Remote patient monitoring has evolved rapidly allowing healthcare providers to manage chronic conditions beyond traditional in-office visits. One important code supporting this shift is CPT 98977 which focuses specifically on Remote Therapeutic Monitoring (RTM) for respiratory system status.
This article is written for healthcare providers, medical billers, coders, and practice administrators in the United States. It provides a clear practical explanation of CPT 98977 including what it covers when it can be billed, documentation requirements compliance considerations and common billing mistakes. The goal is to help practices use this code correctly while maintaining payer compliance and reimbursement accuracy.
What Is CPT Code 98977?
CPT 98977 is defined as:
Remote therapeutic monitoring of respiratory system status, initial setup and patient education on use of equipment
This code is part of the Remote Therapeutic Monitoring (RTM) family and is used to report the initial setup of monitoring devices and patient education related to respiratory conditions.
Key Features of CPT 98977
- Focuses on respiratory system monitoring
- Covers device setup and patient instruction
- Reported once per episode of care
- Separate from ongoing data transmission and treatment management codes
Understanding Remote Therapeutic Monitoring (RTM)
Remote Therapeutic Monitoring allows providers to track non-physiologic data related to patient therapy and treatment adherence.
RTM vs RPM (Remote Patient Monitoring)
- RTM: Therapy adherence and response (e.g., inhaler use, breathing exercises)
- RPM: Physiologic data (e.g., heart rate, blood pressure)
CPT 98977 is RTM-specific and is commonly used for patients with chronic or acute respiratory conditions.
When Can CPT 98977 Be Billed?
CPT 98977 should be billed only at the beginning of RTM services for respiratory monitoring.
Appropriate Use Scenarios
- Initial enrollment in respiratory RTM
- Setup of digital inhaler trackers
- Setup of respiratory monitoring software or devices
- Educating patients on proper device use and data transmission
Example Scenario
A pulmonology clinic enrolls a patient with chronic asthma into an RTM program. Staff set up the monitoring device and educate the patient on proper usage.
Correct billing: CPT 98977
Conditions Commonly Associated with CPT 98977
CPT 98977 is frequently used for patients with respiratory-related diagnoses, including:
- Asthma
- Chronic obstructive pulmonary disease (COPD)
- Chronic bronchitis
- Post-COVID respiratory conditions
- Pulmonary rehabilitation patients
The code supports care coordination and adherence tracking, not diagnosis itself.
Documentation Requirements for CPT 98977
Accurate documentation is critical for compliance and audit protection.
Documentation Must Include:
- Confirmation of respiratory RTM enrollment
- Description of the device or software used
- Date of initial setup
- Proof of patient education and training
- Provider order for RTM services
Compliance Tip: Without documented patient education, CPT 98977 may be denied.
CPT 98977 Billing Rules and Guidelines
Billing Essentials
- Reported once per RTM episode
- Cannot be billed repeatedly for the same patient
- Typically billed by:
- Physicians
- Non-physician practitioners (NPPs)
- Services may be provided by clinical staff under supervision
Codes Commonly Used With 98977
- 98980 – RTM treatment management, first 20 minutes
- 98981 – RTM treatment management, each additional 20 minutes
CPT 98977 covers setup only, while 98980–98981 cover ongoing management.
Common Billing and Coding Mistakes
Avoiding these errors helps prevent denials and audits.
Frequent Mistakes
- Billing 98977 more than once per episode
- Using 98977 without documented patient education
- Confusing RTM with RPM codes
- Billing without an active treatment plan
Accurate code selection and documentation protect both revenue and compliance.
Reimbursement and Payer Considerations
CPT 98977 is recognized by Medicare and many commercial payers, but coverage may vary.
Important Considerations
- Payer-specific policies apply
- Medical necessity must be documented
- Some payers require patient consent
- Device must meet RTM requirements
Practices should verify payer guidelines before implementation.
Benefits of Using CPT 98977 in Clinical Practice
Proper use of CPT 98977 allows providers to:
- Improve treatment adherence
- Monitor therapy effectiveness remotely
- Reduce hospital readmissions
- Enhance patient engagement
- Support value-based care models
This code plays a key role in modern respiratory care delivery.
FAQs
1. What does CPT 98977 cover?
It covers initial setup and patient education for remote therapeutic monitoring of the respiratory system.
2. Can CPT 98977 be billed monthly?
No. It is billed once per episode of care, not monthly.
3. Is CPT 98977 the same as RPM setup codes?
No. CPT 98977 is for RTM, while RPM uses different CPT codes.
4. Does CPT 98977 require patient consent?
Some payers require documented patient consent—always check payer policy.
5. Can clinical staff perform the setup?
Yes, under appropriate provider supervision and documentation.
Conclusion
CPT Code 98977 is a foundational code for initiating remote therapeutic monitoring of respiratory conditions. When used correctly, it supports patient education, improves therapy adherence, and enables proactive respiratory care outside the clinic.
For healthcare providers and billing teams in the United States, success with CPT 98977 depends on proper setup documentation, correct billing frequency, and clear differentiation from RPM services. When these standards are met, CPT 98977 becomes a valuable tool for compliant reimbursement and improved patient outcomes.
