98980 Code: First 20-min RTM Services Overview
98980 - First 20-min RTM services
"The amount of remote therapeutic monitoring, treatment management, physician (or other qualified health care professional) time spent in a calendar month, necessitating at least one interactive communication with the patient or caregiver throughout the calendar month; first 20 minutes."
The requirements for billing 98980 code are automatically tracked by the RTM Timer.
Requirements:
- 20 minutes of RTM treatment management services
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One interactive communication
Frequency:
-
1x per calendar month
When to bill for code 98980?
Provider Scenario:
- Provider Sets up Patient in the system
- Provider renders 20 minutes of RTM treatment management services + one interactive communication in a calendar month
Billing decision:
- Bill code 98980 as soon as the code requirement is met if you think you won't be able to hit requirement for codes 98981.
- 98979 and 98980 OR 98981 cannot be billed at the same time in the same calendar month.
Average Reimbursement: ~$54.38
Notes:
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For the provider usage-based codes: (98980, 98981 & 98979)
Key point: 98979 (10 min) and 98980 (20–39 min) are not additive base codes.
CMS have clarified that you would need to choose the one that best matches total time that month:
- If the total RTM time is ~10–19 minutes → then bill 98979
- If the total RTM Tile is 20–39 minutes → then bill 98980, plus 98981 if you go 40+ minutes
- 98979 and 98980 OR 98981 cannot be billed at the same time in the same calendar month.
- Codes 98981 needs to billed together with code 98980 to get reimbursed, if billed separately code 98981 will be denied.
- Code 98980 is subject to the de minimis policy.