patient so billing staff know not to bill it again in the same episode
• 30-day monitoring calendar: Count data days each period, then bill 98977 for 16 to 30 days or 98985 for 2 to 15 days
• Monthly treatment management log: Capture time toward 98979, 98980, and 98981 as it happens, not at month end
• ERA reconciliation: Match electronic remittance advice (ERA) to submitted RTM claims to catch partial denials and request timely corrections

How claims software keeps 98975 billed once per episode

Most PT and OT practices track RTM episodes in one place, notes in another, and claims in a third. That split is how 98975 ends up billed twice or sent before the second data day.

Pabau, the practice management platform we build, keeps the setup note, consent form, and claim on the same patient record. Its claims management software pulls that record into a pre-filled claim. It then submits and tracks the claim through Claim.MD and posts the ERA when payment comes back.

Your billing team sees which patients already have a 98975 on file and which claims are still open. That way, you bill each episode once and chase denials before they age.

Keep RTM setup claims clean and on time

Pabau keeps RTM setup notes, consent, and claims on one patient record, then submits and tracks claims through Claim.MD. See how it works for your practice.

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Conclusion

Treat CPT 98975 as an event code, not a timed one. The claim stands or falls on four records: consent, the device supplied, the education delivered, and the data days that followed. A stopwatch adds nothing to that file.

The practical change for 2026 is the lower data threshold, which lets you bill setup sooner for short monitoring episodes. Build your episode tracking around it, and keep one rule fixed: one 98975 per episode of care.

Book a demo to see how Pabau keeps RTM documentation and billing on one record for PT, OT, and SLP practices.

Continue your research

Sending RTM claims electronically? Our Claim.MD clearinghouse review covers payer reach, pricing, and how electronic claims are submitted and tracked.

Want to reduce claim denials across your practice? Denial codes in medical billing covers the CARC reason codes that appear on RTM remittances and how to action each one.

Checking RTM coverage before setup? Insurance eligibility verification walks through confirming a patient’s benefits before the first billable service.

Reconciling RTM payments each month? Electronic remittance advice explains how to read an ERA and match it to the claims you sent.

Frequently asked questions