CPT 98975 is the enrollment code at the beginning of a Remote Therapeutic Monitoring (RTM) program. It recognizes the clinical work of introducing RTM to the patient, providing them access to the RTM platform (like Actuvi), getting their consent to participate in the RTM program, and educating them on how to submit their data.
As part of patient education, providers also explain to patients how the remote therapeutic monitoring program supports their care.
This guide explains what 98975 includes, when it becomes billable, the documentation that supports it, and how it relates to the rest of the RTM code family.
What Remote Therapeutic Monitoring CPT 98975 covers
98975 covers RTM initial setup and patient education. That includes:
Introducing the patient to the RTM program
Obtaining and recording consent
Enrolling the patient on the RTM platform
Creating the patient account
Showing the patient how to submit information, complete assigned activities, or otherwise use the RTM service
Explaining how the information will support care and how the patient can contact the clinic
The code captures two related elements: the operational setup and the patient education. A complete record should establish both. An account activation alone is not the full service, and a generic education statement without evidence of the actual setup is not ideal documentation either.
98975 is a flat, one-time payment. It does not vary with the amount of time spent during enrollment. Whether the encounter takes ten minutes or twenty minutes, the service is billed as a single setup-and-education event for that episode of care.
The two-monitored-day requirement for CPT 98975
A clinic may complete enrollment on day one, but it cannot submit 98975 until the patient has generated at least two monitored days.
The claim is meant to follow evidence that the service actually began, rather than compensate a setup process that never progressed beyond enrollment. For this reason, a correct workflow places 98975 in a pending status after setup. The code is released only after the monitored-day requirement is visible in the record.
Actuvi’s platform tracks every CPT code attached to the program and automatically identifies billable patients.
Why “once per episode of care” needs a clinical definition
CMS links the RTM episode to the plan of care: a defined course of treatment for a treatable condition, with clinical goals, a beginning, and an endpoint. When that plan concludes, the related RTM episode concludes. If a new problem requires a distinct plan of care, a separate episode may begin.
This is the reason setup does not repeat month after month. The enrollment and education occur only at the start of the treatment course.
When a former remote therapeutic monitoring (RTM) patient may support another 98975
A prior RTM enrollment does not permanently prevent a patient from receiving 98975 again. The determining question is whether the patient is entering a distinct episode of care.
For example, consider a patient who completes an RTM episode, is discharged, and returns six months later with a different clinical issue. If the later condition has a new plan of care, different treatment goals, and a new RTM enrollment process, the later course may support another 98975.
What meaningful remote therapeutic monitoring (RTM) education looks like
Patient education is a central part of 98975. The patient should finish the process able to participate in the program independently through the episode of care.
Education will vary by condition and program design, but a useful session typically addresses:
How to access the platform or use the relevant device
How and when to submit data or complete prescribed activities
The purpose of the submitted information
How the care team uses information within the patient’s care pathway
What type of follow-up the patient can expect
How to contact the clinic for support or questions
Consent should be documented before billing
Consent belongs at the front of the workflow. Before 98975 is submitted, the record should reflect the patient’s agreement to receive the service, awareness of applicable cost-sharing, and right to discontinue participation.
Actuvi captures patient's consent such as a signed form or electronic confirmation at enrollment. Patients read and sign an e-consent in the app before they can access the program.
Where 98975 fits within the remote therapeutic monitoring (RTM) code set
98975 starts the episode. The remaining RTM services address recurring device supply and treatment-management activity.
CPT | Service | Billing cadence | Reimbursement |
|---|---|---|---|
98975 | Initial setup and patient education | One time per episode | $21.71 |
98984/56 | Device supply, 2–15 days | Once per 30 days | $51.44 |
98976/7/8 | Device supply, 16–30 days | Once per 30 days | $51.44 |
98979 | Treatment management, 10–19 minutes | Once per month | $26.39 |
98980 | Treatment management, initial 20 minutes | Once per month | $54.11 |
98981 | Each additional 20 minutes of treatment management | Multiple times per month, as applicable | $41.42 |
Reimbursement amounts shown are national-average figures and can differ by Medicare locality and payer.
A first-month example for CPT 98975
Suppose a patient is enrolled on January 12. By early February, the record shows ten monitored days, and the clinical team has provided 18 minutes of qualifying management time during January, including one interactive communication.
The applicable claims would be:
98975 for the one-time setup and education service, submitted after the two-monitored-day condition has been met
98985 for device-supply service covering 2 to 15 days of data
98979 for 10 to 19 minutes of treatment management during January
In later months, the recurring supply and management codes may continue when their own requirements are met. 98975 does not repeat unless another clearly separate episode begins.
Situations where CPT 98975 should not be billed
98975 does not turn setup labor into a stand-alone billable service. Several common scenarios do not support the code:
The patient enrolled but did not produce two monitored days
The clinic attempts to bill a second 98975 within the same active episode
Consent is not documented
If the patient disengages immediately after enrollment, the clinic may have performed real work, but the service does not satisfy the billing condition without the required monitored days. The combination of the two-day requirement and the one-time-per-episode rule keeps the code attached to a program that actually commenced.
Required Documentation for CPT 98975:
Document consent
Document set-up and education
Document at least 2 days of data transmitted by the patient
How CPT 98975 works on the Actuvi platform
Care team creates the patient on the platform, and Actuvi sends download instructions and the app link directly to the patient. On first login, the app takes the patients through an e-consent form they sign electronically.
From there, the app guides them through a built-in "Training Mode," which shows them how to use the app, submit information, and complete their monitoring. Training Mode is part of onboarding, but patients can return to it anytime if they need a refresher.
Actuvi's platform tracks the days patients perform their monitoring. Once they have completed the required two days, they appear on the billing page as eligible for CPT 98975.
Frequently asked questions
What does CPT 98975 reimburse in 2026?
The national-average reimbursement is $21.71. The allowed amount can vary by Medicare locality.
Can 98975 be billed on the day the patient is enrolled?
No. The patient must first have at least two monitored days recorded. Enrollment may occur earlier, but the claim should wait until that condition is met.
Can one patient receive 98975 more than once?
Yes, if the patient starts a new episode of care supported by a new plan of care. The documentation must demonstrate that the later service is distinct from the earlier episode rather than a continuation of it.
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