The American College of Rheumatology provides ACR and ARP members with key resources and tools to navigate the ever-changing landscape of coding, documentation, billing and practice guidelines. Visit the ACR’s practice support pages for more tools you and your practice team. Information provided by our coding experts is copyrighted by the ACR and intended for individual practice use only.
Remote physiologic monitoring (RPM) treatment management codes were created to report services that are provided when clinical staff utilize the results of remote monitoring devices to manage a patient under a specific treatment plan. These services are a general telehealth option classified under the evaluation and management (E/M) services to collect and analyze patient vitals on an ongoing basis between regular office visits and can only be furnished by a physician, other qualified healthcare professional or clinical staff under the general supervision of physician (eligible to bill for Medicare E/M services). These services are part of a monthly billable program and track patients’ health issues/status which:
- Must be for an established patient, one with whom the physician has had a prior new patient E/M service. This E/M service is allowed to be done via telehealth; and
- Allow for both chronic and acute conditions.
RPM can be performed through the transmission of multiple clinical data devices, such as weight scales, blood pressure monitors, pulse oximeters, glucometers, heart rate monitors, thermometers and spirometers.
The two general RPM Current Procedural Terminology (CPT) codes are:
| Code | Descriptor | wRVU | Non-Facility Fee |
| 99457 | First 20 minutes of physician’s interpretation and interactive communication with the patient/caregiver every month. | 0.61 | $48.13 |
| 99458 | Subsequent 20 minutes of physician’s interpretation and interactive communication with the patient/caregiver every month. | 0.61 | $38.64 |
Note: “Interactive communication” involves a minimum of real-time synchronous, two-way audio interaction that is capable of being enhanced with video or any other kind of data transmission. Additionally, the 20 minutes for both 99457 and 99458 includes both synchronous, real-time interactions as well as face-to-face care management services.
Activities that Contribute to Clinical Monitoring
In general, any time spent monitoring patient data or communicating with patients regarding their health status can be counted towards billing 99457 and 99458, including:
- Monitoring and analyzing patient data;
- Sending any patient communication inline with HIPAA guidelines (text, phone, video);
- Providing ongoing patient education or communicating patient updates and escalations;
- Reviewing patient’s readings with other care team members or other providers; and
- Making changes to patient’s care plan medications.
Documentation is a very important element when billing and coding RPM services, as with other services. Clinical staff must spend a minimum of 20 minutes in a calendar month conducting the monitoring activities. In addition, the clinical staff must have at least one live or synchronous, two-way, interactive call with the patient. To qualify as synchronous communication, this must be at minimum a live phone call or video call. Text messages and/or voicemails do not meet the interactive call requirement. If you met 20 minutes of care time but did not conduct a live conversation with the patient, CPT code 99457 should not be billed.
Remote Therapeutic Monitoring
The Centers for Medicare & Medicaid Services (CMS) introduced several updates and changes in their 2024 Physician Fee Schedule final rule, which included the ruling that federally qualified health centers (FQHCs) and rural health centers (RHCs) can now bill for RPM services and remote therapeutic monitoring (RTM). The new RTM codes are an expansion of the remote physiologic code but focus on the musculoskeletal system status, respiratory system status, therapy adherence and therapy response, and they represent the review and monitoring of data related to signs, symptoms and functions of a therapeutic response. Below is a detailed outline of the code descriptors for RPM and RTM.
The RTM CPT codes are:
| Code | Descriptor | wRVU | Non-Facility Fee |
| 98975 | Initial set-up and patient education on use of equipment for respiratory system status and musculoskeletal system status | N/A | $19.65 |
| 98977 | Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days | N/A | $46.50 |
| 98980 | Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes | 0.62 | $49.77 |
| 98981 | Each additional 20 minutes of RTM services (List separately in addition to code for primary procedure). | 0.61 | $39.29 |
Coding Notes
CPT code 98975: A one-time billable code for the initial set-up and patient education on use of the equipment. This code requires 16 days of collected data/measures, which can be self-reported.
CPT code 98977 (musculoskeletal): Billable once every 30 days and requires 16 days of collected data/measures, which can be self-reported.
CPT code 98980: A time-based code, billable once every 30 days, that covers the first 20 minutes of care management and interactive communication by clinical staff, MD or QHCP. This code requires at least one interactive communication within the calendar month.
CPT code 98981: A time-based code that covers every additional 20 minutes of care management and interactive communication by clinical staff, MD or QHCP. This requires at least one interactive communication within the calendar month.
Remote Therapeutic Code FAQs
Q: Is remote therapeutic monitoring (RTM) different from remote physiologic monitoring (RPM)?
A: Technically, yes. RTM enables patients’ self-reported data and digitally uploaded non-physiologic and therapeutic data. RPM, on the other hand, requires physiologic data that is automatically transmitted and not manually uploaded.
Q: Can RTM and RPM be billed together?
A: No. At this time, RTM and RPM cannot be billed together. The CMS received various comments indicating that these services are different and should be able to be billed together, but unfortunately this is not the case, and providers will need to wait on additional coding guidance from the CMS.
Q: What devices are used with RTM?
A: Any device that meets the FDA definition of “medical devices” can be used for RTM, but the most commonly used devices at this time are the weight scale and spirometer. While there are many remote patient monitoring devices available on today’s market, providers will need to continue monitoring and verifying any new devices with the FDA.
Q: Who can provide RTM services?
A: Clinical staff, MDs, QHCPs, physical therapists (PTs), occupational therapists (OTs) and speech pathologists. All RTM services can be provided under general supervision.
For questions and additional coding guidance for these services, contact the ACR practice management department at [email protected].
