Anthem Blue Cross Remote Therapeutic Monitoring (RTM) Reimbursement Rates for California PT, OT & Respiratory Practices (2026)

Remote therapeutic monitoring (RTM) is its own billing category, distinct from remote patient monitoring and chronic care management: it covers non-physiologic therapeutic data such as respiratory and musculoskeletal status, medication and therapy adherence, and functional status, rather than physiologic device readings or ongoing care-management time. CMS draws that distinction directly in its own claims-processing material. For the physical therapy, occupational therapy, respiratory care and behavioral health practices that bill this code family, RTM is recurring monthly revenue, which makes the negotiated rate behind each CPT code compound across every enrolled patient. Anthem’s statewide California rate is a starting point for that math, not a contract rate. See how CPT-level verification works.

A quick note on methodology: the figures below come from Fuse’s own extraction of Anthem’s August 2026 California machine readable files. We pulled every dollar-denominated fee schedule rate attached to these CPT codes in the statewide network file (excluding percentage-of-charges entries), matched each listed NPI against the federal NPPES registry, kept only individual physical, occupational and respiratory therapists and behavioral health clinicians (the practitioner types that bill RTM) whose registered practice location is in California, and computed the statistics across distinct provider-rate pairs. Because Anthem sets negotiated fee schedules at the plan and provider-group level rather than by clinician type, these statewide statistics are representative benchmarks for any RTM biller. This page covers RTM only; see the companion analyses of Anthem’s RPM rates in California and Anthem’s CCM rates in California, plus our original look at Anthem’s behavioral health rates in California.

Anthem’s Rates for Remote Therapeutic Monitoring (RTM) CPT Codes in California

Anthem Blue Cross publishes negotiated rates for remote therapeutic monitoring through its California Machine Readable Files. The table below reflects August 2026 data for the five core RTM codes.

Rates extracted from Anthem’s August 2026 California machine readable files.

Anthem’s files update monthly, so this table is labeled with its extraction date and should not be treated as a fixed, permanent figure.

Additional RTM Codes in Anthem’s Rate Data

Beyond the core family, Anthem’s California rate data carries three more RTM codes, all confirmed in Anthem’s clinical policy CG-MED-91 and priced in the CMS 2026 physician fee schedule relative value files: 98978, the device-supply code for cognitive behavioral therapy monitoring, and the new-for-2026 short-duration supply codes 98984 (respiratory) and 98985 (musculoskeletal), covered in their own sections below.

Rates extracted from Anthem’s August 2026 California machine readable files.

What Anthem’s California RTM Rates Actually Tell You

A statewide mean pools an enormous number of distinct negotiated arrangements. Anthem organizes its files by employer EIN for group plans and by HIOS number for individual plans, so the aggregation choices behind any published statistic materially shape the result. Two practices billing the identical CPT code to Anthem in California can see meaningfully different reimbursement depending on the specific plan, the employer group behind it and the provider’s contract.

Anthem describes its machine readable files as comprehensive files containing negotiated in-network rates and historical out-of-network data, updated monthly (Anthem, Machine Readable Files). But a listed rate does not by itself confirm a specific claim will be paid: coverage criteria, plan edits and billing mechanics all sit between the file and the remittance.

Remote Therapeutic Monitoring for Behavioral Health Practices: CPT 98978

RTM is billable by a broader set of practitioners than RPM, and that includes behavioral health. CPT 98978 is the device-supply code for cognitive behavioral therapy monitoring: it covers supplying the device or software that captures a patient’s engagement with a CBT program, billed once per 30 days with 16-30 days of data, distinct from the respiratory (98976) and musculoskeletal (98977) supply codes. Because Anthem’s negotiated fee schedules are set at the plan and provider-group level rather than by clinician type, the statewide statistics above remain representative for behavioral health billers of this code even though the broader RTM sample includes PT, OT and respiratory practices.

What’s New in RTM Billing for 2026: CPT 98984 and 98985

Effective January 1, 2026, two short-duration supply codes joined the family: 98984 (respiratory) and 98985 (musculoskeletal) cover lower-engagement months with only 2-15 days of data transmission, versus the 16-30-day threshold of the standard supply codes 98976 and 98977. Each is mutually exclusive with its full-month counterpart, so a practice bills one or the other for a given 30-day period, never both. Anthem added both codes to CG-MED-91’s coding table in its January 2026 update, and both already carry negotiated rates in the California files.

Anthem’s Coverage Requirements for RTM in California

Anthem’s clinical policy CG-MED-91, “Remote Therapeutic and Physiologic Monitoring Services,” recognizes RTM as medically necessary when the monitoring is clinically appropriate for the patient’s condition, the data is being regularly assessed to detect acute changes and prompt intervention, the patient is at risk of clinically significant changes in medical status, and the policy’s remaining criteria are met. CMS’s own claims-processing material independently confirms the core RTM code family and its non-physiologic-data distinction from RPM. A rate appearing in the machine readable file does not by itself establish coverage: medical necessity, device requirements, patient engagement and interactive-communication requirements can all affect whether a specific claim is payable.

Why RTM Can’t Be Billed on the Same Clock as CCM or RPM

A patient can qualify for RTM alongside remote patient monitoring or chronic care management, but the same clinical-staff or practitioner time cannot be counted toward more than one service in the same period. Documentation has to support separately qualifying work for each service billed. Practices running combined programs should read this page alongside Anthem’s California RPM reimbursement rates and Anthem’s California CCM reimbursement rates.

What This Means for Your Practice

The medical-necessity criteria and the non-double-counting rule point at the same operational need: knowing, before the claim, what the specific member plan covers and requires. A pooled statewide average cannot answer that. Fuse helps practices close that gap by verifying reimbursements against past claims data and placing automated phone calls to payers to confirm insurance coverage, so discrepancies between what a practice expects and what actually gets paid surface before they quietly accumulate into lost revenue.

Verify RTM Coverage and Billing Before Every Claim

A statewide average is a starting point for budgeting and program-design conversations, not a substitute for confirming what a specific patient’s plan will actually pay, or whether the claim meets CG-MED-91’s medical-necessity criteria at all. Fuse verifies current eligibility and plan-specific benefits at the CPT code level before the visit, combining past claims data with automated phone calls to payers, helping practices estimate expected copay, coinsurance and deductible responsibility and get paid what they are contractually owed. See how CPT-level verification works.

Disclaimer: This article uses rate information from the Machine Readable Files that Anthem Blue Cross publishes under the federal Transparency in Coverage rule. These files are posted to satisfy the regulation, not to be read: the file behind this analysis unpacks to 15 gigabytes of raw pricing data, millions of negotiated rates that no spreadsheet can open. Fuse built its own pipeline to extract and verify the figures above. This analysis focuses on a single payer and will not reflect rates from all available insurance options in California. Fuse makes every effort to provide accurate and current information, but healthcare pricing can change frequently, and individual circumstances may affect actual costs. This information does not guarantee specific pricing. Practices should verify current rates directly with Anthem before relying on them for billing or negotiation decisions.