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The rate tableWhy your rate isn't the national numberWhat a compliant month is worth, stackedWhat changed for 2026How to verify your exact rateFAQKey takeaways
- Six codes, six national rates: 98975 $21.71 · 98977/98985 $51.44 · 98979 $26.39 · 98980 $54.11 · 98981 $41.42 (CY2026 non-facility, non-QP).
- A fully stacked compliant month (98977 + 98980 + 98981) is worth roughly $146+ per patient, uncapped because 98981 stacks.
- National rates aren't what you actually collect — locality (GPCI) and the QP/non-QP conversion factor change the real number.
- If you've seen $39.75 for device supply, that figure is stale — superseded by a CMS correction notice.
The CY2026 Medicare national non-facility rates for RTM are: 98975 (initial setup) $21.71, 98977 and 98985 (device supply) $51.44 each, 98979 (treatment management, 10–19 min) $26.39, 98980 (treatment management, 20–39 min) $54.11, and 98981 (each additional 20 min) $41.42. These are national averages at the non-QP conversion factor — your locality and payer contract change the actual amount you collect.
The full 2026 RTM rate table
| Code | Covers | Threshold | CY2026 national rate |
|---|---|---|---|
98975 | Initial setup & patient education | Once per episode | $21.71 |
98985 | Device supply, MSK data | 2–15 data-days | $51.44 |
98977 | Device supply, MSK data | 16–30 data-days | $51.44 |
98979 | Treatment management | 10–19 min + call | $26.39 |
98980 | Treatment management | 20–39 min + call | $54.11 |
98981 | Additional treatment management | Each add'l 20 min (40+ total) | $41.42 |
Why your rate isn't the national number
The table above is a national average — useful for planning, not what lands in your account. Three things move the real number:
- Locality (GPCI). CMS applies a Geographic Practice Cost Index to the work, practice-expense, and malpractice components of each code's RVUs based on where the service is furnished. Rates in a high-cost metro area can run meaningfully above the national figure; rural localities can run below it.
- QP vs non-QP conversion factor. Starting CY2026, a differential conversion factor applies depending on whether the billing clinician is a Qualifying Alternative Payment Model (APM) Participant. The rates above use the non-QP conversion factor ($33.4009); the QP conversion factor is slightly higher ($33.5675).
- Payer contract. Medicare Advantage plans and commercial payers aren't bound to the traditional Medicare fee schedule — they set their own contracted rates, which may be higher, lower, or bundled differently.
Budget off the national table for planning purposes, but confirm the number that actually pays with your MAC or payer contract before you rely on it.
What a compliant month is worth, stacked
RTM codes stack within a calendar month, so the real per-patient value is higher than any single code. A patient who clears the device-supply threshold and the treatment-management call requirement is worth, at national rates: $51.44 (98977, device supply) + $54.11 (98980, first 20 minutes of management) + $41.42 for each additional 20-minute block (98981) — roughly $146 or more per month, and uncapped because 98981 adds in further increments for longer review sessions. The setup code, 98975, is a one-time addition at the start of the episode, not a monthly figure.
What changed for 2026
Two codes are new for CY2026: 98985 gives a device-supply option for patients who log fewer than 16 data-days (2–15), and 98979 adds a lower treatment-management tier (10–19 minutes). Both fill gaps that previously left shorter, lighter months unbillable. Separately, a CMS correction notice (FR 2026-04797, effective 2026-03-12) revised the device-supply valuations after the initial final rule — 98977 and 98985 are both finalized at $51.44. If you've seen figures like $39.75 for device supply or $53.77/$41.80 for treatment management circulating, those reflect the pre-correction publication and are superseded.
How to verify your exact rate
For the number that actually applies to your practice: use the CMS Physician Fee Schedule Look-Up Tool with your specific locality, or check your Medicare Administrative Contractor's published fee schedule. If you bill commercial or Medicare Advantage plans, verify the contracted rate directly with the payer — it's frequently different from the traditional Medicare figure.
Track the rate, then track whether the month actually qualifies.
BoneArc accumulates data-days and management time per patient, captures the call attestation, and rolls it into a certified, audit-ready monthly record — so the rate table above turns into an actual claim, not a spreadsheet estimate.
See it on your panel →FAQ
What are the 2026 RTM reimbursement rates?
National non-facility rates: 98975 $21.71, 98977/98985 $51.44 each, 98979 $26.39, 98980 $54.11, 98981 $41.42. These are national non-QP averages — your locality and payer contract will differ.
How much can a practice collect per patient per month for RTM?
Roughly $146+ per active patient per month when device supply (98977) stacks with treatment management (98980 + 98981), uncapped because 98981 adds in additional 20-minute increments.
Why does my RTM payment differ from the national rate?
Your locality's GPCI adjusts the RVU components, and the QP vs non-QP conversion factor applies depending on the billing clinician's APM status. Commercial and Medicare Advantage payers may contract entirely different rates.
Did RTM rates change for 2026?
Yes — two new codes (98985 and 98979) were added, and a CMS correction notice revised device-supply valuations to $51.44 for both 98977 and 98985, superseding an earlier, lower figure some sources still cite.
Where can I verify the exact RTM rate for my location?
Use the CMS Physician Fee Schedule Look-Up Tool with your locality, or check your MAC's published fee schedule. National averages are for planning only.