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.
- Added a new back-end configuration toggle that allows organizations to track RTM code 98975 after receiving at least two data recordings, instead of requiring two full days of monitoring past the activation date based on interpretation preference.