Remote Therapeutic Monitoring
CPT 98981 in 2026 RTM treatment management add-on 20 minutes
Use 98981 to report additional RTM treatment management time after 98980 in the same calendar month. Think of 98980 as the first block and 98981 as each additional 20-minute block beyond that.
Quick facts
Updated for 2026Time selection rule
Practical tip: Most clinics miss 98981 not because the work is not happening, but because time is not logged consistently.
Always confirm payer and MAC guidance for your state, setting, billing entity, and patient plan.
What typically counts toward additional 98981 time
- Additional review of RTM trends, risks, and adherence signals after the first 20 minutes are already met
- More program updates, progressions, regressions, or education tied to the plan of care
- Follow-up outreach that results in actionable clinical decisions and documented outcomes
- Documenting decisions, goal updates, and any escalations made during the month
98981 should read like deeper clinical oversight, not repeated notes. More time is justified when the patient needs more active management.
How to keep 98981 audit-ready
Add-on time is easiest to defend when your documentation shows a clear sequence.
| Step | What an auditor expects to see |
|---|---|
| 1 | 98980 met and billed for the month |
| 2 | Additional time entries beyond the first 20 minutes, date-stamped and attributed |
| 3 | Clear clinical actions tied to RTM findings |
| 4 | A record of the real-time interactive communication that occurred during the month |
If your notes show the time but not the actions, payers often treat the month as weakly supported.
Documentation checklist
- Calendar month and total minutes for the month
- Confirmation that 98980 was met and billed for the month
- Time entries that support each additional 20-minute block billed with 98981
- Summary of RTM data reviewed and the clinical actions taken in response
- Rendering clinician and any required therapy modifiers when applicable
- Statement that time was not counted toward other billed services for the same work
If you want to keep this lean, document one monthly summary that clearly supports time and actions.
Examples
Many payers cap add-on units. If time is above the cap, document it anyway for clinical continuity, but bill only what the payer allows.
Total time is counted in a calendar month. Keep the month boundary and the time math obvious.
How 98981 fits with other RTM codes
98980
The anchor code for the month. Must be billed before any 98981 units are added.
98979
Use when management time is meaningful but stays below 20 minutes in a calendar month.
98975
One-time onboarding that starts the episode and sets the patient up for RTM tracking.
98985
Device supply for 2 to 15 monitoring days in a 30-day period.
98977
Device supply for 16 to 30 monitoring days in a 30-day period.
RTM guide
End-to-end workflow, including enrollment, documentation, and billing best practices.
98981 is where your billing begins to reflect true intensity of oversight. It is easiest to support when time and clinical actions are logged as they happen.
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
Track time cleanly, capture the live touchpoint, and generate documentation that supports accurate billing.