98975 Code: Initial Setup Overview

98975 - Initial Setup

“Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on the use of equipment).”


The requirements for billing 98975 code are automatically tracked and can be analyzed on the RTM Dashboard.


NEW UPDATE: Changes for 98975 Effective January 1, 2026

  • 98975 now requires at least 2 days of monitoring in a 30-day period, not 16 days as under the old structure.

When to bill for code 98975 (Setup Code)?

Example Patient Scenario:

  • Day 1 (Date: January 15, 2026) — The patient is set up on the app. Patient logs in and achieves 1st data point.
  • Day 2 (Date: January 16, 2026) — Second day of the active Plan of Care.
  • Day 3 (Date: January 17, 2026)  — Eligible to be billed 2 days after patients Plan of Care is activated.

Billing Decision: Bill code 98975 as soon as code requirement is met. You can add CPT 98975 to any visit occurring after the second day of the active Plan of Care.


Frequency:

  • 1x per episode of care

Average Reimbursement: ~$21.82

Notes:

  • Code 98975 can be billed again on a new plan of care for patients that were discharged and then readmitted.
  • Code 98975 still requires 1 day of data point and can be billed 2 days after the patients Plan of Care is activated.
  • Code 98975  is subject to the de minimis policy.


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