2026 Proposed CMS Changes for Remote Therapeutic Monitoring (RTM)
The Centers for Medicare & Medicaid Services (CMS) has proposed significant updates to Remote Therapeutic Monitoring (RTM) for 2026. These changes, if finalized, will make RTM easier to use, more flexible for different patient needs, and more financially sustainable for your practice. Here’s a simple breakdown of what’s new.
Key Change 1: The "16-Day Rule" is Changing
Previously, you had to collect patient data for at least 16 days in a month to bill for RTM device supply codes. Starting in 2026, you can bill for monitoring periods as short as two days.
This is achieved by introducing new codes for 2–15 days of monitoring, while the existing codes will now specifically cover 16–30 days. This flexibility now extends across musculoskeletal, respiratory, and cognitive behavioral therapy monitoring.
New & Updated RTM Device Billing Codes for 2026
Clinical Area | NEW Code (2–15 Days/Month) | Existing Code (16–30 Days/Month) |
|---|---|---|
Respiratory System | 98XX4 | 98976 |
Musculoskeletal (MSK) | 98XX5 | 98977 |
Cognitive Behavioral Therapy (CBT) | 98XX6 | 98978 |
What this means for you: This change opens the door to serve entirely new patient populations who were previously excluded from RTM benefits, including:
Post-surgical patients who need focused monitoring during their critical recovery window
Patients with episodic conditions who benefit from targeted monitoring during flare-ups or symptom changes
Individuals participating in recovery programs with specific touchpoints who couldn't meet the previous 16-day threshold but will greatly benefit from RTM support
Key Change 2: Getting Reimbursed for Shorter Check-Ins
Previously, you needed to spend at least 20 minutes on RTM management per month to bill for your time. Now, you can bill for interactions as short as 10 minutes.
CMS has proposed a new code to cover shorter, yet still valuable, clinical check-ins.
NEW Code 98XX7: Covers 10–19 minutes of RTM treatment management services per month.
Existing Codes 98980 & 98981: Continue to cover time in 20-minute increments.
What this means for you: Meaningful but brief interactions—like a 12-minute call to discuss therapy adherence or a quick review of an alert—are now billable. This reduces uncompensated work and encourages regular patient contact.
Billing & Reimbursement
With new codes come new payment rates. CMS is proposing a novel method of using hospital cost data to set these rates, which leads to some important outcomes.
❗ Important Note: While many rates are stable, this new method means the proposed 2026 payment for the existing 16–30 day MSK code (98977) is lower than its 2025 rate.
Proposed 2026 RTM Reimbursement Rates
CPT Code | Description | Proposed 2026 Payment |
|---|---|---|
98XX5 | NEW RTM Device (MSK), 2–15 days | $39.77 |
98977 | RTM Device (MSK), 16–30 days | $39.77 (Reduced from 2025) |
98XX7 | NEW RTM Management, 10–19 mins | $26.07 |
98980 | RTM Management, first 20 mins | $53.81 (Increased from 2025) |
98981 | Each additional 20 minutes of RTM treatment management services in a month | $41.11 (Increased from 2025) |
A Note on Respiratory & CBT Codes
The device codes for Respiratory (98XX4, 98976) and CBT (98XX6, 98978) will be "contractor priced." This means reimbursement amounts will be set by your local Medicare contractor (MAC) and may vary by region.
How to Prepare for 2026
Review Your Patients: Identify individuals who could benefit from short-term monitoring (2–15 days) but didn't qualify before.
Train Your Staff: Educate your clinical and billing teams on the new codes, time thresholds, and documentation requirements.
Document Everything: Continue to thoroughly document medical necessity and patient engagement to support ongoing RTM services.
Stay Informed: These changes are still proposed. Watch for the CMS Final Rule, expected in November 2025. You can submit comments on the proposed rule until September 12, 2025.
Frequently Asked Questions (FAQ)
When do these changes take effect?
If finalized, these updates will be effective January 1, 2026.
Do these changes also apply to RPM?
Yes, similar changes are proposed for Remote Physiologic Monitoring (RPM) to allow for shorter monitoring periods and time increments. However, the specific CPT codes and reimbursement details are different.
What's the final word on reimbursement rates?
The rates listed above are from the proposed rule. They may be adjusted in the Final Rule. Practices should always verify rates with their local Medicare contractor after the rule is finalized.
Looking Ahead
The proposed 2026 changes to RTM codes are designed to make remote monitoring more practical, flexible, and financially sustainable for providers. By removing outdated barriers and reflecting real-world care patterns, CMS is positioning RTM as a core tool for modern, proactive healthcare.
For more information, see the official CMS proposed rule or consult with our billing and compliance experts to ensure a smooth transition to the new requirements.
If your practice is considering launching remote therapeutic monitoring, now is the right time to get started. Our team can guide you through every step—program design, staff training, billing setup, and more—so you can offer RTM confidently and compliantly. Contact us to learn how you can implement a successful digital care program that fits your workflow.
