{ "source": "https://rehabityhealth.com/rtm-coverage.html", "generated_from": "legal/rtm-payer-coverage.csv", "disclaimer": "A summary of published payer documents, not coverage advice and not a guarantee of payment. A carrier medical policy is not the binding document for self-funded employer plans. Verify for your own patient before billing.", "row_count": 103, "payers": [ { "payer": "Medicare (traditional fee-for-service)", "aliases": [ "Original Medicare", "Medicare Part B", "Traditional Medicare", "Medicare FFS", "CMS" ], "line_of_business": "Medicare Part B", "position": "covered", "codes_addressed": [ "98975", "98976", "98977", "98978", "98979", "98980", "98981", "98984", "98985", "98986" ], "policy_id": "CY2022 PFS final rule; CY2026 PFS added 98979/98984/98985/98986", "source_url": "https://www.apta.org/contentassets/95321a10e951408db650e2f19b96699f/apta-practice-advisory-rtm-codes032023.pdf", "policy_effective_date": "2022-01-01 (2026-01-01 for the four newer codes)", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Covered. Physical therapists may bill. Must be under an active plan of care.", "notes": "CMS initially proposed barring PTs on an 'incident to' theory and reversed in the CY2022 final rule after APTA comment. Patients may self-report and manually enter data. 98975 is once per episode of care and per APTA may be billed on day 17 of monitoring, not at setup. There is no NCD for RTM." }, { "payer": "Medicare Advantage (all carriers)", "aliases": [ "MA", "Part C", "Medicare Part C", "Medicare Advantage plan" ], "line_of_business": "Medicare Part C", "position": "covered_with_conditions", "codes_addressed": [ "Same code set as Part B" ], "policy_id": "No single policy; determined per MA plan", "source_url": "https://www.kff.org/medicare/medicare-advantage-in-2026-premiums-out-of-pocket-limits-supplemental-benefits-and-prior-authorization/", "policy_effective_date": "Varies by plan and plan year", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Must cover Part B benefits but may add its own criteria. Check the specific plan.", "notes": "Because there is NO NCD for RTM, MA plans are permitted to apply their own internal coverage criteria, which is exactly the condition CMS allows it under. Since April 2026 CMS requires MA organizations to publish those internal criteria publicly, free of charge, without an account. Roughly 99% of MA enrollees are in plans applying prior authorization to some services. 'The patient has Medicare' is NOT a sufficient answer when the patient is in MA, and roughly half of Medicare enrollees are." }, { "payer": "Cigna", "aliases": [ "Cigna Healthcare", "Cigna Health", "Evernorth" ], "line_of_business": "Commercial", "position": "not_covered", "codes_addressed": [ "98975", "98976", "98977", "98978", "98979", "98980", "98981", "98984", "98985", "98986" ], "policy_id": "Medical Coverage Policy 0563", "source_url": "https://static.cigna.com/assets/chcp/pdf/coveragePolicies/medical/mm_0563_coveragepositioncriteria_remote_patient_monitoring_and_remote_therapeutic_monitoring.pdf", "policy_effective_date": "2026-05-15 (next review 2027-05-15)", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Not covered. All ten RTM codes excluded for any indication.", "notes": "Verbatim: 'Remote Therapeutic Monitoring (RTM) (CPT codes 98975, 98976, 98977, 98978, 98979, 98980, 98981, 98984, 98985, 98986) is not covered or reimbursable for ANY indication.' All ten codes also appear in the policy's 'Not Covered or Reimbursable' CPT table. This is a categorical exclusion, not a criteria-based restriction." }, { "payer": "Elevance Health (Anthem Blue Cross Blue Shield)", "aliases": [ "Anthem", "Anthem BCBS", "Anthem Blue Cross", "Elevance", "Anthem California", "Anthem Colorado", "Anthem Connecticut", "Anthem Georgia", "Anthem Indiana", "Anthem Kentucky", "Anthem Maine", "Anthem Missouri", "Anthem Nevada", "Anthem New Hampshire", "Anthem New York", "Anthem Ohio", "Anthem Virginia", "Anthem Wisconsin", "Blue Cross of California" ], "line_of_business": "Commercial", "position": "covered_with_conditions", "codes_addressed": [ "98975", "98976", "98977", "98978", "98979", "98980", "98981", "98984", "98985", "98986" ], "policy_id": "Clinical UM Guideline CG-MED-91", "source_url": "https://www.anthem.com/medpolicies/abc/active/gl_pw_e001871.html", "policy_effective_date": "Published 2025-12-18; last MPTAC review 2025-08-07", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Medically necessary when six documented criteria are met.", "notes": "Applies to Elevance's Blue plans across 14 states: CA, CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, VA, WI. Requires ALL of: clinically appropriate per accepted standards; data regularly assessed to detect acute change and prompt intervention; not primarily for convenience; patient at risk of clinically significant change; patient unable to access regularly scheduled outpatient care OR monitoring required between visits; monitoring reasonably likely to prevent avoidable deterioration. NOT medically necessary where similar services are provided concurrently, home health being the example given." }, { "payer": "Aetna (CVS Health)", "aliases": [ "Aetna", "CVS", "CVS Health", "Aetna Better Health" ], "line_of_business": "Commercial", "position": "no_published_policy_found", "codes_addressed": [ "None. RTM codes appear only under 'Other CPT codes related to the CPB'" ], "policy_id": "Clinical Policy Bulletin 1093", "source_url": "https://www.aetna.com/cpb/medical/data/1000_1099/1093.html", "policy_effective_date": "Effective 2026-02-27; last review 2026-05-31", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "No RTM determination exists. The bulletin often cited is an RPM policy.", "notes": "CPB 1093's stated scope is 'remote physiologic monitoring (RPM) services'. It contains exactly two code sections: 'CPT codes covered if selection criteria are met' (99453, 99454, 99457, 99458, all RPM) and 'Other CPT codes related to the CPB' (the RTM codes). There is NO 'codes not covered' section, so claims that Aetna lists RTM as not covered are misreadings of the related-codes list. No separate Aetna RTM bulletin was located. For context, Aetna's RPM policy covers only heart failure, hypertension and diabetes and expressly excludes 'data collected manually by the patient and not automatically transmitted'." }, { "payer": "UnitedHealthcare", "aliases": [ "UHC", "United", "United Healthcare", "United Health Care", "UnitedHealth", "Optum" ], "line_of_business": "Commercial and Individual Exchange", "position": "no_published_policy_found", "codes_addressed": [ "None located for RTM" ], "policy_id": "Medical Policy Update Bulletin January 2026", "source_url": "https://www.uhcprovider.com/content/dam/provider/docs/public/policies/mpub-archives/commercial/medical-policy-update-bulletin-january-2026-full.pdf", "policy_effective_date": "2026-01", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "No RTM policy located. Their widely reported remote-monitoring cut was RPM only and is postponed.", "notes": "UHC's own 49-page commercial bulletin contains ZERO mentions of the RTM codes or the phrase 'remote therapeutic'. It states verbatim: 'The Medical Policy titled Remote Physiologic Monitoring (RPM) will not be effective on Jan. 1, 2026, as previously announced; implementation of the new policy has been postponed until further notice.' Widely reported as an effective January 2026 cut; it was delayed after provider and medical-society pushback. UHC says it still intends to implement in 2026 with advance notice of a new date. That action concerns RPM and does NOT name the RTM codes." }, { "payer": "UnitedHealthcare Medicare Advantage", "aliases": [ "UHC Medicare", "United Medicare Advantage", "UHC MA", "AARP Medicare Advantage" ], "line_of_business": "Medicare Advantage", "position": "no_published_policy_found", "codes_addressed": [ "None located for RTM" ], "policy_id": "Medicare Advantage Medical Policy Update Bulletin January 2026", "source_url": "https://www.uhcprovider.com/content/dam/provider/docs/public/policies/mpub-archives/mamp/medicare-advantage-medical-policy-update-bulletin-january-2026.pdf", "policy_effective_date": "2026-01", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Same as UHC commercial. No RTM policy; the RPM change is postponed.", "notes": "UHC's MA bulletin carries the identical postponement notice and likewise contains zero mentions of the RTM codes. With no MA-specific RTM criteria published, Part B rules govern by default." }, { "payer": "Humana", "aliases": [ "Humana Medicare", "Humana Gold Plus", "Humana MA" ], "line_of_business": "Commercial and Medicare Advantage", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy found. Verify directly.", "notes": "Good-faith search found no published Humana RTM coverage policy for either line of business. Humana generally aligns with CMS policy on remote monitoring, but that is an inference from its telehealth guidance and not a located RTM determination. Absence of a located policy is not evidence of coverage or non-coverage." }, { "payer": "Highmark", "aliases": [ "Highmark Blue Cross Blue Shield", "Highmark BCBS", "Highmark Pennsylvania", "Highmark PA", "Highmark West Virginia", "Highmark Delaware", "Highmark New York", "Blue Cross Pennsylvania" ], "line_of_business": "Commercial (PA, WV, NY)", "position": "covered_with_conditions", "codes_addressed": [ "98975", "98976", "98977", "98978", "98980", "98981" ], "policy_id": "Medical Policy M-89-001 (Remote Patient Monitoring)", "source_url": "https://securecms.highmark.com/content/dam/medpolicy/en/highmark/mpu/M-89-001-dft.pdf", "policy_effective_date": "2025-11-24 (last revision 2025-08)", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Medically necessary with criteria. Physical therapists are explicitly named. But FDA-authorized technology is required.", "notes": "⚠ The single most consequential criterion in this register: 'All technology utilized has been authorized by the FDA, either through approval, clearance, or emergency use authorization.' A platform that is not FDA cleared would not meet it. Note the internal tension: the same policy defines RTM data as 'typically self-reported'. On the favorable side, the authorized provider list explicitly includes Physical Therapist (PT) and Occupational Therapist (OT) alongside MD, DO, NP, PA, CNM, CP, CSW, MHC, MFT and SLP. Treatment plan must be respiratory, musculoskeletal or cognitive. Initial authorization is 3 months, reauthorization in 3-month blocks requiring documented ongoing measurable improvement. Quantity limit: setup/supply/education once per 30-day period, max 6 per calendar year." }, { "payer": "Blue Cross Blue Shield of North Carolina", "aliases": [ "Blue Cross NC", "BCBSNC", "BCBS North Carolina", "Blue Cross of North Carolina" ], "line_of_business": "Commercial", "position": "covered_with_conditions", "codes_addressed": [ "98975", "98976", "98977", "98978", "98979", "98980", "98981", "98984", "98985", "98986" ], "policy_id": "Remote Therapeutic and Physiologic Monitoring", "source_url": "https://www.bcbsnc.com/providers/policies-guidelines-codes/commercial/medical/updates/remote-therapeutic-and-physiologic-monitoring", "policy_effective_date": "2023-04-18 (last review 2026-02)", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Covered when medical necessity criteria are met.", "notes": "Verbatim: 'BCBSNC will provide coverage for Remote Therapeutic and Physiologic Monitoring when it is determined to be medically necessary because the medical criteria and guidelines shown below are met.' The 2026 codes (98979, 98984, 98985, 98986) were added effective 2026-01-01. Criteria mirror the Anthem pattern including 'unable to access regularly scheduled outpatient care'. Does NOT specifically name physical therapists; refers to 'physician or other qualified healthcare professional'. BCBSNC may request medical records to determine medical necessity. Note its own caution: 'Inclusion of a code in this section does not guarantee that it will be reimbursed.'" }, { "payer": "Blue Cross Blue Shield of Michigan / Blue Care Network", "aliases": [ "BCBSM", "BCBS Michigan", "Blue Cross Michigan", "Blue Care Network", "BCN", "Blue Cross of Michigan" ], "line_of_business": "Commercial (BCN commercial HMO includes self-funded groups unless otherwise specified)", "position": "covered", "codes_addressed": [ "98975", "98976", "98977", "98980", "98981" ], "policy_id": "Joint BCBSM/BCN Medical Policy: Remote Therapeutic Monitoring", "source_url": "https://www.bcbsm.com/amslibs/content/dam/public/mpr/mprsearch/pdf/2170383.pdf", "policy_effective_date": "2023-03-01 (policy established 2023-01-01)", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "'Established' when criteria are met. Self-reported data explicitly accepted.", "notes": "Requires a written order from a physician or qualified practitioner specifying the medical condition and the length of time for RTM, up to 90 days. 'Data may be self-reported by the individual or may be electronically captured by a device.' Also: 'The use of a device is not required. If a platform is able to track data from an individual (eg, software, a wearable, self-reported information), remote therapeutic monitoring is achieved.' RTM 'is not intended to be an ongoing modality; it is intended to monitor a patient's response to a plan of care, until goals are reached.' The RTM device itself, including apps and software, is generally NOT separately covered. CAUTION: the retrieved document lists its own Next Review Date as 4th Qtr 2023, so it may have been superseded. Re-verify before relying on it." }, { "payer": "Health Care Service Corporation (HCSC)", "aliases": [ "HCSC", "Blue Cross Illinois", "BCBSIL", "Blue Cross Texas", "BCBSTX", "Blue Cross Oklahoma", "Blue Cross New Mexico", "Blue Cross Montana" ], "line_of_business": "Commercial (IL, TX, OK, NM, MT)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "https://www.bcbsil.com/docs/provider/il/standards/cpcp/2025/cpcp033-01012025.pdf", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No RTM-specific policy located across the five HCSC states.", "notes": "HCSC is the Blue licensee for Illinois, Texas, Oklahoma, New Mexico and Montana, making it one of the largest gaps in this register by covered lives. A telemedicine/virtual care policy exists (CPCP033) but no RTM-specific determination was located. Verify directly with the state plan." }, { "payer": "Kaiser Permanente", "aliases": [ "Kaiser", "KP", "Kaiser Foundation Health Plan" ], "line_of_business": "Commercial and Medicare Advantage", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No public RTM policy found. Kaiser is largely a closed integrated system.", "notes": "Kaiser operates as an integrated payer-provider, so external published coverage policies are sparse by design and outside referrals are limited. For an outpatient PT clinic this is usually a contracting question rather than a coverage-policy question." }, { "payer": "Centene", "aliases": [ "Centene", "Ambetter", "Wellcare", "Health Net", "Fidelis Care" ], "line_of_business": "Commercial, Medicaid managed care and Medicare Advantage", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy found. Largely a Medicaid managed-care organization.", "notes": "Centene operates primarily in Medicaid managed care and the exchanges under brands including Ambetter, Wellcare, Health Net and Fidelis. Because its Medicaid business follows each state's Medicaid rules, the state Medicaid answer usually governs rather than a national Centene policy." }, { "payer": "Molina Healthcare", "aliases": [ "Molina", "Molina Healthcare" ], "line_of_business": "Medicaid managed care and Medicare Advantage", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy found. Medicaid rules usually govern.", "notes": "Molina is predominantly a Medicaid managed-care organization. As with Centene, the governing answer is usually the state's Medicaid policy rather than a national Molina determination." }, { "payer": "Other Blue Cross Blue Shield licensees", "aliases": [ "BCBS", "Blue Cross", "Blue Shield", "Blue Cross Blue Shield", "Blues", "Blue plan" ], "line_of_business": "Commercial", "position": "no_published_policy_found", "codes_addressed": [ "Not researched" ], "policy_id": "Varies by licensee", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Any Blue licensee not listed separately here has not been researched.", "notes": "'Blue Cross' is not one payer. It is 33+ independently operated licensees, each publishing its own medical policy, and a determination by one binds no other. The register now names every large licensee we could identify, so search your specific plan by name first. This row exists for the smaller licensees not listed individually. Proof that licensee positions do not travel: Blue Cross Blue Shield of Texas and Blue Cross Blue Shield of Illinois share a parent (HCSC) and were recorded with opposite RTM positions, and Idaho has two Blues that disagree." }, { "payer": "State Medicaid programs", "aliases": [ "Medicaid", "state Medicaid", "Medical Assistance" ], "line_of_business": "Medicaid fee-for-service", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "Varies by state", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "Varies by state", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Varies by state and not independently verified here.", "notes": "APTA's State Medicaid Payment Rate Guide reports 25 states as possibly reimbursing RTM: AZ CO CT DE GA HI IN IA KY ME MA MI MN MS MO MT NE NJ NM NC OH RI UT VA WY. That guide is APTA-member-only and this list was NOT independently verified against state fee schedules. RTM Medicaid coverage is materially narrower than RPM coverage: CCHP reports roughly 41 states reimburse RPM, which is a different question about different codes. Texas Medicaid is reported as not reimbursing RTM. Individual state Medicaid fee schedules are public and are the authoritative check." }, { "payer": "Workers' compensation", "aliases": [ "workers comp", "workmans comp", "work comp", "WC" ], "line_of_business": "Workers' compensation", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "Varies by state", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Out of scope for this version and deliberately not researched.", "notes": "Workers' compensation runs on state-specific fee schedules and rules entirely separate from group health. It is a real part of most outpatient PT payer mixes, so its absence here is a known gap rather than an oversight." }, { "payer": "Blue Cross of Idaho", "aliases": [ "BCI", "Blue Cross Idaho", "BCBS Idaho", "Blue Cross of Idaho Health Service" ], "line_of_business": "Commercial (ID)", "position": "covered_with_conditions", "codes_addressed": [ "98975", "98976", "98977", "98978", "98979", "98980", "98981", "98984", "98985", "98986" ], "policy_id": "PAP521 Remote Monitoring", "source_url": "https://providers.bcidaho.com/policies-and-procedures/pap/pap521.page", "policy_effective_date": "2026-08", "retrieved_date": "2026-08-28", "verification": "primary", "summary": "Reimbursable with criteria. But it excludes manual logs and non-FDA-compliant software.", "notes": "⚠ The second payer in this register with a technology requirement, and the more pointed of the two. Reimbursable when 'the member requires monitoring of therapeutic adherence or therapeutic response' and 'data is generated by a medical device or approved digital therapeutic platform'. It explicitly EXCLUDES monitoring via 'phone calls, texting, or manual logs' and excludes non-FDA-compliant software. Whether a structured patient-reported app counts as a 'manual log' or as an 'approved digital therapeutic platform' is exactly the ambiguity a clinic should resolve with the plan before billing. Also note: RTM device-supply codes for different durations cannot be billed together in the same 30-day period for the same system, and 98979 cannot be billed with 98980 in the same calendar month." }, { "payer": "Blue Cross Blue Shield of Texas", "aliases": [ "BCBSTX", "BCBS Texas", "Blue Cross Texas", "Blue Cross of Texas", "HCSC Texas" ], "line_of_business": "Commercial (TX)", "position": "covered", "codes_addressed": [ "98975", "98976", "98977", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported the RTM codes as covered. Not independently verified.", "notes": "Part of HCSC. Notably the survey recorded a DIFFERENT answer for Blue Cross Blue Shield of Illinois, which is the same parent company, so do not assume HCSC states share a position. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Blue Cross Blue Shield of Illinois", "aliases": [ "BCBSIL", "BCBS Illinois", "Blue Cross Illinois", "Blue Cross of Illinois", "HCSC Illinois" ], "line_of_business": "Commercial (IL)", "position": "not_covered", "codes_addressed": [ "98975", "98976", "98977", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported the RTM codes as not covered. Not independently verified.", "notes": "Part of HCSC, and the survey recorded the opposite answer for Blue Cross Blue Shield of Texas under the same parent. That divergence is itself the lesson: a licensee's position does not travel across states. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Blue Shield of California", "aliases": [ "Blue Shield CA", "BSC", "Blue Shield of Cal" ], "line_of_business": "Commercial (CA)", "position": "covered", "codes_addressed": [ "98975", "98976", "98977", "98978", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported all RTM codes as covered. Not independently verified.", "notes": "Distinct from Anthem Blue Cross of California, which is a separate company operating in the same state under CG-MED-91. California has two Blue licensees and they are not interchangeable. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Blue Cross Blue Shield of Massachusetts", "aliases": [ "BCBSMA", "BCBS Massachusetts", "Blue Cross Massachusetts" ], "line_of_business": "Commercial (MA)", "position": "covered_with_conditions", "codes_addressed": [ "98975", "98976", "98977", "98978", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported the RTM codes as reimbursable in most cases. Not independently verified.", "notes": "Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Tufts Health Plan (Point32Health)", "aliases": [ "Tufts", "Point32", "Point32Health", "Harvard Pilgrim" ], "line_of_business": "Commercial (New England)", "position": "covered", "codes_addressed": [ "98975", "98976", "98977", "98978", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported all RTM codes as covered. Not independently verified.", "notes": "Tufts merged with Harvard Pilgrim to form Point32Health; the survey predates full policy consolidation. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Regence (Cambia)", "aliases": [ "Regence", "Cambia", "Regence BlueCross BlueShield", "Regence Oregon", "Regence Washington", "Regence Utah", "Regence Idaho" ], "line_of_business": "Commercial (OR, WA, UT, ID)", "position": "not_covered", "codes_addressed": [ "98975", "98976", "98977", "98980", "98981" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "AMA's 2023 survey reported most RTM codes as not covered. Not independently verified.", "notes": "Note Blue Cross of Idaho, a separate company also operating in Idaho, has a 2026 primary policy that IS reimbursable with criteria. Two Idaho Blues, two different answers. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "CareFirst BlueCross BlueShield", "aliases": [ "CareFirst", "CareFirst BCBS", "Blue Cross Maryland", "BCBS Maryland", "Blue Cross DC", "CareFirst Virginia" ], "line_of_business": "Commercial (MD, DC, N. VA)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No RTM position located. AMA's 2023 survey recorded the RTM codes as not applicable for CareFirst.", "notes": "CareFirst does cover remote PHYSIOLOGIC monitoring for a defined condition list (CHF, COPD, CKD, high blood pressure), which is a different question about different codes and must not be read across to RTM. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Horizon Blue Cross Blue Shield of New Jersey", "aliases": [ "Horizon", "Horizon BCBS", "Horizon Blue Cross", "BCBS New Jersey", "Blue Cross New Jersey" ], "line_of_business": "Commercial (NJ)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No RTM position located. AMA's 2023 survey recorded the RTM codes as not applicable for Horizon.", "notes": "Horizon's remote physiologic monitoring is reported as vendor-delivered and limited to COPD, which is a different question about different codes. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Florida Blue", "aliases": [ "Florida Blue", "BCBS Florida", "Blue Cross Florida", "Blue Cross Blue Shield of Florida", "GuideWell" ], "line_of_business": "Commercial (FL)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "AMA commercial payer coverage survey", "source_url": "https://www.ama-assn.org/system/files/issue-brief-commercial-payer-coverage-digital-care.pdf", "policy_effective_date": "2023-08-31", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No RTM position located, and AMA's 2023 survey recorded even the RPM codes as not covered.", "notes": "Florida Blue was one of the more restrictive plans in the survey, recorded as not covering the remote physiologic monitoring codes at all. That is a different code set, but it is not an encouraging signal. Source is the AMA's commercial-payer digital-medicine coverage survey, last updated 2023-08-31. ⚠ That is roughly three years old and this category has moved a great deal since: Elevance was 'under review' there and has since published CG-MED-91, and Highmark was blank there and has since published M-89-001. Treat this as a dated indication, not a current determination, and verify before billing. Where we hold a 2026 primary document for a payer, that supersedes this survey." }, { "payer": "Independence Blue Cross", "aliases": [ "IBX", "Independence", "Independence Blue Cross", "Blue Cross Philadelphia" ], "line_of_business": "Commercial (Southeastern PA)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Tennessee", "aliases": [ "BCBST", "BCBS Tennessee", "Blue Cross Tennessee" ], "line_of_business": "Commercial (TN)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Alabama", "aliases": [ "BCBS Alabama", "Blue Cross Alabama" ], "line_of_business": "Commercial (AL)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Premera Blue Cross", "aliases": [ "Premera", "Blue Cross Washington", "BCBS Washington", "Premera Alaska" ], "line_of_business": "Commercial (WA, AK)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Oklahoma", "aliases": [ "BCBSOK", "BCBS Oklahoma", "Blue Cross Oklahoma", "HCSC Oklahoma" ], "line_of_business": "Commercial (OK)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of New Mexico", "aliases": [ "BCBSNM", "BCBS New Mexico", "Blue Cross New Mexico", "HCSC New Mexico" ], "line_of_business": "Commercial (NM)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Montana", "aliases": [ "BCBSMT", "BCBS Montana", "Blue Cross Montana", "HCSC Montana" ], "line_of_business": "Commercial (MT)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Mississippi", "aliases": [ "BCBS Mississippi", "Blue Cross Mississippi" ], "line_of_business": "Commercial (MS)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Kansas", "aliases": [ "BCBS Kansas", "Blue Cross Kansas" ], "line_of_business": "Commercial (KS)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Louisiana", "aliases": [ "BCBS Louisiana", "Blue Cross Louisiana" ], "line_of_business": "Commercial (LA)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Arizona", "aliases": [ "BCBS Arizona", "Blue Cross Arizona", "AZ Blue" ], "line_of_business": "Commercial (AZ)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of South Carolina", "aliases": [ "BCBS South Carolina", "Blue Cross South Carolina" ], "line_of_business": "Commercial (SC)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Nebraska", "aliases": [ "BCBS Nebraska", "Blue Cross Nebraska" ], "line_of_business": "Commercial (NE)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Vermont", "aliases": [ "BCBS Vermont", "Blue Cross Vermont" ], "line_of_business": "Commercial (VT)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Wyoming", "aliases": [ "BCBS Wyoming", "Blue Cross Wyoming" ], "line_of_business": "Commercial (WY)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of North Dakota", "aliases": [ "BCBS North Dakota", "Blue Cross North Dakota" ], "line_of_business": "Commercial (ND)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Wellmark Blue Cross Blue Shield", "aliases": [ "Wellmark", "BCBS Iowa", "Blue Cross Iowa", "BCBS South Dakota" ], "line_of_business": "Commercial (IA, SD)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Capital Blue Cross", "aliases": [ "Capital Blue Cross", "Capital BlueCross" ], "line_of_business": "Commercial (Central PA)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Excellus BlueCross BlueShield", "aliases": [ "Excellus", "BCBS Upstate New York", "Univera" ], "line_of_business": "Commercial (Upstate NY)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Hawaii (HMSA)", "aliases": [ "HMSA", "BCBS Hawaii", "Blue Cross Hawaii" ], "line_of_business": "Commercial (HI)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Arkansas Blue Cross Blue Shield", "aliases": [ "Arkansas Blue Cross", "BCBS Arkansas", "Blue Cross Arkansas" ], "line_of_business": "Commercial (AR)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Rhode Island", "aliases": [ "BCBSRI", "BCBS Rhode Island", "Blue Cross Rhode Island" ], "line_of_business": "Commercial (RI)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Minnesota", "aliases": [ "BCBS Minnesota", "Blue Cross Minnesota" ], "line_of_business": "Commercial (MN)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Blue Cross Blue Shield of Delaware / Highmark Delaware", "aliases": [ "BCBS Delaware", "Blue Cross Delaware", "Highmark Delaware" ], "line_of_business": "Commercial (DE)", "position": "no_published_policy_found", "codes_addressed": [ "None located" ], "policy_id": "Not located", "source_url": "", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "No published RTM policy located. Ask the plan directly.", "notes": "A good-faith search found no published RTM coverage determination for this licensee. Absence of a located policy is NOT evidence of coverage or non-coverage: many Blue plans publish medical policies only behind a provider portal. Ask the plan directly, and if you get a written answer we will publish it. Note that Blue Cross licensees are independent companies, so a position held by another Blue plan tells you nothing about this one." }, { "payer": "Alaska Medicaid", "aliases": [ "Alaska Medicaid", "AK Medicaid", "Medicaid Alaska", "Alaska Medical Assistance" ], "line_of_business": "Medicaid (AK)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Alaska among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Alaska's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Alabama Medicaid", "aliases": [ "Alabama Medicaid", "AL Medicaid", "Medicaid Alabama", "Alabama Medical Assistance" ], "line_of_business": "Medicaid (AL)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Alabama among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Alabama's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Arkansas Medicaid", "aliases": [ "Arkansas Medicaid", "AR Medicaid", "Medicaid Arkansas", "Arkansas Medical Assistance" ], "line_of_business": "Medicaid (AR)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Arkansas among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Arkansas's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Arizona Medicaid", "aliases": [ "Arizona Medicaid", "AZ Medicaid", "Medicaid Arizona", "Arizona Medical Assistance" ], "line_of_business": "Medicaid (AZ)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Arizona among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Arizona's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "California Medicaid", "aliases": [ "California Medicaid", "CA Medicaid", "Medicaid California", "California Medical Assistance" ], "line_of_business": "Medicaid (CA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list California among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against California's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Colorado Medicaid", "aliases": [ "Colorado Medicaid", "CO Medicaid", "Medicaid Colorado", "Colorado Medical Assistance" ], "line_of_business": "Medicaid (CO)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Colorado among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Colorado's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Connecticut Medicaid", "aliases": [ "Connecticut Medicaid", "CT Medicaid", "Medicaid Connecticut", "Connecticut Medical Assistance" ], "line_of_business": "Medicaid (CT)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Connecticut among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Connecticut's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "District of Columbia Medicaid", "aliases": [ "District of Columbia Medicaid", "DC Medicaid", "Medicaid District of Columbia", "District of Columbia Medical Assistance" ], "line_of_business": "Medicaid (DC)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list District of Columbia among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against District of Columbia's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Delaware Medicaid", "aliases": [ "Delaware Medicaid", "DE Medicaid", "Medicaid Delaware", "Delaware Medical Assistance" ], "line_of_business": "Medicaid (DE)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Delaware among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Delaware's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Florida Medicaid", "aliases": [ "Florida Medicaid", "FL Medicaid", "Medicaid Florida", "Florida Medical Assistance" ], "line_of_business": "Medicaid (FL)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Florida among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Florida's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Georgia Medicaid", "aliases": [ "Georgia Medicaid", "GA Medicaid", "Medicaid Georgia", "Georgia Medical Assistance" ], "line_of_business": "Medicaid (GA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Georgia among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Georgia's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Hawaii Medicaid", "aliases": [ "Hawaii Medicaid", "HI Medicaid", "Medicaid Hawaii", "Hawaii Medical Assistance" ], "line_of_business": "Medicaid (HI)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Hawaii among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Hawaii's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Iowa Medicaid", "aliases": [ "Iowa Medicaid", "IA Medicaid", "Medicaid Iowa", "Iowa Medical Assistance" ], "line_of_business": "Medicaid (IA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Iowa among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Iowa's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Idaho Medicaid", "aliases": [ "Idaho Medicaid", "ID Medicaid", "Medicaid Idaho", "Idaho Medical Assistance" ], "line_of_business": "Medicaid (ID)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Idaho among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Idaho's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Illinois Medicaid", "aliases": [ "Illinois Medicaid", "IL Medicaid", "Medicaid Illinois", "Illinois Medical Assistance" ], "line_of_business": "Medicaid (IL)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Illinois among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Illinois's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Indiana Medicaid", "aliases": [ "Indiana Medicaid", "IN Medicaid", "Medicaid Indiana", "Indiana Medical Assistance" ], "line_of_business": "Medicaid (IN)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Indiana among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Indiana's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Kansas Medicaid", "aliases": [ "Kansas Medicaid", "KS Medicaid", "Medicaid Kansas", "Kansas Medical Assistance" ], "line_of_business": "Medicaid (KS)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Kansas among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Kansas's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Kentucky Medicaid", "aliases": [ "Kentucky Medicaid", "KY Medicaid", "Medicaid Kentucky", "Kentucky Medical Assistance" ], "line_of_business": "Medicaid (KY)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Kentucky among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Kentucky's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Louisiana Medicaid", "aliases": [ "Louisiana Medicaid", "LA Medicaid", "Medicaid Louisiana", "Louisiana Medical Assistance" ], "line_of_business": "Medicaid (LA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Louisiana among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Louisiana's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Massachusetts Medicaid", "aliases": [ "Massachusetts Medicaid", "MA Medicaid", "Medicaid Massachusetts", "Massachusetts Medical Assistance" ], "line_of_business": "Medicaid (MA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Massachusetts among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Massachusetts's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Maryland Medicaid", "aliases": [ "Maryland Medicaid", "MD Medicaid", "Medicaid Maryland", "Maryland Medical Assistance" ], "line_of_business": "Medicaid (MD)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Maryland among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Maryland's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Maine Medicaid", "aliases": [ "Maine Medicaid", "ME Medicaid", "Medicaid Maine", "Maine Medical Assistance" ], "line_of_business": "Medicaid (ME)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Maine among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Maine's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Michigan Medicaid", "aliases": [ "Michigan Medicaid", "MI Medicaid", "Medicaid Michigan", "Michigan Medical Assistance" ], "line_of_business": "Medicaid (MI)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Michigan among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Michigan's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Minnesota Medicaid", "aliases": [ "Minnesota Medicaid", "MN Medicaid", "Medicaid Minnesota", "Minnesota Medical Assistance" ], "line_of_business": "Medicaid (MN)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Minnesota among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Minnesota's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Missouri Medicaid", "aliases": [ "Missouri Medicaid", "MO Medicaid", "Medicaid Missouri", "Missouri Medical Assistance" ], "line_of_business": "Medicaid (MO)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Missouri among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Missouri's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Mississippi Medicaid", "aliases": [ "Mississippi Medicaid", "MS Medicaid", "Medicaid Mississippi", "Mississippi Medical Assistance" ], "line_of_business": "Medicaid (MS)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Mississippi among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Mississippi's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Montana Medicaid", "aliases": [ "Montana Medicaid", "MT Medicaid", "Medicaid Montana", "Montana Medical Assistance" ], "line_of_business": "Medicaid (MT)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Montana among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Montana's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "North Carolina Medicaid", "aliases": [ "North Carolina Medicaid", "NC Medicaid", "Medicaid North Carolina", "North Carolina Medical Assistance" ], "line_of_business": "Medicaid (NC)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists North Carolina among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against North Carolina's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "North Dakota Medicaid", "aliases": [ "North Dakota Medicaid", "ND Medicaid", "Medicaid North Dakota", "North Dakota Medical Assistance" ], "line_of_business": "Medicaid (ND)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list North Dakota among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against North Dakota's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Nebraska Medicaid", "aliases": [ "Nebraska Medicaid", "NE Medicaid", "Medicaid Nebraska", "Nebraska Medical Assistance" ], "line_of_business": "Medicaid (NE)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Nebraska among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Nebraska's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "New Hampshire Medicaid", "aliases": [ "New Hampshire Medicaid", "NH Medicaid", "Medicaid New Hampshire", "New Hampshire Medical Assistance" ], "line_of_business": "Medicaid (NH)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list New Hampshire among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against New Hampshire's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "New Jersey Medicaid", "aliases": [ "New Jersey Medicaid", "NJ Medicaid", "Medicaid New Jersey", "New Jersey Medical Assistance" ], "line_of_business": "Medicaid (NJ)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists New Jersey among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against New Jersey's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "New Mexico Medicaid", "aliases": [ "New Mexico Medicaid", "NM Medicaid", "Medicaid New Mexico", "New Mexico Medical Assistance" ], "line_of_business": "Medicaid (NM)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists New Mexico among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against New Mexico's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Nevada Medicaid", "aliases": [ "Nevada Medicaid", "NV Medicaid", "Medicaid Nevada", "Nevada Medical Assistance" ], "line_of_business": "Medicaid (NV)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Nevada among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Nevada's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "New York Medicaid", "aliases": [ "New York Medicaid", "NY Medicaid", "Medicaid New York", "New York Medical Assistance" ], "line_of_business": "Medicaid (NY)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list New York among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against New York's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Ohio Medicaid", "aliases": [ "Ohio Medicaid", "OH Medicaid", "Medicaid Ohio", "Ohio Medical Assistance" ], "line_of_business": "Medicaid (OH)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Ohio among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Ohio's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Oklahoma Medicaid", "aliases": [ "Oklahoma Medicaid", "OK Medicaid", "Medicaid Oklahoma", "Oklahoma Medical Assistance" ], "line_of_business": "Medicaid (OK)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Oklahoma among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Oklahoma's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Oregon Medicaid", "aliases": [ "Oregon Medicaid", "OR Medicaid", "Medicaid Oregon", "Oregon Medical Assistance" ], "line_of_business": "Medicaid (OR)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Oregon among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Oregon's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Pennsylvania Medicaid", "aliases": [ "Pennsylvania Medicaid", "PA Medicaid", "Medicaid Pennsylvania", "Pennsylvania Medical Assistance" ], "line_of_business": "Medicaid (PA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Pennsylvania among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Pennsylvania's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Rhode Island Medicaid", "aliases": [ "Rhode Island Medicaid", "RI Medicaid", "Medicaid Rhode Island", "Rhode Island Medical Assistance" ], "line_of_business": "Medicaid (RI)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Rhode Island among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Rhode Island's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "South Carolina Medicaid", "aliases": [ "South Carolina Medicaid", "SC Medicaid", "Medicaid South Carolina", "South Carolina Medical Assistance" ], "line_of_business": "Medicaid (SC)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list South Carolina among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against South Carolina's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "South Dakota Medicaid", "aliases": [ "South Dakota Medicaid", "SD Medicaid", "Medicaid South Dakota", "South Dakota Medical Assistance" ], "line_of_business": "Medicaid (SD)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list South Dakota among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against South Dakota's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Tennessee Medicaid", "aliases": [ "Tennessee Medicaid", "TN Medicaid", "Medicaid Tennessee", "Tennessee Medical Assistance" ], "line_of_business": "Medicaid (TN)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Tennessee among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Tennessee's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Texas Medicaid", "aliases": [ "Texas Medicaid", "TX Medicaid", "Medicaid Texas", "Texas Medical Assistance" ], "line_of_business": "Medicaid (TX)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Texas among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Texas's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Utah Medicaid", "aliases": [ "Utah Medicaid", "UT Medicaid", "Medicaid Utah", "Utah Medical Assistance" ], "line_of_business": "Medicaid (UT)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Utah among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Utah's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Virginia Medicaid", "aliases": [ "Virginia Medicaid", "VA Medicaid", "Medicaid Virginia", "Virginia Medical Assistance" ], "line_of_business": "Medicaid (VA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Virginia among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Virginia's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Vermont Medicaid", "aliases": [ "Vermont Medicaid", "VT Medicaid", "Medicaid Vermont", "Vermont Medical Assistance" ], "line_of_business": "Medicaid (VT)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Vermont among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Vermont's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Washington Medicaid", "aliases": [ "Washington Medicaid", "WA Medicaid", "Medicaid Washington", "Washington Medical Assistance" ], "line_of_business": "Medicaid (WA)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Washington among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Washington's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Wisconsin Medicaid", "aliases": [ "Wisconsin Medicaid", "WI Medicaid", "Medicaid Wisconsin", "Wisconsin Medical Assistance" ], "line_of_business": "Medicaid (WI)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list Wisconsin among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Wisconsin's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "West Virginia Medicaid", "aliases": [ "West Virginia Medicaid", "WV Medicaid", "Medicaid West Virginia", "West Virginia Medical Assistance" ], "line_of_business": "Medicaid (WV)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "Not on APTA's list of states that may reimburse RTM. Not independently verified.", "notes": "APTA's State Medicaid Payment Rate Guide does NOT list West Virginia among the 25 states that may reimburse RTM. That is not the same as a confirmed exclusion. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against West Virginia's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." }, { "payer": "Wyoming Medicaid", "aliases": [ "Wyoming Medicaid", "WY Medicaid", "Medicaid Wyoming", "Wyoming Medical Assistance" ], "line_of_business": "Medicaid (WY)", "position": "varies_by_plan", "codes_addressed": [ "Varies by state" ], "policy_id": "State Medicaid fee schedule", "source_url": "https://www.apta.org/your-practice/payment/medicaid/state-medicaid-payment-rate-guide", "policy_effective_date": "", "retrieved_date": "2026-08-28", "verification": "secondary_unverified", "summary": "APTA reports this state may reimburse RTM. Not independently verified. Check the state fee schedule.", "notes": "APTA's State Medicaid Payment Rate Guide lists Wyoming among 25 states that MAY reimburse RTM. ⚠ That guide is APTA-member-only, so this is reported secondhand and has NOT been checked against Wyoming's own published fee schedule, which is the authoritative source and is public. Two further cautions that apply to every state: RTM coverage is materially narrower than RPM coverage and the two are constantly conflated (roughly 41 state Medicaid programs reimburse RPM, a different question about different codes); and a Medicaid managed-care plan such as Centene or Molina generally follows the state's rules rather than a national policy." } ] }