What the New PT CPT Codes Mean for RTM Billing in 2026

The CMS Calendar Year 2026 Physician Fee Schedule Final Rule introduced the most significant update to Remote Therapeutic Monitoring since the service was created in 2022, and it comes down to three new PT CPT codes that finally close a gap that practices have been billing around for years. Until now, RTM device supply required a full 16 to 30 days of data before it was billable at all - anything shorter simply went unpaid, regardless of clinical value. Effective January 1, 2026, that all-or-nothing threshold is gone. This guide breaks down the three new codes, how they fit alongside the existing RTM family, and the billing rules and modifiers that come with them.

The Three New PT CPT Codes for 2026

Per CMS's own Therapy Services update, three new codes were added to the CY2026 therapy code list, all effective January 1, 2026:

These three codes exist specifically to make RTM billable for shorter monitoring windows and lighter-touch treatment management - a patient monitored for 10 days instead of 20, or managed with 15 minutes of clinical time instead of 20, is now reimbursable where it previously wasn't.

How the New Codes Fit With the Existing RTM Family

The billing rule to know: the new and existing codes are mutually exclusive within the same calendar month. A practice can't bill both 98985 (2–15 days) and 98977 (16–30 days) for the same patient in the same 30-day period, and can't bill both 98979 (10–19 minutes) and 98980 (20+ minutes) either. The patient's actual monitoring duration and clinical time that month determine which set applies - not practice preference. Our overview of what the new codes mean for RPM providers and patients covers the identical structural change CMS made on the physiologic monitoring side, since RTM and RPM were updated in parallel this cycle.

Modifiers and "Sometimes Therapy" Billing Rules

CMS designated all three new codes - 98979, 98984, and 98985 - as "sometimes therapy" services, which brings specific modifier requirements:

• Modifier CQ - Required when an outpatient physical therapist assistant furnishes more than 10% of the treatment time for the code being billed
• Modifier CO - The occupational therapy assistant equivalent of CQ
• No modifier needed - When the service is furnished entirely by the licensed therapist, physician, or other qualified healthcare professional
• Modifier GP - Still required, as with other outpatient PT claim lines, to indicate the service falls under a physical therapy plan of care

Our detailed breakdown of the CMS 2026 proposed rule covers how these three codes were finalized alongside a parallel set of RPM changes and other CY2026 provisions.

Other 2026 PT Billing Changes Worth Knowing

The new RTM codes arrived alongside two other changes that affect every PT claim, not just RTM billing:

• New conversion factor - $33.40 for non-APM participants (up from $32.35 in 2025), and $33.57 for APM participants. This is the multiplier applied to every code's relative value units to calculate the Medicare payment amount.
• KX modifier threshold - Set at $2,480 for CY2026, the amount above which the KX modifier is required to confirm medical necessity for continued therapy services.

Use the CMS Physician Fee Schedule Look-up Tool to confirm current reimbursement for any specific code and locality before finalizing a fee schedule update.

Common Mistakes to Avoid With the New PT CPT Codes

• Billing both the short-duration and long-duration device supply codes (e.g., 98985 and 98977) for the same patient in the same calendar month
• Stacking 98979 and 98980 instead of choosing based on actual clinical time that month
• Omitting modifier CQ or CO when a PTA or OTA performed more than 10% of the billed treatment time
• Assuming these are "always therapy" codes - they're "sometimes therapy," which changes how modifiers apply compared to core PT treatment codes
• Applying the old 16-day threshold by habit, missing legitimate reimbursement for patients who fall in the new 2–15 day window

Practices should also avoid treating RTM billing as fully separate from the rest of a patient's chronic care picture - many patients monitored under these codes for musculoskeletal or respiratory conditions are also managing other chronic conditions that qualify separately for Chronic Care Management and RPM programs, which can be billed alongside RTM when the conditions and time are documented separately.

Where New PT CPT Codes Connect to Circle Health's Care Management Programs

Circle Health doesn't bill physical therapy or RTM services directly - RTM stays with the treating PT, OT, or physician under the codes above. But RTM and Remote Patient Monitoring (RPM) were restructured in parallel this cycle for the same reason: CMS wanted shorter, more flexible monitoring windows across both physiologic and therapeutic monitoring. Circle Health's core RPM program runs on that same structure - see our guide to CPT 99445, the RPM equivalent of 98984/98985, for how the parallel 2–15 day device supply code works on the physiologic side. For practices evaluating whether to bring RTM in-house alongside an existing RPM program, our RTM software platforms guide covers what a unified platform needs to handle both code families correctly.

Conclusion

The new PT CPT codes for 2026 - 98979, 98984, and 98985 - close a real gap in RTM billing by making shorter monitoring windows and lighter treatment management reimbursable for the first time. The mechanics are straightforward once the mutually exclusive rule is clear: pick the code set that matches the patient's actual monitoring duration and clinical time that month, apply the CQ/CO modifier when a PTA or OTA is involved, and don't default to the old thresholds out of habit.

CPT and RTM billing rules are reviewed by CMS on an annual cycle, so treat this guide as a starting reference rather than a final word. Always verify current codes and rates against the latest CMS and AMA publications, and loop in your billing team or a certified coder whenever a claim doesn't fit neatly into the categories above.

Frequently Asked Questions

What are the new PT CPT codes for 2026?

Three new codes were added effective January 1, 2026: 98984 (RTM device supply, respiratory, 2–15 days), 98985 (RTM device supply, musculoskeletal, 2–15 days), and 98979 (RTM treatment management, 10–19 minutes per month).

Can the new RTM codes be billed alongside the existing ones?

No, not for the same patient in the same calendar month. 98985 and 98977 are mutually exclusive, as are 98979 and 98980 - the code chosen depends on the patient's actual monitoring duration or clinical time that month.

What modifier is required for PTA or OTA time on these codes?

Modifier CQ is required when a physical therapist assistant furnishes more than 10% of the billed treatment time, and modifier CO applies to the occupational therapy assistant equivalent.

What is the 2026 Medicare conversion factor for PT billing?

$33.40 for non-APM participants and $33.57 for APM participants, up from $32.35 in 2025 - this multiplier applies to every CPT code's relative value units to calculate payment.

What does "sometimes therapy" mean for these new codes?

CMS designated 98979, 98984, and 98985 as "sometimes therapy" services, meaning they can be furnished in therapy or non-therapy contexts, which affects when the CQ/CO modifiers apply compared to "always therapy" codes.

How can Circle Health help?

While Circle Health doesn't bill physical therapy or RTM services directly, its AI-powered care management platform runs the parallel 2026-updated RPM codes as a core service, and supports CCM, PCM, BHI, and TCM for the same patients managing chronic conditions alongside their PT and RTM care.