Updated November 11, 2021
The following are additions, revisions, and deletions to Current Procedural Terminology (CPT® American Medical Association) and Healthcare Common Procedures Coding System (HCPCS) Level II codes for speech-language pathologists (SLPs), effective January 1, 2022. There are no major changes to HCPCS Level II devices codes for 2022. SLPs can contact ASHA's health care policy team at firstname.lastname@example.org for questions.
For past updates, see speech-language pathology CPT and HCPCS code changes for 2021 and 2020.
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New Remote Monitoring CPT Codes
The following new CPT codes are effective January 1, 2022. There are no new HCPCS Level II codes related to speech-language pathology services or devices in 2022.
98975 Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment
98976 device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor respiratory system, each 30 days
98977 device(s) supply with scheduled (eg, daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days
98980 Remote therapeutic monitoring treatment management services, physician/other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes
98981 each additional 20 minutes (listed separately in addition to code for primary procedure)
- The new codes allow clinicians to report remote monitoring of non-physiologic data and can be used to monitor a range of health conditions. The remote monitoring device or system may collect and transmit objective data and/or subjective data reported by the patient (e.g., responses to standardized questionnaires). The data collected should inform a patient's treatment plan during an episode of care.
- For example, SLPs may use voice or swallowing training devices or speech, language, and/or cognitive training applications/software that allow the clinician to design customized, interactive home training activities and exercises for the patient to promote carryover at home. These devices/systems may provide feedback to the patient, produce and transmit objective data, and allow the clinician to remotely monitor progress and adjust activities through a secure portal.
- For RTM, an episode of care begins when remote monitoring of a specific condition or treatment goal is initiated and ends when the targeted data is collected and/or treatment goals are met.
- The three codes of interest to SLPs are 98975, 98980, 98981. 98976 and 98977 represent the cost of supplies for specific types of monitoring systems, however, they may not apply to speech-language pathology related services.
- Count cumulative time spent in data review and patient/caregiver interaction in a calendar month (not each 30 days). Report the base and add-on codes together on the claim, based on total time, at the end of each calendar month. The base code (98980) may only be reported once per calendar month.
- Time related to any other services, such as a speech-language evaluation or treatment session, can't be counted towards RTM time.
- Don't report these codes if activities total less than 20 minutes in a calendar month.
- 98975: Use to report the initial time spent setting up and teaching the patient/caregiver how to use the device. Report this code once per episode of care, regardless of the amount of time spent. Monitoring devices/systems must be approved by the U.S. Food and Drug Administration. Check directly with the manufacturer regarding FDA device status.
- 98980 and 98981: Use to report the first and each subsequent 20-minute increment of time spent reviewing and integrating the data collected during remote monitoring to inform treatment goals; monitor the patient’s progress and adherence to the treatment plan; and provide clinical feedback to the patient/caregiver.
- Remember to check each payer for policies related to same-day billing with other codes (National Correct Coding Initiative or CCI edits).
- In its release of the 2022 Medicare Physician Fee Schedule final rule, the Centers for Medicare & Medicaid Services (CMS) indicated certain nonphysician providers, including as SLPs, may report these codes for Medicare beneficiaries.
- SLPs should include the -GN modifier when reporting these codes to indicate services provided under a therapy plan of care.
- For more information, see ASHA's summary analysis of the final rule.
- Non-Medicare payers may also cover these codes when reported by SLPs. Check with individual payers directly.
Revised or Deleted CPT and HCPCS Codes
There are no revised or deleted CPT or HCPCS Level II codes directly related to speech-language pathology services or devices in 2022.