Remote Therapeutic Monitoring (RTM) is a family of CPT codes for reviewing self-reported data a client generates outside sessions with software their clinician supplied. PsyBird records that data as your clients do their assigned work and measures the time you spend on it. For each client you bill through insurance, it also prepares the monthly report for you to review and sends its claim when you sign it. Whether you can bill RTM depends on your license, your payer, and the work you actually do each month. This page lays out all three, with the arithmetic.
The short version. Medicare, Medicare Advantage and several BCBS and UHC plans cover RTM. Cigna’s and Aetna’s commercial plans do not cover it, Medicaid rarely does, and cash-pay clients bill nothing. The codes and the published Medicare amounts are in the table below; whether you can bill them, and what you collect, depends on your license, your payer and your coder. For a client you bill through insurance, PsyBird prepares the monthly report and, when you sign it, sends its claim; neither costs anything extra beyond the $1 PsyBird charges for the claim itself. PsyBird costs $10 a month for each connected client, plus $1 for each insurance claim PsyBird files, with no cap, and only a client you bill through insurance has a monthly report to sign, a row on the RTM page, and a claim. To use RTM, turn on I bill insurance in Settings → Insurance billing profile, then switch the client to insurance billing on their Billing tab. For a client you do not bill through insurance, PsyBird still counts engagement days and measures your time on their file, so without reimbursement it remains a between-session engagement and outcomes tool, but there is no RTM report for that client.
| CPT | What it covers | Threshold | 2026 Medicare national |
|---|---|---|---|
| 98975 | Initial setup and patient education on the monitoring software | Once per episode of care; PsyBird asks you to document at least 20 minutes | $21.71 |
| 98978 | Supply of the monitoring software for cognitive behavioral therapy, with data | 16–30 engagement days in 30 | Contractor-priced (Novitas ~$38–45) |
| 98986 | The same supply, for a thinner month new for 2026 | 2–15 engagement days in 30 | Contractor-priced |
| 98979 | First 10–19 minutes of treatment management, with one patient interaction new for 2026 | Monthly | $26.39 |
| 98980 | First 20 minutes of treatment management, with one patient interaction | Monthly | $54.11 |
| 98981 | Each additional 20 minutes | Monthly, as accrued | ~$41 |
Only one supply code (98978 or 98986) per 30 days. 98976, 98977, 98984 and 98985 are the respiratory and musculoskeletal supply codes and do not apply. The two CBT supply codes carry no national rate: your Medicare Administrative Contractor or payer contract sets the amount, and some pay nothing. Clients owe 20% coinsurance under Medicare Part B. RTM is not telehealth: no modifier 95 or 93, place of service is your office.
| License | Medicare RTM | Notes |
|---|---|---|
| Psychiatrist, psychiatric NP or PA | Yes | Staff time may count under general supervision |
| Clinical psychologist | Yes | Psychologists may bill incident-to; APA has confirmed RTM eligibility |
| Clinical social worker (LCSW) | Yes | Must personally perform the 20 minutes; no incident-to |
| MFT or mental health counselor (LPC, LMHC) | Unconfirmed | Medicare-enrolled since 2024; CMS has not addressed RTM for these types. Ask your MAC in writing before billing |
| Not Medicare-enrolled | No | Commercial and Medicaid per payer only |
Commercial payers. Cigna (policy 0563) and Aetna (CPB 1093) do not cover RTM for any indication. UnitedHealthcare covers it on some plans with prior authorization. Several BCBS plans list 98975–98981 as covered. Medicare Advantage plans must cover Part B services, subject to plan authorization. Medicaid: only California and Colorado mention RTM at all; none document it for behavioral health. Call the payer before you enroll a client.
RTM requires that the monitoring software meet the FDA’s definition of a medical device, as opposed to a general wellness product. It does not require FDA clearance. PsyBird’s client-facing monitoring functions (clinician-assigned exercises and plans, symptom and mood check-ins, PHQ-9 and GAD-7, and sharing that self-reported information with you) are software intended to help clients with a diagnosed condition maintain skills you assign and report back to you. We understand those functions to fall within the FDA’s device definition and within the category of low-risk software for which the FDA has said it does not intend to enforce premarket review (FDA, Policy for Device Software Functions and Mobile Medical Applications: software that helps patients with diagnosed psychiatric conditions maintain coping skills and self-manage without providing treatment suggestions). PsyBird is not FDA cleared or approved, and we make no promise that a given payer or auditor will accept it as a qualifying device; that determination is yours. Psy, the conversational assistant, is a support feature you configure, not a treatment, and is not part of the monitoring functions. A device description you can place in the chart is in the app under Settings → Insurance billing profile, and the same description is printed on every monthly report.
Because that determination is yours rather than ours, the supply line is the one part of RTM PsyBird leaves switched off. See the two switches below.
Engagement days. A day counts when the client completes at least one assigned exercise, meditation, check-in, or outcome measure. Days follow the calendar in the client’s own time zone and are totaled by calendar month, which is the period the report and its claim cover. CPT describes the supply codes per 30 days, and a calendar month runs 28 to 31 days, so confirm with your contractor or payer that PsyBird’s calendar month meets that period before you switch the supply line on. Chats with Psy and direct messages never count, however long they run. The month’s report names the supply code the days support: 98978 at 16 or more, 98986 from 2 to 15. Whether that line reaches a claim is a switch you control, and it ships off.
Your time. PsyBird accrues minutes while a client’s file is open on your screen and you are active in it, takes measured duration from calls, and adds minutes you type in; it does not estimate time. Auto-measured minutes stay pending until you review them, and you should confirm only minutes you spent on that client’s monitoring and treatment management; the report will not let you sign until you have. Off-screen time you add by hand. A minute counts toward one program only: time you tag or move to care management on the report stops counting toward RTM. The month’s confirmed RTM minutes land in 98979, 98980, or 98981 by their own thresholds, and the report records the live interaction you had with the client that month: a call in PsyBird, with its measured minutes, or a session on your calendar that you marked completed, in person, by video or by phone. A message is never counted as the interaction or as time, because Medicare reads the treatment-management codes as requiring a live, interactive communication.
Setup. 98975 is documented once, when you enroll the client: what you taught them, how their data reaches you, and the goals of monitoring. You write it in the client file’s Export menu, under Document RTM setup. The record is dated the day you write it, so write it on the day of the setup session. It will not save for under 20 minutes, or with any of its five statements unconfirmed, and the 98975 line then rides on the report for the month you wrote it. A report can be signed once the client has a setup record or you have started care management for them; a month in which no setup record was written carries no 98975 line.
Reports. The monthly report exists only for a client you bill through insurance, and it can be signed once its month is over. Each report is e-signed by you, and signing is what files the claim. The row above your signature names the claim that signing will send and the payer it goes to, so you can uncheck it for that month. For a client set to “I file by hand”, signing builds the claim as a draft on the Claims page and sends nothing, and once you record that a client has asked that their insurer not be told about their care, PsyBird files no claim for them while that restriction is recorded. The report itself stays with the chart; it is not attached to the claim.
Two switches ship off, each because it rests on a determination that is yours and not ours. One withholds a line from every claim; the other only bites where a month carries both kinds of work. Both live in Settings → Insurance billing profile, where they appear once I bill insurance is on, and when a claim leaves a line off it records the reason in words rather than silently dropping it.
The supply line (98978 and 98986). Off by default. This is the line that turns on the device question above, so PsyBird will not put it on a claim on your behalf until you have settled that question for your own practice. The management codes (98979, 98980 and 98981) and the setup code 98975 file either way.
RTM and care management in the same month (G0323 or 99484). Off by default. Where a month carries both RTM treatment management and a care-management code, PsyBird files the RTM lines and leaves the care-management line off unless you switch this on, which you should do only once your Medicare contractor has confirmed in writing that it will pay both.
One more thing worth knowing before an audit: every RTM and care-management line on a month’s claim carries one date for the whole month rather than being spread across it. By default that date is the last day of the month billed. A third setting in the same place changes it to the day you sign the report; with that setting, two months’ reports signed for the same client on the same day carry the same date, and a payer may refuse the second as a duplicate. Which date your payer or contractor expects is yours to confirm. Only 98975 carries its own date: the day you wrote the setup record.
A Medicare client you bill through insurance who gets 20 measured minutes of your review time and at least one interaction in a month supports 98980 that month. If they also engage on 16 or more days, the month supports 98978 as well, once you have settled the device question and switched the supply line on. The published Medicare amounts are in the table above, against PsyBird’s $10 a month for each connected client, plus $1 for each insurance claim PsyBird files; only a client you bill through insurance has a monthly report and an RTM claim. What you actually collect is between you, your contract and your MAC: not every client engages every month, not every payer pays, and the two supply codes carry no national rate at all. A practice that is mostly cash-pay or on Cigna and Aetna should not build a month around RTM; a psychologist or LCSW with a Medicare-heavy caseload is on much firmer ground. We deliberately do not forecast what you would collect, because that depends on your payer, your license type and your coder, and it is your determination to make.
The accounting view in the app runs the sum with the rate you enter for each code, so you are reading your own numbers rather than a national average. Read it as an estimate of what the month’s work would support, not as a preview of what PsyBird will file: it counts every client’s month, including clients you do not bill through insurance, who have no report to sign, and it counts the supply line and same-month care management, which claims leave off until you switch them on.
PHQ-9, GAD-7 and other standardized instruments your clients complete and score in PsyBird can be billed as CPT 96127, about $5 per instrument under Medicare and up to three per date of service. Turn it on in Settings → Insurance billing profile. With it on, those lines go onto the claim PsyBird files for an insured client’s session day, and onto the superbill you print or export for a private pay client. The superbill PsyBird sends to a client carries the paid session lines only. PsyBird only adds lines for instruments the client actually completed and scored in the app, and never for a questionnaire whose title it does not recognize as a standardized instrument. Many payers bundle 96127 into same-day psychotherapy and some do not pay it for every license type, so check before you count on it. Separately from the dollars, longitudinal scores are what measurement-based care and network quality programs run on.
It does not choose your codes: the session CPT is a fixed list you choose from, the RTM codes on a report are proposed from measured data for you to review and are fixed only by your signature, and 96127 lines are added only if you turn that setting on. Every code on a claim is yours to confirm. It does not decide what is billable, determine coverage, or verify that your license type can bill a given code. It does not enroll you in PECOS, obtain a PTAN, or register you with a state Medicaid system, though it tells you where those happen and in what order. It files corrections, not appeals: an appeal is a letter Psy will draft in your voice for you to send through the payer’s own channel. And it never guarantees payment.
This page is not billing, legal, or regulatory advice. Codes, thresholds, and payment amounts are our reading of published CPT descriptors and 2026 Medicare national amounts and may be incomplete, outdated, or inapplicable to your payer, locality, or license. Whether the software qualifies, whether you may bill, and whether a claim is accurate are your determinations. Reports you sign in PsyBird are your attestations, and signing a report that files a claim, completing a session with the confirmation to file its claim, or submitting a claim is your certification that the services were furnished as described and that the claim is accurate. Confirm the specifics with your MAC, and with your biller if you use one, before you sign a report or file a claim.