Reimbursement
Carrier Priced
Threshold
2d
2026 Status
Active
What is CPT Code 98986?
CPT 98986 is defined as: Remote therapeutic monitoring device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor cognitive behavioral therapy, 2-15 days of data transmission within a 30-day period.
This code is primarily used for RTM services. It falls under the category of Remote Therapeutic Monitoring (RTM) and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
Physician Effort
PE (Non-Fac)
Practice Expense
Malpractice
Risk Factor
Total RVU
Note: Reimbursement is determined by individual MACs or commercial payers.
2026 CMS Policy Intelligence
16 day gate reform
Eliminates the 'all-or-nothing' risk by providing a lower-tier payment for 2-15 days of monitoring.
short cycle protection
Protects revenue for providers when patients fall short of full compliance while maintaining therapeutic visibility.
carrier pricing
Individual MACs will set the fee (likely lower than 98978 if it were national).
Administrative Framework
Operational Requirements
minimum time
2 days of data transmission within a 30-day period
staff type
Not applicable (Technical/Supply component)
frequency
Once per 30-day period (only if 16 days not met)
add on codes
care plan requirement
New for 2026: specifically designed to capture low-intensity or treatment-entry monitoring phases.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Ensure your RTM platform can automatically distinguish between the 15-day and 16-day transmission thresholds.
Common Clinical Scenarios
CMS Eligibility: Patients starting or ending CBT programs. Initial engagement or tapering phases
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Billing Differentiation
VS 98978
98978 is for 16-30 days; 98986 is the safety net for 2-15 days.
VS 99445
99445 is the RPM equivalent (2-15 days) for physiologic monitoring.
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