On this page
The short answerWhere 98980/98981 sit in the RTM ladder98980 vs 98981, side by sideHow the stacking math worksWorked examplesThe interactive-call requirementCommon mistakesFAQKey takeaways
- 98980 bills the first 20 minutes of monthly RTM treatment-management time. 98981 is an add-on for each additional full 20-minute block — never billed alone.
- 98981 attaches to 98980 only, never to 98979 — a low-time month bills 98979 alone, never 98979 plus 98981.
- CMS sets no unit cap on 98981 in a month; each full additional 20 minutes of documented, medically necessary management time supports one more unit.
- Every treatment-management code — 98979, 98980, 98981 — requires one documented interactive call per calendar month. Its duration counts toward the minute total.
CPT 98980 bills the first 20 minutes of a calendar month's RTM treatment-management time (20 minutes or more, at least one documented interactive call). CPT 98981 is an add-on code — never billed by itself — for each additional full 20-minute block of management time beyond that first 20, and CMS places no cap on how many 98981 units a month can carry. A 62-minute month, for example, bills one 98980 plus two units of 98981.
Where 98980 and 98981 sit in the RTM treatment-management tier
RTM's treatment-management bucket has three codes, all paying for the same thing — your time reviewing a patient's remote data and managing their care over a calendar month — split by how many minutes accumulate:
98979— first 10 minutes (10–19 min in the month). New for 2026.98980— first 20 minutes (20 min or more in the month).98981— each additional full 20-minute block beyond the 20 covered by 98980.
98979 and 98980 are mutually exclusive within the same month — CMS is explicit that the two "are also not additive," so a given month picks whichever of the two fits the accumulated time, never both. 98981 only ever adds on top of 98980; there's no path from 98979 to 98981 in the same month. See the full 2026 RTM CPT code guide for how these three sit alongside the setup and device-supply codes.
98980 vs 98981, side by side
| 98980 | 98981 | |
|---|---|---|
| Covers | First 20 minutes of monthly management time | Each additional full 20-minute block beyond the first 20 |
| Minute threshold | ≥ 20 minutes total in the month | First unit requires ≥ 40 minutes total; each further unit needs another full 20-minute block |
| Billable alone? | Yes | No — add-on to 98980 only, never to 98979 |
| Unit cap | N/A (single code) | None set by CMS — bounded by documented time, not a regulatory ceiling |
| Interactive call required? | Yes, ≥1 per calendar month | Yes, same monthly call requirement applies to the whole management-time code set |
| CY2026 national non-facility rate (non-QP) | $54.11 | $41.42 per unit |
How the stacking math actually works
The unit rule CMS adopted for 98981 is a full-block rule, not the "more than half" midpoint convention some practices know from other timed CPT codes. The first 98981 unit requires the month's total management time to reach 40 minutes — the 20 covered by 98980, plus one complete additional 20-minute block. Each subsequent unit needs another complete 20-minute block; a partial block that doesn't reach the next full 20 minutes doesn't support another unit.
98981 counts whole 20-minute blocks, not fractions of one — a month that ends at 35 minutes past the 98980 threshold still bills only one unit, not one-and-a-fraction.
In practice: subtract the first 20 minutes (covered by 98980) from the month's total documented management time, then divide by 20 and round down. That's the 98981 unit count.
Worked examples
| Total monthly management minutes | Codes billed | Estimated national payment* |
|---|---|---|
| 25 minutes | 98980 only | $54.11 |
| 40 minutes | 98980 + 1× 98981 | $54.11 + $41.42 = $95.53 |
| 62 minutes | 98980 + 2× 98981 (42 min beyond the first 20 → 2 full blocks, 2 min unused) | $54.11 + (2 × $41.42) = $136.95 |
| 90 minutes | 98980 + 3× 98981 (70 min beyond the first 20 → 3 full blocks, 10 min unused) | $54.11 + (3 × $41.42) = $178.37 |
Notice the pattern: minutes that don't complete another full 20-minute block simply don't convert into an extra unit that month. They aren't lost forever if the case is ongoing — they just don't count toward this month's total, since RTM's management-time clock resets each calendar month.
The interactive-call requirement applies to all three codes
98979, 98980, and 98981 all sit under the same CMS requirement: at least one documented, real-time, two-way interactive communication with the patient (or caregiver) per calendar month. That call's duration counts toward the cumulative management-time total, but it doesn't have to be the whole total — chart review, data interpretation, and care-plan updates fill out the rest of the minutes. There's no separate call requirement per 98981 unit; one qualifying call per month covers the entire management-time code set for that month. See the full interactive-call guide for what documentation the call itself needs.
Common mistakes with 98980/98981
- Billing 98981 without a base 98980. 98981 has no independent existence on a claim — it attaches to 98980 in the same month or it doesn't get billed.
- Attaching 98981 to a 98979 month. If the month's total lands in the 98979 range (10–19 minutes), it stays there; 98981 never stacks on 98979.
- Rounding a partial block up. A month at 38 minutes past the 98980 threshold is still only one full 20-minute block (40 minutes total), not two — the remaining 18 minutes doesn't round up.
- Skipping the call in a high-minute month. Racking up management time without a documented interactive call still fails the requirement for the entire code set that month, no matter how many 98981 units the minutes would otherwise support.
- Losing track of which minutes are RTM-eligible. Time already billed under a separate timed visit code the same day can't also be counted toward the RTM management-time total — see RTM and same-day visits.
Stacking 98981 correctly means knowing the running total, not reconstructing it at month-end.
BoneArc accumulates management time from portal review and the logged call as it happens, so the 98980/98981 unit count is already right when the month closes — not a spreadsheet exercise on the 1st.
See it on your panel →FAQ
What's the actual difference between CPT 98980 and 98981?
98980 bills the first 20 minutes of monthly RTM management time. 98981 is an add-on for each additional full 20-minute block beyond that — never billed on its own, and uncapped by CMS.
Can I bill 98981 without billing 98980 first?
No. 98981 attaches to 98980 only. A month under 20 minutes bills 98979 (if it reaches 10) or nothing from this tier — never 98981 alone.
Is there a limit on how many 98981 units I can bill in one month?
CMS sets no unit cap in the CY2026 rule. Unit count is bounded by documented, medically necessary management time — not a regulatory ceiling — and unusually high volumes can still draw payer medical review.
Can I bill 98979 and 98981 in the same calendar month?
No. 98981 only adds onto 98980, and 98979/98980 are themselves mutually exclusive in the same month. A month bills 98979 alone, 98980 alone, or 98980 plus 98981 units — never 98979 with 98981.
Does the interactive call's time count toward the 98980/98981 minutes?
Yes. The call's duration counts toward the cumulative management-time total, though it doesn't have to account for all of it — data review and care-plan work can fill out the rest.
payer-rules/medicare-baseline.json (verified 2026-07-03, cross-checked against an independent CMS carrier pricing file to the cent). This article introduces no new dollar amount, day threshold, or minute threshold beyond what that already-verified source establishes. Educational information, not billing or legal advice — verify against current CMS guidance and your fee schedule.