The new RTM billing codes can be categorized into two distinct groups:

  • Setup, Supply, and Data Receiving Codes (98975, 98977)

  • Patient Monitoring Codes (98980, 98981)

These two different groups have distinct characteristics that are important to understand when completing services for RTM. In this article, we will discuss the first group of codes, how they are important, and how to bill for them using PatchRx.

CPT® code 98975 (~$18)

Definition: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment

This would equate to the setup of a PatchCap and gateway, and education to the patient on how to use the PatchCap and gateway to track their medication compliance. Unlike other codes, this code can only be billed once every 365 days. Additionally, this code can not be billed until after 16 days of data have been received from the patient, meaning that it should only be submitted once 98977 is completed.

In the PatchRx Web Portal, we store the day the patient is added as the day that the patient was educated on the PatchRx system. During the add patient process, there is a checkbox in which the patient must agree that they received education on how to use the PatchCap and Gateway device. A patient's confirmation of this checkbox is required in order to be added to PatchRx.

After the first 16 days of data are reported for this patient, you will be able to export this billing code to be uploaded to the patient's EHR for billing purposes.

CPT® code 98977 (~$54)

Definition: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days

This code is specific to diagnoses that fall under the category of “Musculoskeletal”. This distinction is important to make in the setup process of RTM as only musculoskeletal conditions are eligible for billing under code 98977. You can also bill for code 98976 for respiratory patients, but as pain patients typically fall into the musculoskeletal category, we have excluded it from this guide.

This code requires that we are remotely receiving data on the patient's medication compliance over a course of 30 days and requires that we receive data for at least 16/30 days. Once we have received 16 days' worth of data, you will also be able to bill for code 98977. This is also tracked based on the patient setup date for the first 30 day cycle. After the first 30 days are completed, we restart data tracking for code 98977 starting on day 31, and so on for the duration of the patient's remote monitoring.


If you have additional questions on how RTM billing codes work or how to bill for them on PatchRx, please contact us at (918) 727-2962, at support@patchrx.io, or on our website or app chat.

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