CPT 98981: Each Additional 20 Minutes of RTM Treatment Management | Orva

Remote Therapeutic Monitoring

CPT 98981: Each Additional 20 Minutes of RTM Treatment Management

Use 98981 to report each additional 20 minutes of RTM treatment management time in a calendar month, after 98980 has been met. At least one interactive, real-time, patient-facing communication with the patient or caregiver is required during the month. This page covers quick facts, requirements, documentation, examples, and how 98981 pairs with 98980.

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Quick facts

Short descriptionEach additional 20 minutes of RTM treatment management time in a calendar month, with interactive communication
Who can billPhysicians and other qualified health care professionals. When furnished by therapists, services are therapy and require the correct therapy modifier
Billing periodPer calendar month
Relationship to 98980Use 98981 only after the first 20 minutes in the month have been met and billed with 98980
Interactive communicationRequired in the month. Synchronous, real-time, patient-facing contact with the patient or caregiver
What counts as managementReviewing RTM data, adjusting the plan, coordinating care, patient coaching, documenting decisions
Therapy modifiersGP, GO, or GN under a therapy plan of care. Add CQ or CO when assistant involvement exceeds the de minimis threshold
Unit limitsFollow payer policy for how many units of 98981 may be reported in a month
Do not double countDo not count time toward other services in the same period

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

What you need

  • At least 40 minutes total management time in the month for one unit of 98981 after 98980
  • At least one real-time, patient-facing communication in the month
  • Additional units only when cumulative time crosses each additional 20-minute threshold in the same month
  • Time can occur on different days and is summed across the month; do not overlap with other billed services

Documentation checklist

  • Monthly time log reaching 40 minutes for one unit of 98981, 60 minutes for two units, and so on
  • Interactive communication details: date, duration, participant, and purpose
  • Link to the therapy plan of care and clinical decisions made from the data
  • Confirmation that time was not counted toward other billed services

Examples

40 minutes total with one call

Total management time in the month is 40 minutes and includes at least one real-time check in. Bill 98980 for the first 20 minutes and one unit of 98981 for the additional 20 minutes.

60 minutes total with two calls

Total management time is 60 minutes with at least one real-time call. Bill 98980 and two units of 98981.

25 minutes total

Total management time is 25 minutes with a real-time call. Bill 98980 only. Do not bill 98981 because the additional 20-minute threshold was not reached.

45 minutes but no real-time call

Total time is 45 minutes but there was no interactive, real-time communication. Do not bill 98980 or 98981. Schedule a quick patient-facing touchpoint before month end.

Payers may cap the number of 98981 units per month. Check your contracts and policies.

How 98981 fits with other RTM codes

98975

Initial set-up and patient education. Report once per episode of care.

98977

Device supply and therapeutic data collection each 30 days.

98980

First 20 minutes of management time in a month with interactive communication.

For the full picture visit the RTM guide.

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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