Does Medicare cover remote therapeutic monitoring?

What the document says

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's advisory updated January 29, 2026, needs at least two days of monitoring in a 30-day period, so it may be billed on day 3 of monitoring, not at setup. There is no NCD for RTM.

RTM codes the document addresses:

• 98975
• 98976
• 98977
• 98978
• 98979
• 98980
• 98981
• 98984
• 98985
• 98986

What Medicare requires

• Physical therapists can bill the RTM codes. CMS proposed barring PTs in July 2021 and reversed in the CY2022 final rule after APTA's comments.
• An active plan of care. RTM and its treatment management must be included in and provided under an active plan of care during the episode of care.
• Patient-reported data counts. Patients "can self-report, manually enter, and digitally upload RTM data on a device that meets the FDA definition of a medical device."
• No established patient relationship is needed for RTM, unlike remote physiologic monitoring (RPM).
• Consent. CMS requires patient consent for non-face-to-face services, and staff under general supervision can obtain it. The usual Part B cost sharing applies, so say so when you ask.
• One practitioner per patient per 30-day period, and RPM and RTM cannot be billed together for the same patient.
• PTAs. Since January 1, 2025, PTAs in private practice can work under general supervision for RTM. 98975 is subject to the PTA payment adjustment. The device codes are not.

Sources: APTA Practice Advisory, updated January 29, 2026; CMS MLN901705, December 2025. The code-by-code rules are in our RTM CPT codes guide, and the billing steps are in how to bill RTM.

2026 Medicare rates

National, non-facility amounts (outpatient private practice), before your locality adjustment. Medicare pays 80% of the allowed amount after the deductible, and the patient owes the rest.

Total RVUs x the 2026 conversion factor of $33.4009, from CMS's October 2026 relative value file (RVU26D). Your locality's rate: RTM calculator.

What happens to the claims

CMS's 2025 claims data for physical therapists in private practice shows the extra-time code is where claims go wrong. At least 43% of 98981 services were denied in 2025, up from about 10% in 2023, while 98980 was denied about 9% of the time. CMS does not publish the reasons. The same data shows about 1.1 months of device supply billed per RTM enrollment: most patients come off RTM when visits stop.

Source: CMS Physician/Supplier Procedure Summary 2023 and 2025, provider specialty 65. "At least" because CMS suppresses small counts.

Medicare Advantage is a different answer

Roughly half of Medicare enrollees are in Medicare Advantage, and an MA plan can add its own criteria. "The patient has Medicare" is not enough to know. See does Medicare Advantage cover RTM.

Other payers

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.