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
Day 2 (Date: January 17, 2026) — The patient activates their account (achieves 1 day with data point)
Day 3 (Date: January 19, 2026) — The patient logs in to the app, mark their exercise as complete or messaged their provider. (achieves 2 days with data points)
Day 4 (Date: January 20, 2026) — Expected Ready for Billing Date

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: ~$20

Notes:

Code 98975 can be billed again on a new plan of care for patients that were discharged and then readmitted.