98981 Code: Additional 20-min RTM Services Overview

98981 - Additional 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; each additional 20 minutes."

The requirements for the 98981 billing code are automatically tracked by the RTM Timer.

Requirements:

20 minutes of RTM treatment management services
98981 now requires an additional live interaction. That means: that in order to bill the first 98981 code, providers would have to log 2 live interactions.

Summary:

a.) First 98981 → requires 2 total live interactions

b.) Second 98981 → requires 3 total live interactions
Code 98981 needs to billed together with code 98980 to get reimbursed, if billed separately code 98981 will be denied.

Frequency:

Multiple times per calendar month

Provider Scenario:

Provider Sets up Patient in the system
Provider renders 21+ minutes of RTM treatment management services + one interactive communication in a calendar month

Billing decision:

If you hit RTM Code 98981 requirement, you'll have to do an addendum to add it to the same visit that you billed 98980.
Otherwise you can wait to bill RTM code 98980 if you think you'll hit 98981 later in the month.

Average Reimbursement: ~$41.63

Notes:

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 98981 is subject to the de minimis policy.