Reference · payer coverage
Does your payer cover RTM?
Pick a program, a payer and a state. This shows what that payer’s published policy says, with the citation it came from. Medicare, the national commercial carriers, the Blue Cross licensees, and all 51 state Medicaid programs.
Read this before you trust an answer
215 of the 354 rules in here, 61%, come back “verify with the payer”, not a clean yes or no. That is where RTM coverage stands in 2026, not a gap in this reference. Most commercial plans have not published a position on these codes yet.
So use it to learn which of your payers are settled and which are open. The open ones are worth a call to the payer, not a guess.
Policy snapshot: May 27, 2026. Payer policies change without notice, and a rule that was accurate then may not be today. Check the citation date on any rule you plan to act on.
Found your payers? Here is what they mean for your clinic.
Name your payers in the free caseload audit. It checks each one against its published policy, counts your billable-eligible patients, and tells you, honestly, whether the install is a fit.
Get your free caseload auditRates are CY2026 Medicare national non-facility payment amounts from the CMS Physician Fee Schedule. Actual rates are geographically adjusted and vary by locality and payer contract.
Estimates count the device-supply code only (98977 or 98985). Treatment-management codes are billed on your own clinicians’ logged time and are not included.
Billed is not collected. This is an educational estimate, not a guarantee of revenue or reimbursement.
Your clinic bills under its own NPI. Movra packages the documentation your biller submits. Movra does not bill on your behalf.
Commercial and Medicaid coverage of RTM varies by payer and by plan. A published policy is not a benefits verification. Confirm coverage with each payer before enrolling.
This page is general coverage reference, not coding, billing or legal advice, and it is not a benefits verification. Confirm coverage, medical-necessity criteria and documentation requirements with each payer and with your biller before submitting a claim. Your clinic bills under its own NPI — Movra packages the documentation your biller submits and does not bill on your behalf.
CPT is a registered trademark of the American Medical Association. Code descriptions here are Movra’s own summaries, not AMA text.