CPT 98975 in 2026: RTM Initial Set-Up and Patient Education | Orva

Remote Therapeutic Monitoring

CPT 98975 in 2026: Initial Set-Up and Patient Education

Use 98975 to report the one-time set-up and education needed to start an RTM episode. This page covers requirements, documentation, and how 98975 fits with 98985, 98977, 98979, 98980, and 98981.

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Quick facts

Updated for 2026
Short description Initial set-up and patient or caregiver education for an RTM system used to collect therapeutic data
Frequency Once per episode of care
What it covers Configuration plus instruction so the patient can follow the daily workflow and generate usable therapeutic data
What it does not cover Device supply or ongoing management work that is billed separately when appropriate
Who can bill Physicians and other qualified health care professionals. When furnished by therapists, services follow therapy billing rules and modifiers when applicable
Therapy modifiers When billed as therapy, use GP, GO, or GN under a therapy plan of care. Add CQ or CO when required by payer policy for assistant involvement
Where it happens Set-up and education may occur in the clinic or the patient’s home, based on workflow and payer rules

Always confirm payer and MAC guidance for your state, setting, billing entity, and patient plan.

What you need

  • An RTM system intended to collect therapeutic data relevant to the plan of care
  • Set-up completed so the patient can follow the daily workflow (program schedule, reminders, check-ins, symptom tracking)
  • Education delivered to the patient or caregiver, including what to do if issues come up
  • Report 98975 once per episode, then bill other RTM codes only when their separate requirements are met

Practical tip: If you start with HEP only and enable RTM later in the episode, 98975 is the onboarding event tied to that RTM start.

Documentation checklist

  • RTM system used and the clinical purpose tied to the plan of care
  • Date of set-up and what was configured (schedule, program, prompts, check-ins)
  • Education details and confirmation the patient or caregiver understood the workflow
  • Billing context: episode start date, rendering clinician, and any modifiers used when applicable

Keep this specific. When 98975 is challenged, payers typically want to see clear education plus a clear link to clinical goals.

How 98975 fits with other RTM codes

98985

MSK device supply and data access or transmissions each 30 days, billed separately when requirements are met.

98977

MSK device supply and data access or transmissions each 30 days, billed separately when requirements are met.

98979

Treatment management time, billed separately when requirements are met.

98980

Treatment management time, billed separately when requirements are met.

98981

Additional treatment management time in the same month after 98980, billed separately when requirements are met.

RTM guide

See the full workflow, including enrollment, documentation, and billing best practices.

98975 starts the RTM episode. The remaining RTM codes are billed separately when their requirements are met.

Common scenarios

New postoperative patient

The therapist sets up the patient with a daily program and educates the patient on logging completion and symptoms. Bill 98975 once for the episode. Then bill other RTM codes separately when their requirements are met.

HEP first, RTM enabled later

The clinic begins with HEP only. Later, the therapist enables RTM and trains the patient on the RTM workflow. Bill 98975 once at the RTM start. Then bill other RTM codes separately when their requirements are met.

Caregiver supported patient

A caregiver assists with daily logging. Document that education was provided to the patient or caregiver as appropriate and that the caregiver understands the workflow, including what to do if the patient has issues using the system.

Restarting after a lapse

If a patient stops using RTM for a period and later restarts, confirm payer guidance on whether a new episode exists. If payer policy supports a new episode, document what changed and what new education was provided.

Compliance note

Orva has signed the APTA Digital Transparency Pledge. Coding guidance here is educational and does not guarantee coverage or payment. Confirm payer policy and MAC guidance for your state, setting, billing entity, and patient plan.

Make RTM simple for your therapists

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