What does Remote Therapeutic Monitoring pay in 2026?
| Code | What it covers | CY2026 national non-facility |
|---|---|---|
| 98975 | setup + patient education, once per episode | $21.71 |
| 98976 | device supply — respiratory, 16+ days | $52.11 |
| 98977 | device supply — musculoskeletal, 16+ days | $51.44 |
| 98984 | device supply — respiratory, 2–15 days (new 2026) | $52.11 |
| 98985 | device supply — musculoskeletal, 2–15 days (new 2026) | $51.44 |
| 98979 | treatment management, 10–19 min (new 2026) | $26.39 |
| 98980 | treatment management, first 20 min / month | $54.11 |
| 98981 | treatment management, each added 20 min, max 3 units | $41.42 |
National averages from our verified CY2026 fee-schedule config (source: CMS Physician Fee Schedule). Actual payment varies by locality, payer, and site of service.
Who can bill it?
Physicians, NP/PA/CNS practitioners — and the therapy disciplines directly: physical therapists, occupational therapists, and speech-language pathologists billing under their own NPIs.
Therapy assistants (PTA/OTA) can furnish RTM services under supervision — with the CQ/CO modifier and the payment reduction that comes with it (see the traps below).
One practitioner bills RTM for the patient's episode in a given period; the device supply and the management time ride the same billing relationship.
What are the day and minute thresholds?
- 16 or more days of device data in a 30-day period opens the full supply codes (98976 respiratory / 98977 musculoskeletal).
- 2–15 days of data bills the new 98984/98985 (CY2026).
- 20 management minutes in the calendar month opens 98980; each added 20 minutes adds a 98981 unit, capped at 3 (CMS MUE).
- 10–19 management minutes bills the new 98979 (CY2026).
- Management codes require an interactive communication with the patient during the month.
What has to be in place first?
- A linked therapy plan of care
- RTM is a 'sometimes therapy' service — management codes must tie to a therapy plan of care before they can bill.
- The GP / GO / GN discipline modifier
- Every RTM therapy claim carries the discipline modifier matching the plan of care — GP (physical therapy), GO (occupational therapy), or GN (speech-language pathology).
- Patient consent on file
- Documented consent before billing begins.
- An interactive contact for management codes
- Like RPM, the management codes need a real-time interactive communication with the patient in the month.
What gets claims denied?
- Missing plan-of-care linkage or modifier
- A management claim without the therapy plan-of-care linkage, or without the GP/GO/GN modifier, is not payable as furnished — both are structural requirements, not paperwork niceties.
- The assistant reduction nobody applies
- When a PTA or OTA furnishes the service, the claim carries the CQ/CO modifier and Medicare pays 85% of the rate (BBA §53107). Billing full rate for assistant-furnished services is an overpayment.
- Carrier-priced supply codes
- The cognitive-behavioral supply codes (98978/98986) have no national rate — they're carrier-priced. Without your MAC's amount on file, the dollars hold rather than guess.
- Billing full supply under 16 days
- Same trap as RPM: under 16 days of data the CY2026 short-supply codes (98984/98985) apply, not the full-rate codes.
- Unverified-rate confidence
- Several CY2026 RTM figures (the new short codes) haven't been independently confirmed against a CMS primary source — they're flagged as estimates in the table above rather than presented as verified.
What could this look like for your panel?
Estimates only, not billing advice. Actual Medicare reimbursement varies by region, payer, and year. Figures approximate CY2026 national non-facility averages from our verified fee-schedule config.
Frequently asked questions
- Can a physical therapist bill RTM directly?
- Yes — PTs, OTs, and SLPs bill RTM under their own NPIs. That's the family's defining feature: it gives therapy disciplines a direct monitoring lane that RPM reserves for physicians and NP/PA/CNS practitioners.
- What's the difference between RTM and RPM?
- RPM monitors physiologic data (blood pressure, glucose) and bills through physicians and NP/PA/CNS practitioners. RTM monitors therapeutic data — musculoskeletal or respiratory status, adherence, response — and adds the therapy disciplines as direct billers.
- What happens when a therapy assistant furnishes RTM?
- The claim carries the CQ (PTA) or CO (OTA) modifier and pays at 85% of the rate under BBA §53107. The device-supply codes aren't reduced — the reduction applies to the service codes an assistant furnishes.
- Which supply code do I use — respiratory or musculoskeletal?
- The one matching what's monitored: 98976 (respiratory) or 98977 (musculoskeletal) at 16+ days of data, or their CY2026 short-supply versions 98984/98985 at 2–15 days.
- Is RTM telehealth?
- No — RTM is not a telehealth service, so telehealth expiration dates don't apply to it. It's between-visit monitoring by design.
This page is general information, not billing, coding, or legal advice. Verify current requirements with the relevant payer before billing. Mallowa helps practices capture and document coordination time and generates claim-ready superbills; it does not submit claims or determine eligibility.