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

Remote Therapeutic Monitoring

CPT 98975: Initial Set-Up and Patient Education

Use 98975 to report the one-time set-up and patient or caregiver education for an eligible RTM app or device. Below you will find quick facts, requirements, documentation, and how 98975 fits with 98977, 98980, and 98981.

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Quick facts

Short descriptionInitial set-up and patient education for an RTM app or device used to collect therapeutic data
Who can billPhysicians and other qualified health care professionals. When furnished by therapists, services are therapy and require the correct therapy modifier
FrequencyOnce per episode of care
ActivationMany payers expect monitoring that occurs for at least 16 days in a 30-day period within the episode
Interactive communicationNot required for 98975. The interactive requirement applies to 98980 and 98981
Therapy modifiersGP, GO, or GN under a therapy plan of care. Add CQ or CO when assistant involvement exceeds the de minimis threshold
Place of ServiceSet-up and education may occur in-clinic or in the patient’s home. Follow payer rules for non-face-to-face services

Always confirm payer and MAC policy for your state and setting.

What you need

  • Initial set-up of an eligible RTM app or device for therapeutic data collection
  • Education for the patient or caregiver on use of the app or device
  • Activation with monitoring that occurs for at least 16 days in a 30-day period within the episode, per payer policy
  • Report once per episode of care

Documentation checklist

  • App or device name, clinical purpose, and linkage to the plan of care
  • What was set up and how the patient was educated
  • Date of activation and confirmation that monitoring occurred for at least 16 days in the 30-day period
  • Therapy modifiers used: GP, GO, or GN. Add CQ or CO when required

How 98975 fits with other RTM codes

98977

Device supply and therapeutic data collection each 30 days. Often requires 16 days of data in the period.

98980

First 20 minutes of management time in a month with at least one real-time patient-facing communication.

98981

Each additional 20 minutes of management time in the same month with real-time patient-facing communication.

For the full picture visit the RTM guide.

Common scenarios

New postoperative patient

The therapist sets up the patient with a daily HEP and shows how to log completion and pain. The patient completes more than 16 days in the first 30-day period. Report 98975 once for set-up and education. Bill 98977 if device data thresholds are met. Add 98980 or 98981 for management time if requirements are met.

HEP start then RTM enabled

The clinic begins with HEP only. Later in the episode the therapist enables RTM and educates the patient on the app workflow. When the patient meets 16 days of monitoring in the period, report 98975 once for the episode and pair with other RTM codes as applicable.

Compliance note

Orva has signed the APTA Digital Transparency Pledge. Digital physical therapy services are provided or directed by licensed physical therapists in accordance with regulations. Coding guidance here is educational and does not guarantee coverage or payment. Always confirm payer policy and local MAC rules.

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