CPT Code 98985 for Short-Duration RTM Services

When new procedure codes are introduced, it’s important for healthcare organizations to update their billing strategies and documentation workflows. One such addition is CPT code 98985, a newly released code effective January 1, 2026. In this article, we will examine what CPT code 98985 is, how it fits into existing reimbursement frameworks, and practical considerations for implementation.

1. Background of CPT Code 98985

CPT code 98985 is part of the forthcoming 2026 CPT update released by the American Medical Association (AMA). The update introduces 288 new codes overall, including several focused on digital health and remote monitoring services¹.

New additions—such as 98984, 98985, and 99445—expand reimbursement options for shorter-duration remote therapeutic monitoring (RTM) services¹. These updates reflect a growing recognition that digital monitoring is valuable even when patient engagement or data transmission occurs for shorter periods.

Previously, RTM codes such as 98975–98981 captured longer episodes of monitoring and management, typically 16 days or more³. The addition of 98985 allows reimbursement for meaningful yet shorter periods of care.

For billing teams and clinical leaders, the introduction of 98985 represents an opportunity to align coding strategy with real-world care delivery, particularly in hybrid or at-home digital therapy programs.

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2. Key Requirements for Proper Use

Accurate documentation, clear clinical justification, and payer alignment remain central to using CPT 98985 correctly.

a) Service definition and time thresholds
Initial commentary suggests the new code covers RTM when the monitoring or management duration falls below prior thresholds—fewer than 16 days of data collection or under 20 minutes of provider time^1,2.

b) Device eligibility
The code applies only when data are collected via an FDA-defined medical device that transmits physiologic or therapeutic information. Documentation must identify the device, transmission dates, and clinical purpose^3,4.

c) Interactive communication requirements
As with 98980 and 98981, providers must document an interactive communication with the patient or caregiver (e.g., phone or video) and the duration of that interaction³.

d) Billing period and payers
Since 98985 is new for 2026, payer adoption may vary. Medicare Administrative Contractors (MACs) will determine pricing and coverage policies in the coming months⁵. Organizations should monitor contractor guidance and update electronic health record (EHR) billing tables accordingly.

e) Documentation tips

• Record the monitoring period and number of data days

• Document the interactive session (duration, participants, clinical summary)

• Attach device transmission logs to support the claim

• Link RTM activities to a specific plan of care

• Retain audit-ready records in accordance with payer policies

3. Example: Using CPT Code 98985 in Practice

Scenario:
A physical therapist initiates remote therapeutic monitoring for a 58-year-old patient recovering from a rotator cuff repair.

1. On January 5, the therapist sets up the device and educates the patient.

2. From January 6–20 (15 days), the device transmits movement and pain data to the therapist’s dashboard.

3. On January 25, the therapist conducts a 12-minute video consult to review the data and adjust the exercise plan.

Because the monitoring period was shorter than 16 days and the provider time was under 20 minutes, the session qualifies for CPT code 98985. The claim includes device usage logs, session notes, and the revised care plan.

If monitoring continues for longer periods in subsequent months, codes 98980 or 98981 would apply instead.

CPT code 98985 represents an important addition for organizations delivering digital or remote care models. It enables billing for shorter monitoring episodes that still require clinical oversight.

By educating providers, updating coding manuals, and verifying payer acceptance in advance, healthcare teams can confidently leverage 98985 starting January 2026. This supports more flexible reimbursement for remote care while maintaining quality and accountability.

The information presented here is for educational purposes only and is not meant to be interpreted as billing or legal advice. Please consult with your payors and their policies for more information on your requirements for this service. Information provided is sourced from the 2025 APTA Practice Advisory and the 2026 AMA CPT Manual, Professional Edition. 

References

1. American Medical Association. “288 New CPT Codes Cover Digital Health, AI and More.” https://www.ama-assn.org/practice-management/cpt/288-new-cpt-codes-cover-digital-health-ai-and-more

2. MedCentral. “CPT 2026 Updates Expand Lab, Category III, and AI Codes.” https://www.medcentral.com/coding-reimbursement/cpt-2026-updates-expand-lab-category-iii-and-ai-codes

3. APTA. “Remote Therapeutic Monitoring (Codes 98975–98981): Practice Advisory.” https://www.apta.org/contentassets/95321a10e951408db650e2f19b96699f/apta-practice-advisory-rtm-codes032023.pdf

4. Telehealth.HHS.gov. “Billing for Remote Patient Monitoring.” https://telehealth.hhs.gov/providers/best-practice-guides/telehealth-and-remote-patient-monitoring/billing-remote-patient

5. Elevare Law. “CMS RPM and RTM CPT Code Changes for 2026.” https://www.elevarelaw.com/blog-articles/cms-rpm-rtm-cpt-code-changes-2026