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Does Medicare Advantage cover RTM?

What Medicare Advantage's own published policy says about Remote Therapeutic Monitoring (CPT 98975 to 98986), with the document, its dates and the day we read it.

Covered with criteriaUNVERIFIEDwe could not read a primary document

Short answer for Medicare Advantage

Yes, with criteria.

Must cover Part B benefits but may add its own criteria. Check the specific plan.

Applies to
Medicare Part C
Document
No single policy; determined per MA plan
Dates
Varies by plan and plan year
Source
Read the document
We read it
August 28, 2026

What the document says

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.

Codes addressed: Same code set as Part B.

How to check one MA plan

  1. Find the plan, not the carrier. The card's plan name and contract decide it.
  2. Ask for the plan's internal coverage criteria for the RTM codes. Since April 2026 CMS requires MA organizations to publish them publicly, free of charge, without an account.
  3. Ask about prior authorization for the codes you intend to bill, by code.
  4. Record the answer (date, representative, reference number) where your whole clinic can see it.

Two of the largest MA carriers: UnitedHealthcare published no RTM-specific MA criteria we could find, so Part B rules govern by default, and Humana published no RTM policy we could locate.

Other payers

MedicareUnitedHealthcareHumanaSearch any payer

How to use this page

This is a summary of a published payer document. It is not coverage advice and it cannot tell you whether one patient's claim will pay. The line of business, the employer's plan document and the patient's eligibility all sit between a policy and a payment. Our coverage guide walks through how to verify for a specific patient, and how to bill RTM covers the rest of the claim.

Policies change, usually in January. If you have a newer document or a remittance that contradicts this page, send it to contact@rehabityhealth.com and we will update the page.

Rehabity builds home exercise and remote therapeutic monitoring software for outpatient physical therapy clinics. We researched payer policy because we needed the answer ourselves. If you want to see what we build, read about the therapist side or join the waitlist.