CPT 98975 Remote Therapeutic Monitoring Reimbursement

CPT code 98975 covers the initial setup and patient education for remote therapeutic monitoring (RTM) equipment, a critical entry point for delivering digital health interventions that support ongoing therapy outside traditional clinical encounters. Nationally, this code matters because it documents and bills the time and expertise required to configure devices and train patients, enabling longitudinal remote monitoring that can improve adherence and clinical oversight. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context of the service, how the code is used to capture the setup and education component of RTM programs, and the payer landscape involved in coverage for such services. The publication provides benchmarks and common billing practices, highlights policy and coverage considerations affecting adoption, and explains where CPT code 98975 fits within a broader remote therapeutic monitoring workflow. Data not available in the input for specific payer policies, reimbursement rates, and associated diagnosis codes are noted where applicable.

Billing Code Overview

CPT code 98975 describes the initial setup of equipment for remote therapeutic monitoring and includes patient education on how to use the device. The service involves configuring monitoring hardware or software and instructing the patient so they can participate in an ongoing remote therapeutic monitoring program.

Service type: Device setup and patient education for remote therapeutic monitoring
Typical site of service: Outpatient clinic, ambulatory care setting, or the patient's home when setup is performed in a home-based visit

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical Context

A 58-year-old patient with chronic low back pain and radiculopathy is prescribed a remote therapeutic monitoring (RTM) program to track activity, pain scores, and therapy adherence. During an office visit or a dedicated device setup encounter, the clinician or qualified health professional performs the initial setup of the RTM equipment, configures the device/app, pairs sensors, enrolls the patient in the monitoring platform, and provides patient education on device use, data transmission, troubleshooting, and expectations for follow-up. The setup visit typically occurs in an outpatient clinic, physical therapy department, or hospital-affiliated outpatient setting. The workflow includes device inventory check, software account creation, demonstration of sensor placement and operation, verification of successful data transmission, documentation of equipment serial numbers and patient consent, and scheduling of remote monitoring follow-up sessions or care management based on incoming data.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the professional interpretation/clinical service distinct from device or technical components during setup education by a physician.
`59`	Distinct procedural service

Taxonomy Code	Specialty	Notes
261QM0800X	Physical Therapist	Physical therapists commonly perform device setup, sensor placement, and patient education for therapeutic monitoring programs.
207L00000X	Physical Medicine & Rehabilitation Physician	PM&R physicians oversee therapy programs and may perform or supervise RTM setup and education.
207R00000X	Pain Medicine Physician	Pain specialists prescribe RTM programs for chronic pain and coordinate setup and follow-up.
163WP0800X	Occupational Therapist	Occupational therapists perform functional assessments and may set up RTM equipment focused on activity and function.
173K00000X	Clinical Nurse Specialist	Advanced practice nursing staff often conduct device education and technical setup as part of care coordination.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M54.5`	Low back pain	Common indication for therapeutic monitoring of activity, exercises, and pain reporting via RTM devices.
`M54.16`	Radiculopathy, lumbar region	RTM can track activity tolerance and adherence to rehabilitation for lumbar radiculopathy.
`M25.571`	Pain in right hip	Joint or regional musculoskeletal pain often managed with home exercises and activity monitoring via RTM.
`M25.572`	Pain in left hip	Similar relevance for bilateral or contralateral joint monitoring and therapy adherence.
`G89.29`	Other chronic pain	Chronic pain conditions managed with therapeutic programs that benefit from remote monitoring of function and adherence.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`98975`	The provider performs initial setup of equipment for remote therapeutic monitoring. The provider also educates the patient on use of the equipment.	This is the primary code describing the initial RTM device setup and patient education encounter.
`98976`	Remote therapeutic monitoring of respiratory system status, initial period; supply of device(s) and/or equipment for respiratory monitoring.	Used when the RTM program includes remote respiratory monitoring and devices are provided; may be billed for ongoing device supply distinct from setup.
`98977`	Remote therapeutic monitoring of respiratory system status, subsequent; set-up and patient education not separately billable when billed with `98975` during the initial encounter.	Billed for subsequent monitoring or device data transmission services after initial setup.
`98980`	Remote therapeutic monitoring treatment management services, physician or other qualified health care professional; first 20 minutes.	Used for time-based clinical management of RTM data following initial setup and education.
`99457`	Remote physiologic monitoring treatment management services, first 20 minutes of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver.	May be billed for clinical management that includes interactive communication in addition to RTM data review; complements `98975` when active management is required.
`99091`	Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient to the physician or other qualified health care professional, requiring a minimum of 30 minutes of time.	Used when substantial clinician time is spent collecting and interpreting RTM data; may be billed in appropriate workflows after setup.

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Summary & Overview

CPT 98975: Remote Therapeutic Monitoring Equipment Setup and Patient Education