Coding changes have arrived for 2022, and some key new codes are now available for respiratory therapy. These new codes are intended for remote therapeutic monitoring. With such new codes in play, coders and compliance officers may have several questions surrounding the coding. When is it appropriate to use each code? What should I know about the codes themselves before reporting? By reviewing the fundamentals and rationale, coders can better understand how and when to code for these services for success throughout the year.
Effective this year, codes 98975 and 98976 are available to report remote non-physiologic, therapy response/adherence monitoring services related to respiratory system status during a 30-day period. So, what are the circumstances where each code should be reported? Code 98975 may be reported for the set-up and patient education on using the device. Code 98976 is billed for reporting the supply of the device for scheduled recordings or programmed alert transmissions. Understand that like RPM, codes 98975, 98976 are not reported if monitoring is fewer than 16 days. However, unlike RPM, data can be self-reported by the patient to the practitioner as opposed to requiring automatic transmission by the device.
| 98975 | Remote therapeutic monitoring (eg, respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment
Revenue Codes: 0410, 0419, 051x |
| 98976 | Remote therapeutic monitoring (eg, respiratory system status, musculoskeletal system status, therapy adherence, therapy response); device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days
Revenue Codes: 0410, 0419, 051x |
Note that code 98975, which encompasses the initial work associated with onboarding new patients, equipment setup, and patient education, is reported for each episode of care. What about codes 98980 and 98981? These codes are used to report remote therapeutic monitoring treatment management services performed by other qualified health care professionals in addition to physicians.
| 98980 | 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 or caregiver during the calendar month; first 20 minutes
Revenue Codes: 096x, 098x |
| +98981 | Each additional 20 minutes (List separately in addition to code for primary procedure)
Revenue Codes: 096x, 098x |
From a billing perspective, code 98981 may be reported when appropriate with 98980, an add-on code for each additional 20 minutes of time. Note that these are time-based codes requiring at least one interactive communication with the patient or caregiver during the calendar month. Documentation is an especially vital component when coding for this service. Pay particular attention to documentation practices to fully support charges.
When performed in the outpatient setting, code 98975 is reimbursed by CMS according to APC 5012. CPT® 98976 is designated as having a status indicator of “Q1.” A “Q1” is an “STV-packaged” procedure. A procedure that has this designation may be separately reported to Medicare, but separate payment will be received only if no other status indicator “S,” “T,” or “V,” APC reimbursed procedure is billed on the same claim. Codes 98980 and +98981 are assigned an APC status indicator of “B” while being payable to the interpreting physician or other qualified health care professional.
Explore more billing tips and insight for respiratory CPT coding solidified by our nationally renowned experts. As part of our “Breathe Easy, March is Respiratory Therapy Month,” enjoy 20% off of our 2022 RT/Pulmonary Function: 3-Part Coding, Billing & Compliance Set or any of our single products. Now is the best time to act, offer expires 3/31!
MedLearn Media is launching an online resource believed to be useful for professional coders, charge capture, compliance, and revenue integrity specialists alike. DrugCode Pro is
I recently came across a denial indicating that a query was noncompliant because it did not include evidence why the query was needed. I was
Please log in to your account to comment on this article.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Stay ahead of Medicare Advantage’s 2025-2026 regulatory changes in this critical webcast featuring expert Tiffany Ferguson, LMSW, CMAC, ACM. Learn how new CMS rules limit MA plan denials, protect hospitals from retroactive claim reopenings, and modify Two-Midnight Rule enforcement—plus key insights on omitted SDoH mandates and heightened readmission scrutiny. Discover actionable strategies to safeguard revenue, ensure compliance, and adapt to evolving health equity priorities before the June 2025 deadline. Essential for hospitals, revenue cycle teams, and compliance professionals navigating MA’s shifting landscape.
Struggling with CMS’s 3-Day Payment Window? Join compliance expert Michael G. Calahan, PA, MBA, CCO, to master billing restrictions for pre-admission and inter-facility services. Learn how to avoid audit risks, optimize revenue cycle workflows, and ensure compliance across departments. Critical for C-suite leaders, providers, coders, revenue cycle teams, and compliance teams—this webcast delivers actionable strategies to protect reimbursements and meet federal regulations.
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Copyright © 2025 ICD10monitor. Powered by MedLearn Media.
Celebrate Lab Week with MedLearn! Sign up to win one year of our Laboratory All Access Pass! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
