Can therapists bill RTM?

Psychologists can bill RTM, and many practices also bill it for master's-level clinicians credentialed with Medicare. Payment rules can differ by license, so confirm with your biller before you start.

Why does my fee schedule show $0 for 98978?

CMS doesn't set a national rate for the CBT monitoring codes 98978 and 98986. Each Medicare contractor prices them, so some fee schedules list no amount. Medicare still covers them.

Does RTM software need to be FDA cleared?

RTM requires a device that meets the FDA definition of a medical device. For behavioral health this is usually software. Medicare doesn't require FDA clearance.

Can I bill 98979 and 98980 in the same month?

No. 98979 covers 10 to 19 minutes of treatment management and 98980 covers the first 20 minutes, so you bill one or the other for a client in a given month.

RTM Billing for Behavioral Health in 2026

Remote therapeutic monitoring (RTM) lets a practice bill Medicare for the structured support clients get between sessions. For behavioral health, that means skill practice and check-ins for cognitive behavioral therapy (CBT) and similar programs, reviewed by the treating clinician.

This guide covers the codes, what each one needs, and the 2026 Medicare rates. It's informational, not billing advice. Confirm the details with your biller and your Medicare contractor.

The codes

RTM has two kinds of codes. Device supply codes pay for the monitoring itself. Treatment management codes pay for the clinician's time reviewing the data and working with the client.

Code	What it covers	How often
98975	Setting up the client and teaching them to use the program	Once per episode of care
98978	Monitoring for CBT, 16 to 30 days of data in a 30-day period	Once per 30 days
98986	Monitoring for CBT, 2 to 15 days of data in a 30-day period (new in 2026)	Once per 30 days
98980	First 20 minutes of treatment management in a calendar month, with at least one live interaction with the client	Once per month
98981	Each additional 20 minutes in the same month	Add-on to 98980
98979	10 to 19 minutes of treatment management in a calendar month (new in 2026)	Instead of 98980

Two changes in 2026 make RTM easier to bill for behavioral health. A client with only 2 to 15 days of data in a month can now count toward 98986, and a month with 10 to 19 minutes of review can now be billed as 98979.

What Medicare pays in 2026

These are Medicare's 2026 national rates for an office setting, from the CMS Physician Fee Schedule relative value files (October release, conversion factor $33.4009):

Code	2026 national rate
98975	$21.71
98980	$54.11
98981	$41.42
98979	$26.39
98978 and 98986	Set by your Medicare contractor

Your actual payment depends on your location, and Medicare pays 80% of the allowed amount. The client or a secondary plan covers the remaining 20% coinsurance.

Why the CBT monitoring codes show $0

CMS doesn't set a national rate for 98978 and 98986. Each Medicare Administrative Contractor (MAC) prices them for its region. That's why some fee schedules list no amount for these codes. Medicare still covers them. Ask your MAC, or check its fee schedule, for the amount in your state.

What a claim needs

Qualifying software. RTM requires a device that meets the FDA definition of a medical device. For behavioral health this is usually software, known as Software as a Medical Device. A text message or a paper worksheet doesn't count.
Medical necessity. A diagnosis and a care plan for skill development or education, documented in your EHR before you bill.
Client consent to remote monitoring.
The data behind each code. Days of data for the monitoring codes, and minutes plus at least one live interaction for treatment management.

Who can bill

Psychologists can bill RTM. Many practices also bill it for master's-level clinicians credentialed with Medicare, such as LCSWs, LMFTs and mental health counselors. Payment rules for these licenses can differ (some services are paid at 75% of the full rate), so confirm your clinicians' licenses and rates with your biller before you start.

How Nudge helps

Nudge is software that meets the FDA definition of a medical device (Software as a Medical Device) for remote therapeutic monitoring. It is not FDA cleared or approved, and Medicare doesn't require clearance.

Nudge delivers the daily program to your clients by text or email, counts monitoring days, times your clinicians' review minutes, and creates a signed monthly report per client for your biller. Your medical necessity documentation stays in your EHR.