For four years there was a cliff in the RTM code set, and every practice billing these codes fell off it at least once.
The cliff was 16 days. CPT 98977 covers device supply with scheduled recordings or programmed alert transmissions, and it requires at least 16 days of data inside a 30 day period. Fifteen days got you nothing. Not a reduced payment. Nothing.
I have a patient in mind. Post-op knee, motivated, did her program, transmitted for eleven days, then her daughter had a baby three states away and she was gone for two weeks. We monitored her. We reviewed her data. We called her. And when the billing ran, there was no device supply code to put on the claim, because eleven is not sixteen.
That is what 98985 fixed.
What CPT 98985 is, in one sentence
98985 is device supply for 2 to 15 days of data inside a 30 day period. It is new for 2026. It sits directly underneath 98977, which still covers the 16 to 30 day range.
That is the whole change. It sounds small. It is not, and the reason has nothing to do with the code itself.
The patients this actually captures
Think about who was falling into the gap. In my experience it is four groups, and none of them are the patients you would call non-compliant.
The short episode. Someone with an acute low back strain who is genuinely better in three weeks. You monitored them for twelve days and then discharged them because they got better. Under the old set, doing your job well meant billing less.
The late enroller. You did not think about RTM at the eval. You thought about it at visit four, when it became clear this person was going to need work between sessions. By then the calendar month is half gone.
The interrupted patient. Travel, illness, a work trip, a family emergency. The data stops for a stretch and never gets back above the line.
The tester. The patient who is not sure about any of this and agrees to try it. Two weeks in they either commit or they do not. Either way you did the setup, you supplied the device, and you were monitoring.
Add those four groups up on your own caseload and it is not a rounding error. When we looked at our own numbers, the patients who transmitted somewhere between 2 and 15 days were a meaningful slice of everyone we enrolled, and every one of them had been unbillable on the device supply side.
Run the arithmetic on your own caseload
Do not take my word for the size of this. Go pull it yourself, because the answer is different in a hand therapy clinic than it is in a sports practice.
Take your last 100 RTM enrollments. Sort them by transmission days inside their first 30 day window. Count how many landed between 2 and 15.
Every one of those is a device supply code you did not bill in 2025 and can bill now. Then do the second half of the math, which nobody does: those same patients still need the treatment management side. If you were monitoring them, you were spending time. Put your own numbers into the calculator rather than trusting a vendor slide.
I am not going to quote you a dollar figure here. Rates vary by locality and by year, and a blog post that hands you a number you then build a budget around is doing you harm. Pull your own from the CMS Physician Fee Schedule lookup for your region.
What 98985 did not change
This is where I want to slow down, because a new code creates a very specific kind of optimism and it needs some cold water.
The device still has to be a device. 98985 is device supply. If the thing your patient is using does not meet the FDA definition of a medical device, adding a new supply code does not help you. A home exercise app by itself is generally not going to clear that bar. Get this wrong and you are not looking at denials, you are looking at a repayment demand.
The 30 day gap rule still applies. You cannot stack device supply codes back to back for the same patient inside the same window. 98977 and 98985 are alternatives for a period, not additions to each other.
And the labor did not get cheaper. This is the part that gets lost. 98985 broadens who you can bill device supply for. It does nothing about the 20 minutes of clinical time that 98980 requires, or the interactive communication inside the calendar month. A wider enrollment funnel with the same staffing produces the same month three collapse, just with more patients in it.
Where practices are going to get this wrong
Two predictions, and I would like to be wrong about both.
First, some practices are going to treat 98985 as a reason to enroll everyone. Wider net, more codes, more revenue. That is backwards. Enrollment was never your constraint. Monitoring capacity was. If you double enrollment without adding the clinical hours, your adherence drops, your outcomes get worse, and the whole program starts to look like billing for the sake of billing. Which is exactly what an auditor is looking for.
Second, people are going to conflate 98985 with 98979, because both are new for 2026 and both lower a threshold. They are not the same thing and they are not even on the same side of the program. 98985 is device supply. 98979 is treatment management, covering 10 to 19 minutes of clinical time. One is about how many days of data came in. The other is about how many minutes your clinician spent. Mixing them up on a claim is an avoidable denial.
What this means for your clinic
If you already run RTM, this is a billing hygiene task, not a strategy change. Sit down with whoever touches your RTM claims and make sure your workflow can tell a 2 to 15 day patient from a 16 to 30 day patient at the end of the window, and route the right code. If your system cannot see that distinction automatically, someone is going to have to look, and you should know who that someone is before the month closes.
If you are not running RTM yet, 98985 does make the entry easier. It means a pilot with thirty patients no longer has to hit a 16 day bar to produce anything on the device supply side. But it does not answer the question that decides whether your program survives, which is who on your staff is doing the monitoring minutes every month.
Answer that one first. The codes are the easy part.
If you want to see how this plays out against your actual caseload, request a demo and we will go through it with you. If you would rather just look at the numbers on your own first, the RTM calculator is the lower commitment place to start.