Cognitive Behavioral Therapy (CBT) Billing Within RTM For 2025

By HealthArc | January 20, 2025

The American Medical Association’s Current Procedural Terminology (CPT®) code 98978 falls under the category of Remote Therapeutic Monitoring (RTM) and is a medical procedural code for Cognitive Behavioral Therapy (CBT). It denotes the supply of one or more devices for cognitive behavioral therapy’s remote therapeutic monitoring procedure, including scheduled recording and/or programmed alert transmission, and it is reported once every 30 days.

CPT code 98978 addresses the methodical process of promoting patient engagement and makes it easy for a healthcare professional to understand patient experience in a more dynamic and real-time manner.

This code represents supplying one or more devices for remote therapeutic monitoring for cognitive behavioral therapy. This code is reported once per 30 days and includes scheduled recording and/or programmed alert transmission every time the patient needs to engage with the RTM.

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Brief Overview Of Billing CPT Code 98978

It covers the cost of supplies for CBT monitoring devices. It does not cover the time the therapist spends evaluating and integrating data or engaging insights with the patient/caregiver.
To qualify for reporting within the RTM, the device used must be approved by the US Food and Drug Administration (FDA).
Report this code only once every 30 days (not to be counted for every calendar month).
Unlike the other RTM codes, it has not been allocated a particular value and can be priced or covered at the payer’s discretion.
Before billing, check with payers directly (for pricing coverage).
When reporting cognitive behavioral therapy, Medicare will cover 98978 along with RTM services.
Use specific modifiers to indicate CBT services provided and check with your local Medicare contractor for pricing and billing information.

Physicians Final Schedule For Digital Cognitive Behavioral Therapy

In the Physician Fee Schedule (PFS) final rule, CMS finalized a new RTM code for the supply of a device for cognitive behavioral therapy monitoring (CPT Code 98978). Unlike the other CPT codes, there isn’t a standard reimbursement amount for this code yet.

Since the technologies for this service are still evolving, there were no invoices for devices specific to cognitive behavioral therapy monitoring. To improve the opportunities and challenges related to coverage and claim processing, CMS is currently requesting information from clinicians, practitioners, and auxiliary staff.

HealthArc is committed to keeping our clients updated with the CBT billing guidelines and changes. We implement the latest updates to our digital healthcare systems and clinical software for efficient billing. Book a free demo now. For any queries on CBT billing and RTM, feel free to talk to our team at +201 885 5571.

Frequently Asked Questions (FAQs)

1. What does CPT Code 98978 mean?

CPT 98978 is a code for Cognitive Behavioral Therapy (CBT) that is used for Remote Therapeutic Monitoring (RTM). It includes the delivery of FDA-approved digital devices for CBT monitoring, which are reported every 30 days.

2. Who can charge CPT 98978?

This code can be billed by qualified healthcare professionals and practices that use approved CBT monitoring devices, as long as they follow the rules set by the payer and keep records.

3. What does CPT 98978 include?

It pays for the cost of providing and using CBT digital devices, such as recording and alerts. It doesn’t include the time the therapist spends evaluating or interpreting the data.

4. How often can you bill 98978?

It might be billed once every 30 days, not every month.

5. Will Medicare pay for CPT 98978?

Yes. Medicare includes CPT 98978 in RTM billing, but the amount paid back may be different in different areas and at the discretion of the payer.

6. Are there set rates for CPT 98978?

CPT 98978 does not have a set national reimbursement rate like other RTM codes do. The payer decides what is covered and how much to pay.

7. What do you need to do to bill 98978?

The FDA must have approved the device.

Tags: #billingrtm, #remotetherapeuticmonitoring, #rtm, #rtmmonitoing, #therapeuticcare