CPT Code 98977: Remote Therapeutic Monitoring Device Supply and Data Transmission
What is CPT Code 98977?
CPT code 98977 represents the ongoing supply of Remote Therapeutic Monitoring technology and data transmission services for musculoskeletal conditions. This code covers the monthly provision of RTM devices, data collection, storage, and transmission to healthcare providers for clinical review.
Code Description: Remote therapeutic monitoring (RTM) treatment management services, physician or other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; initial 20 minutes
Billing Frequency: Once every 30 days
Average National Reimbursement: $47.27 (rates vary by region and payer)
Core Purpose and Function
Unlike the one-time setup covered by 98975, CPT 98977 represents the recurring technological infrastructure that enables continuous remote monitoring. This code compensates practices for providing patients with ongoing access to medical-grade monitoring technology and ensuring reliable data transmission for clinical decision-making.
The code specifically covers:
Monthly device availability and functionality
Secure data collection and storage
Encrypted transmission to healthcare providers
Technical support and troubleshooting
Device maintenance and updates
Critical Billing Requirements
16-Day Usage Threshold
Similar to 98975, billing 98977 requires documented patient engagement with the RTM device for at least 16 days within each 30-day billing period. This ensures patients are actively participating in their monitoring program rather than simply possessing unused equipment.
30-Day Billing Cycles
98977 follows calendar-based billing cycles, typically aligned with monthly periods. Claims should be submitted only after the completion of each 30-day period and verification of the usage requirements.
Medical Device Compliance
The technology supporting 98977 claims must maintain medical device classification throughout the billing period. This includes:
FDA compliance for therapeutic monitoring
HIPAA-compliant data handling
Clinical-grade accuracy and reliability
Audit-ready data logging capabilities
Musculoskeletal Focus
98977 is specifically designed for musculoskeletal and movement-related conditions. Unlike Remote Patient Monitoring (RPM) codes that track vital signs, 98977 focuses on therapeutic adherence, exercise performance, and recovery metrics.
Data Transmission Requirements
Clinical-Grade Data Collection
The data transmitted under 98977 must provide clinically relevant information for treatment decisions. This typically includes:
Exercise adherence and performance metrics
Range of motion measurements
Pain and functional status reporting
Activity level and progression tracking
Secure Transmission Standards
All data transmission must meet healthcare security requirements:
End-to-end encryption
HIPAA-compliant storage and transmission
Audit trails for data access
Secure provider dashboard access
Real-Time Availability
Data collected under 98977 should be available to providers in near real-time, enabling timely clinical interventions and care plan adjustments throughout the monitoring period.
Relationship to Other RTM Codes
Foundation Requirement: 98975
98977 cannot be billed without first establishing proper 98975 documentation. The initial setup and patient education must be completed and the 16-day threshold met before any 98977 billing begins.
Integration with Clinical Management: 98980/98981
While 98977 covers the technology infrastructure, codes 98980 and 98981 address the clinical time spent reviewing and acting on the data transmitted. These codes work together to create comprehensive RTM coverage:
98977 ensures data availability
98980/98981 compensate for clinical interpretation and patient communication
Continuous Care Cycle
98977 creates the foundation for ongoing remote care by maintaining the technological connection between patients and providers throughout the episode of care.
Documentation Requirements
Usage Tracking
Accurate documentation must demonstrate:
Daily device usage patterns
Specific days of engagement within each billing period
Technical performance and data quality
Any interruptions or technical issues
Device Management Records
Maintain detailed records of:
Device assignments and configurations
Technical support provided to patients
Software updates or modifications
Hardware maintenance or replacements
Clinical Integration
Document how 98977 data integrates with overall patient care:
Provider review of transmitted data
Clinical decisions based on monitoring information
Care plan adjustments informed by RTM data
Common Billing Challenges and Solutions
Premature Claims Submission
Challenge: Submitting 98977 claims before completing the full 30-day period or confirming 16-day usage.
Solution: Implement systematic billing schedules that verify usage thresholds before claim submission.
Overlapping Provider Claims
Challenge: Multiple providers attempting to bill RTM codes for the same patient simultaneously.
Solution: Establish clear protocols for verifying exclusive RTM provider status during patient intake.
Technical Interruptions
Challenge: Device malfunctions or connectivity issues affecting the 16-day usage requirement.
Solution: Maintain backup systems and rapid technical support to minimize disruptions.
Data Quality Issues
Challenge: Incomplete or clinically irrelevant data transmission affecting claim validity.
Solution: Regular data quality audits and patient education on proper device use.
Payer-Specific Considerations
Medicare Coverage
Medicare consistently reimburses 98977 when properly documented, with no therapy caps or prior authorization requirements. The code is classified as “sometimes therapy,” often eliminating patient copays.
Commercial Insurance Variability
Commercial payer coverage varies significantly:
Some follow Medicare guidelines exactly
Others require prior authorization or additional documentation
Reimbursement rates may differ substantially from Medicare amounts
Verify benefits before program enrollment
Medicare Advantage Plans
Most Medicare Advantage plans cover 98977 but may require:
Enhanced documentation
Prior notification of RTM programs
Specific technical specifications for devices
Regular usage reporting
Revenue Optimization Strategies
Consistent Billing Cycles
Establish regular monthly billing schedules to maximize revenue capture and reduce administrative burden. Many practices find success billing on the first Saturday of each month.
Patient Engagement Monitoring
Proactively monitor patient usage to ensure 16-day thresholds are met. Early intervention for low-engagement patients protects revenue and improves outcomes.
Technology Investment
Choose RTM platforms that automatically track usage and generate billing-ready documentation to reduce administrative costs and improve accuracy.
Staff Training
Ensure billing staff understand the unique requirements of 98977 compared to traditional therapy codes, including timing, documentation, and usage thresholds.
Compliance and Audit Preparedness
Essential Documentation
Maintain comprehensive records including:
Daily usage logs for each patient
Data transmission records and quality metrics
Device assignment and maintenance logs
Patient communication regarding technical issues
Audit Response Strategy
Organize documentation to clearly demonstrate:
Legitimate medical device use
Consistent data transmission
Clinical relevance of collected information
Compliance with usage requirements
Quality Assurance
Regular internal audits of 98977 billing help identify potential issues before external review:
Verify usage calculations
Confirm data transmission quality
Review patient engagement patterns
Validate device compliance status
Future Considerations
2026 Policy Updates
Proposed changes may reduce the 16-day requirement and introduce more flexible billing options. However, the core concept of 98977 as technology supply compensation is expected to remain stable.
Technology Evolution
As RTM technology advances, practices should ensure their chosen platforms continue meeting medical device requirements and providing audit-ready documentation.
Market Expansion
Growing commercial payer adoption of RTM coverage creates opportunities for revenue growth, making proper 98977 implementation increasingly valuable.
CPT code 98977 represents the technological backbone of successful RTM programs. When properly implemented and billed, it provides sustainable monthly revenue while supporting improved patient outcomes through continuous remote monitoring capabilities.