CPT Code 98980: Paymedics Billing Guide for Remote Therapeutic Monitoring 2026

Remote therapeutic monitoring can create recurring clinical work for your practice.

It can also create recurring billing problems. A provider may review therapeutic data, assess patient progress, communicate with the patient, and document the work. Yet, a claim can still face denial if the service is coded incorrectly.

That is where CPT code 98980 becomes important.

For 2026, providers and billing teams also need to understand the newer RTM code structure. CMS added 98979 for shorter treatment-management services. This makes accurate time tracking more important than before.

This guide explains the coding and billing considerations providers should review before submitting RTM claims.

What Is CPT Code 98980?

CPT code 98980 reports remote therapeutic monitoring (RTM) treatment-management services. The code represents the first 20 minutes of physician or other qualified healthcare professional time in a calendar month. The service requires at least one interactive communication with the patient or caregiver during that calendar month.

The provider uses information obtained through RTM to help manage the patient’s therapeutic care.

Examples may include monitoring:

• Therapy adherence
• Therapy response
• Respiratory-system status
• Musculoskeletal-system status
• Digital therapeutic interventions
• Other qualifying therapeutic information

The exact service must satisfy applicable CPT and payer requirements. For medical billing teams, the distinction matters. A device supplying data and the provider managing treatment are not represented by the same CPT code.

Why CPT Code 98980 Matters for Providers

RTM billing requires a provider to establish that the service was clinically appropriate, properly performed, and documented. For CPT code 98980, the billing record should support the required treatment-management time and interactive communication.

A strong RTM workflow therefore connects four elements:

1. Clinical need
2. Remote therapeutic data
3. Provider treatment-management work
4. Complete documentation

This creates a clearer connection between the patient’s condition and the billed service.

CMS also emphasizes that remote monitoring services must be necessary. Only one practitioner may bill remote monitoring for a patient during a 30-day period under Medicare guidance.

That makes coordination between providers and billing staff essential.

How CPT Code 98980 Works in 2026

The 2026 RTM structure includes an important change.

CMS added 98979, which addresses the first 10 minutes of RTM treatment-management time. The existing 20-minute management structure remains represented by CPT code 98980, while 98981 represents additional 20-minute periods.

The important point is that practices should update their billing workflows for the 2026 code set.

A billing system built around older RTM assumptions can create coding errors when shorter treatment-management periods occur. The American Medical Association’s 2026 CPT update includes new digital-health and remote-monitoring codes.

Documentation Requirements for RTM Billing

Good documentation protects both the provider and the revenue cycle. For an RTM treatment-management claim, documentation should clearly support the service performed.

Consider documenting:

1. Patient and clinical condition

Record the condition being treated and why remote therapeutic monitoring is appropriate. The medical record should establish medical necessity.

2. Remote therapeutic information

Document the relevant information reviewed or used for treatment management. Avoid vague statements such as:

“Reviewed RTM data.”

Instead, describe what information was reviewed and why it mattered clinically.

3. Treatment-management activity

Explain the provider’s clinical work.

For example:

• Treatment response assessed
• Adherence reviewed
• Symptoms discussed
• Treatment recommendations provided
• Therapy plan reinforced
• Clinical intervention made

4. Interactive communication

Document the required real-time interactive communication.

Include:

• Date
• Participants
• Communication method
• Clinical topic
• Outcome or recommendations

5. Time

Track qualifying treatment-management time carefully. Your EHR or billing workflow should allow the practice to distinguish RTM time from time reported under another service.

This is especially important when multiple care-management services occur during the same month.

Common Billing Mistakes to Avoid

Billing without required communication

The code requires at least one interactive communication with the patient or caregiver during the applicable month. Missing communication documentation can create a compliance concern.

Confusing RTM with RPM

RTM and RPM are different code families. Using an RPM code for therapeutic monitoring can result in incorrect coding.

Counting the same time twice

CMS allows certain remote monitoring services to coexist with other care-management services in some circumstances, but the same time and effort cannot be counted twice. Your billing team should maintain separate time records.

Ignoring the 2026 RTM changes

The addition of 98979 changes the way shorter RTM treatment-management services can be represented. Practices should update their coding references and billing software.

Assuming Medicare and commercial payers work identically

Commercial insurers can establish their own coverage and billing requirements. Always verify payer-specific guidance.

What About Physical and Occupational Therapy Practices?

RTM is particularly relevant to therapy practices.

CMS classifies several RTM services as “sometimes therapy” services. For 2026, CMS added 98979, 98984, and 98985 to the therapy code list.

CMS also provides specific guidance concerning therapy modifiers and services furnished by physical therapist assistants (PTAs) and occupational therapy assistants (OTAs).

For example, CMS provides a billing scenario involving 47 minutes of RTM treatment management and explains how 98980 and 98981 are handled when PT and PTA time contribute to the service.

Therefore, therapy practices should not rely only on a generic RTM billing workflow.

They should review:

• Therapy plan-of-care requirements
• Applicable GP/GO/GN modifiers
• PTA/OTA involvement
• CQ/CO modifier requirements
• De minimis rules
• Medicare contractor guidance

This is an area where payer-specific and discipline-specific billing knowledge matters.

Does CPT Code 98980 Have a Fixed Reimbursement Rate?

There is no single universal reimbursement amount that every provider should use for 2026. Medicare payment can vary based on applicable fee-schedule and geographic factors.

Commercial payer contracts can differ even more.

For example, CMS’s Medicare data tools show that actual submitted charges, allowed amounts, and Medicare payments can vary among providers.

Therefore, practices should avoid using a single online dollar figure as a guaranteed reimbursement rate.

Instead, verify:

1. The patient’s payer
2. Provider participation status
3. Geographic locality
4. Applicable Medicare fee schedule
5. Commercial payer contract
6. Claim-specific adjustments
7. Patient responsibility

For revenue-cycle planning, your billing team should use actual remittance data whenever possible.

2026 RTM Billing: What Providers Should Watch

The RTM code family continues to evolve. The 2026 CPT code set introduced additional remote-monitoring codes, reflecting shorter-duration monitoring services.

At the same time, CMS has already proposed additional RTM policy changes for 2027.

The CY 2027 proposed Physician Fee Schedule includes proposals concerning established-patient requirements, initiating visits, clinical staff, contractor arrangements, and valuation of remote-monitoring services. These are proposals, not 2026 requirements.

Providers should therefore avoid updating their 2026 billing workflow based on proposed 2027 rules.

Keep current requirements and future proposals clearly separated.

Example: How a Provider Might Document RTM

Consider a patient receiving remote therapeutic monitoring as part of an ongoing treatment plan.

During the month, the provider reviews the available therapeutic information and assesses the patient’s response. The provider then conducts an interactive communication with the patient.

During that communication, the provider discusses the patient’s progress and reinforces or adjusts the treatment plan.

The provider documents the clinical assessment, communication, treatment-management work, and qualifying time.

If the service meets all applicable requirements, the billing team can then evaluate whether the appropriate 2026 RTM treatment-management code should be submitted.

The important point is not simply reaching a time threshold.

The documentation should demonstrate why the service occurred and what clinical work was performed.

How Paymedics Can Help With RTM Medical Billing

RTM billing requires coordination between clinical documentation, coding, payer rules, and revenue-cycle management.

That is where an experienced medical billing partner can support a practice.

At Paymedics, our medical billing approach focuses on connecting clinical documentation with accurate claim submission and revenue-cycle processes.

For practices using RTM, an effective billing workflow can include:

• Patient eligibility verification
• Insurance verification
• CPT coding review
• Documentation review
• Claim submission
• Clearinghouse rejection management
• Denial management
• Payment posting
• Accounts receivable follow-up
• Revenue-cycle reporting

The goal is to submit clean, defensible claims supported by appropriate documentation. For providers, that distinction matters.

Final Thoughts

RTM can extend patient care beyond the traditional clinical encounter. But remote monitoring also creates another layer of billing responsibility.

For 2026, providers need to understand the distinction between RTM device services and treatment-management services, document clinical work carefully, track qualifying time, and verify payer-specific requirements.

The introduction of 98979 also makes the 2026 RTM code structure more important for billing teams to understand.

Accurate coding starts with accurate clinical documentation.

Accurate reimbursement follows from a billing process that connects the two.

For practices that want to reduce preventable denials and strengthen their revenue cycle, Paymedics provides medical billing support designed around accurate coding, documentation review, claims management, and ongoing revenue-cycle oversight.

Need help reviewing your RTM billing workflow? 

Contact Paymedics to discuss your practice’s medical billing needs.

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