CPT 98980: Converting Data into Care (and Revenue)

Remote Therapeutic Monitoring (RTM) allows providers to collect non-physiological data—like therapy adherence, pain levels, and functional response—and use that insight to guide treatment. While the device collects the data, CPT 98980 is the code that pays for the clinician’s expertise in analyzing it. It turns “monitoring” into “management.” 

What is CPT 98981? 

CPT 98981 is the “Add-On” code for Remote Therapeutic Monitoring Treatment Management. 

It covers each additional 20 minutes of interactive communication and treatment management services provided in a calendar month. 

The Golden Rule of 98981: 

You cannot bill this code by itself. It is mathematically tied to the base code (CPT 98980). 

• First 20 Minutes: Bill CPT 98980. 

• Next 20 Minutes: Bill CPT 98981. 

Think of CPT 98981 as the “Overtime” code. It ensures that when you have a complex patient requiring significant attention, your time is still reimbursed. 

The “High-Acuity” Use Case 

Not every patient needs 40+ minutes of remote management a month. If you are using 98981 on every single patient, you are likely over-billing. This code is best reserved for High-Acuity cases where things aren’t going to plan. 

Ideal Scenarios for CPT 98981: 

• Post-Surgical Complications: Patients dealing with infection risks, scar tissue buildup, or excessive pain who need frequent video check-ins. 

• Chronic Pain Management: Patients with central sensitization who require extensive education and reassurance to maintain movement. 

• Multi-Trauma: Patients managing rehabilitation for multiple body parts simultaneously (e.g., a patient with both a rotator cuff repair and a knee replacement). 

The Math: How to Calculate the Time 

Billing CPT 98981 requires precise time tracking. You generally need to hit a 40-minute total threshold to bill this code successfully. 

• 0–19 mins: No billing (currently). 

• 20–39 mins: Bill CPT 98980 (1 Unit). 

• 40+ mins: Bill CPT 98980 (1 Unit) + CPT 98981 (1 Unit). 

Note: You can bill multiple units of 98981 if the care is extensive (e.g., 60 minutes total = 1 unit of 98980 + 2 units of 98981), though this is rare in standard outpatient practice. 

Best Practices for Compliance 

Because CPT 98981 generates higher reimbursement, it faces higher scrutiny. 

1. “Audit-Proof” Your Time Logs
   If you bill an add-on code, you must be able to prove exactly when that extra time occurred. “Estimated time” is not enough. You need timestamps showing exactly when you reviewed data and exactly how long your calls lasted.
2. Justify Medical Necessity
   Your documentation must explain whythe patient needed so much time. 

• Bad Note: “Spoke with patient for 40 minutes.” 

• Good Note: “Extended discussion required (25 mins) to address new onset of night pain and modify HEP to prevent regression. Reviewed medication adherence and coordinated with referring surgeon.” 

3. Use Technology to Track It
   Manually adding up minutes on a sticky note is a recipe for errors.

• The EMBODI Advantage: Our platform automatically aggregates your time. It knows that once you pass the 20-minute mark, the next bucket begins. It visualizes your progress toward the CPT 98981 threshold so you know exactly which high-needs patients are eligible for the add-on code. 

Stay Tuned: Preparing for 2026 

While CPT 98981 is a powerful tool for complex cases today, the regulations surrounding time-based billing are evolving. 

In January, we will release our “2026 RTM Code Guide.” 
We will break down how the new year’s changes will impact documentation standards for these high-value codes.  

Disclaimer: The information contained in this document does not, and is not intended to, constitute legal, billing, or regulatory advice or guidance. All information, content, and material is for general information purposes and independent review and/or counsel should be obtained before making any legal or billing decisions.