Deep Dive into CPT Code 98981: Unlocking Extended RTM Management for Deeper Patient Impact in Physical Therapy

Remote Therapeutic Monitoring (RTM) is transforming MSK care by reimbursing extended clinical oversight, and CPT code 98981 is the add-on powerhouse for time beyond the initial 20 minutes. This code captures each additional 20 minutes of data review, plan adjustments, and patient interactions in a calendar month—requiring the same live communication as its base code. With no 16-day data threshold, 98981 rewards thorough management, adding $39+ monthly per patient. In late 2025, it’s essential for PTs scaling hybrid models without denials. Here’s the full breakdown with tips and scenarios.

What Exactly is CPT Code 98981?

AMA definition: Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure).

As an add-on to 98980, it reimburses cumulative time for interpreting RTM data (e.g., HEP adherence, pain trends), modifying therapies, and direct engagement. Activities must tie to therapy adherence/response; no physiologic data needed.

For PTs, this means extra dashboard dives into risk alerts or video call extensions—stackable for complex cases.

Billing Requirements: Add-On Rules and No Data Minimums

98981 is strictly additive, with CMS flexibility:

• Each Additional 20+ Minutes: Beyond 98980’s first 20; bill per full 20 (e.g., 41-60 min = one unit). No partials—59 min = one unit.
• Must Pair with 98980: Standalone denied; same month, provider, patient.
• One Interactive Communication: Inherited from 98980—real-time (phone/video); applies to total time.
• No 16-Day Rule: Management codes bill regardless of transmissions—focus on clinical effort.
• Calendar Month: Unlimited units if time accrues; one provider only.
• Supervision/Modifiers: General for auxiliaries; GP for therapy; CQ/CO if PTA/COTA >50% (15% reduction).
• No Overlaps: Not with RPM management or duplicates.

Bill month-end; time aggregates across sessions.

Documentation: Proving Every Extra Minute

Audits target add-ons—detail cumulatively:

• Total Additional Time: Breakdown (e.g., “25 min: 15 reviewing trends, 10 video coaching”).
• Link to 98980: Reference base code; shared interaction.
• Data/Decisions: Specifics (e.g., “Adherence 65%; added stretches; risk alert resolved”).
• Necessity: POC tie-in (e.g., “Extended for post-op complications”).
• No Inflation: Exact minutes; auto-logs help.

Tip: Platforms timestamp reviews/calls—export for claims. PTAs? Flag contributions for modifiers.

Reimbursement Rates in 2025

National non-facility average: ~$39.14 (locality-varying; e.g., urban boost). PFS Look-Up Tool for MAC specifics—stacks for 60+ min cases. Additive revenue with zero hardware.

Real-World PT Scenarios: Stacking for Success

Scenario 1: Moderate Extension Knee rehab patient: Month total 45 min (20 base + 25 add’l: 15 analytics, 10 call). Bill 98980 + one 98981. $39 extra; HEP refined mid-month.

Scenario 2: High-Needs Chronic Pain Back patient logs variably. PT: 20 base + 65 add’l (dashboards, three 10-min videos, alerts). Bill 98980 + three 98981. Outcomes: 80% adherence, 30% faster progress.

Scenario 3: The Add-On Trap PT logs 38 min total (no extra 20). Bill only 98980—missed unit. Tip: Track cumulatively; MovementRx timers flag thresholds.

Scenario 4: PTA Hybrid PTA: 30 min reviews/calls; PT: 20 min adjustments. Total 50 min. Bill 98980 + one 98981 (CQ if PTA-heavy—check de minimis).

Pitfall Example: 59 min scattered, no sync extension. One unit max. Always aggregate; predictive tools prompt deeper dives.

Common Pitfalls and Pro Tips

• No Base Code: Forgetting 98980—full denial.
• Partial Minutes: 19 add’l = zero units. Bundle sessions.
• Interaction Shortfall: Base interaction covers, but document.
• Modifier Misses: CQ/CO errors reduce pay.
• Overbilling: Multiple providers or non-RTM time.
• Tip: No data min means bill low-volume months. Always-on apps feed richer reviews, justifying extras. Use in-app chat/video for easy interactions.

Why Excel at 98981? Maximizing RTM ROI

This add-on turns thorough care into $100+ monthly stacks, boosting adherence 80%+ and cutting dropouts. Clinics layering it see 20-50% lifts with superior outcomes.

Ready to stack minutes seamlessly? MovementRx auto-tracks extras, prompts communications, and flags billable thresholds—compliant docs included. Free demo at mymovementrx.com to extend your RTM reach.

For more guidance on Remote Therapeutic Monitoring (RTM) and compliant billing practices, physical therapists can explore the AMA CPT® Code Set for official definitions and updates to codes like 98981. The CMS Physician Fee Schedule Look-Up Tool provides the latest reimbursement rates by region, while the CMS RTM Fact Sheet outlines federal coverage criteria for remote care. For a professional perspective, the American Physical Therapy Association’s RTM Overview details how these codes integrate into physical therapy workflows. To better understand RTM’s clinical impact, review peer-reviewed research in PubMed, including recent NIH-funded studies demonstrating improved adherence and patient outcomes with digital MSK programs.