RTM · ICD-10 Codes

RTM ICD-10
Codes.

Musculoskeletal or respiratory conditions requiring ongoing therapeutic monitoring: pain management, physical therapy adherence, respiratory therapy outcomes.

364 codes · ICD-10-CM FY2026

All Programs RPM CCM PCM BHI RTM

What RTM actually requires

Minimum Conditions

1 chronic condition

Duration

Acute or chronic (no minimum duration)

CPT Codes

98975 98976 98977 98980 98981

RTM monitors non-physiologic therapy outcomes for musculoskeletal and respiratory conditions. Unlike RPM which tracks vital signs, RTM tracks therapy adherence, pain levels, functional status, and respiratory therapy outcomes using patient-reported and device-generated data.

RTM Diagnoses

Every code, by condition.

364 billable ICD-10-CM codes across 18 conditions that can support Remote Therapeutic Monitoring. CMS does not approve codes for RTM, so treat this as the code set for those conditions rather than an eligibility list.

364 codes listed

Endocrine and metabolic

Cystic fibrosis and metabolic developmental disorders

E84, E70, E71, E72, E74, E75, E76, E77, E79, E80183 codes in familyrpmccmpcmrtm

Lung function and oxygenation for cystic fibrosis, with weight as a nutritional marker.

CMS other chronic or potentially disabling condition · CCW category: Cystic Fibrosis and Other Metabolic Developmental Disorders · Devices: Spirometer or peak flow meter, Pulse oximeter, Connected weight scale

This family runs to 183 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within E84, E70, E71, E72, E74, E75, E76, E77, E79, E80.

Respiratory

COPD, emphysema and bronchiectasis

J40, J41, J42, J43, J44, J4718 codesrpmccmpcmrtm

Oxygen saturation is the primary signal, with symptom scores and inhaler adherence supporting RTM.

CMS chronic condition · CCW category: Chronic Obstructive Pulmonary Disease · Devices: Pulse oximeter, Spirometer or peak flow meter

Read the copd, emphysema and bronchiectasis monitoring guide

Code	Official ICD-10-CM description	Programs	Risk adjustment
J40	Bronchitis, not specified as acute or chronic	rpmccmpcmrtm	not risk adjusted
J41.0	Simple chronic bronchitis	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J41.1	Mucopurulent chronic bronchitis	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J41.8	Mixed simple and mucopurulent chronic bronchitis	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J42	Unspecified chronic bronchitis	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J43.0	Unilateral pulmonary emphysema [MacLeod's syndrome]	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J43.1	Panlobular emphysema	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J43.2	Centrilobular emphysema	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J43.8	Other emphysema	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J43.9	Emphysema, unspecified	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J44.0	Chronic obstructive pulmonary disease with (acute) lower respiratory infection	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J44.1	Chronic obstructive pulmonary disease with (acute) exacerbation	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J44.81	Bronchiolitis obliterans and bronchiolitis obliterans syndrome	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J44.89	Other specified chronic obstructive pulmonary disease	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J44.9	Chronic obstructive pulmonary disease, unspecified	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J47.0	Bronchiectasis with acute lower respiratory infection	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J47.1	Bronchiectasis with (acute) exacerbation	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders
J47.9	Bronchiectasis, uncomplicated	rpmccmpcmrtm	HCC 280 · Chronic Obstructive Pulmonary Disease, Interstitial Lung Disorders, and Other Chronic Lung Disorders

Asthma

J4518 codesrpmccmrtm

Peak flow and symptom frequency. Inhaler adherence and technique are the classic RTM targets.

CMS chronic condition · CCW category: Asthma · Devices: Spirometer or peak flow meter, Pulse oximeter, Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
J45.20	Mild intermittent asthma, uncomplicated	rpmccmrtm	not risk adjusted
J45.21	Mild intermittent asthma with (acute) exacerbation	rpmccmrtm	not risk adjusted
J45.22	Mild intermittent asthma with status asthmaticus	rpmccmrtm	not risk adjusted
J45.30	Mild persistent asthma, uncomplicated	rpmccmrtm	not risk adjusted
J45.31	Mild persistent asthma with (acute) exacerbation	rpmccmrtm	not risk adjusted
J45.32	Mild persistent asthma with status asthmaticus	rpmccmrtm	not risk adjusted
J45.40	Moderate persistent asthma, uncomplicated	rpmccmrtm	not risk adjusted
J45.41	Moderate persistent asthma with (acute) exacerbation	rpmccmrtm	not risk adjusted
J45.42	Moderate persistent asthma with status asthmaticus	rpmccmrtm	not risk adjusted
J45.50	Severe persistent asthma, uncomplicated	rpmccmrtm	HCC 279 · Severe Persistent Asthma
J45.51	Severe persistent asthma with (acute) exacerbation	rpmccmrtm	HCC 279 · Severe Persistent Asthma
J45.52	Severe persistent asthma with status asthmaticus	rpmccmrtm	HCC 279 · Severe Persistent Asthma
J45.901	Unspecified asthma with (acute) exacerbationlow specificity	rpmccmrtm	not risk adjusted
J45.902	Unspecified asthma with status asthmaticuslow specificity	rpmccmrtm	not risk adjusted
J45.909	Unspecified asthma, uncomplicatedlow specificity	rpmccmrtm	not risk adjusted
J45.990	Exercise induced bronchospasm	rpmccmrtm	not risk adjusted
J45.991	Cough variant asthma	rpmccmrtm	not risk adjusted
J45.998	Other asthma	rpmccmrtm	not risk adjusted

Neurologic and cognitive

Parkinson's disease and secondary parkinsonism

G20, G21, G23, G24, G2545 codesccmpcmrtm

Gait, activity and fall detection, with therapy adherence tracked under RTM.

CMS chronic condition · CCW category: Parkinson's Disease and Secondary Parkinsonism · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)

G20 alone is no longer valid. Code to G20.A1, G20.A2, G20.B1, G20.B2 or G20.C.

Code	Official ICD-10-CM description	Programs	Risk adjustment
G20.A1	Parkinson's disease without dyskinesia, without mention of fluctuations	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G20.A2	Parkinson's disease without dyskinesia, with fluctuations	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G20.B1	Parkinson's disease with dyskinesia, without mention of fluctuations	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G20.B2	Parkinson's disease with dyskinesia, with fluctuations	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G20.C	Parkinsonism, unspecified	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G21.0	Malignant neuroleptic syndrome	ccmpcmrtm	not risk adjusted
G21.11	Neuroleptic induced parkinsonism	ccmpcmrtm	not risk adjusted
G21.19	Other drug induced secondary parkinsonism	ccmpcmrtm	not risk adjusted
G21.2	Secondary parkinsonism due to other external agents	ccmpcmrtm	not risk adjusted
G21.3	Postencephalitic parkinsonism	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G21.4	Vascular parkinsonism	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G21.8	Other secondary parkinsonism	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G21.9	Secondary parkinsonism, unspecified	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.0	Hallervorden-Spatz disease	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.1	Progressive supranuclear ophthalmoplegia [Steele-Richardson-Olszewski]	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.2	Striatonigral degeneration	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.3	Hypomyelination with atrophy of the basal ganglia and cerebellum	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.8	Other specified degenerative diseases of basal ganglia	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G23.9	Degenerative disease of basal ganglia, unspecified	ccmpcmrtm	HCC 199 · Parkinson and Other Degenerative Disease of Basal Ganglia
G24.01	Drug induced subacute dyskinesia	ccmpcmrtm	not risk adjusted
G24.02	Drug induced acute dystonia	ccmpcmrtm	not risk adjusted
G24.09	Other drug induced dystonia	ccmpcmrtm	not risk adjusted
G24.1	Genetic torsion dystonia	ccmpcmrtm	not risk adjusted
G24.2	Idiopathic nonfamilial dystonia	ccmpcmrtm	not risk adjusted
G24.3	Spasmodic torticollis	ccmpcmrtm	not risk adjusted
G24.4	Idiopathic orofacial dystonia	ccmpcmrtm	not risk adjusted
G24.5	Blepharospasm	ccmpcmrtm	not risk adjusted
G24.8	Other dystonia	ccmpcmrtm	not risk adjusted
G24.9	Dystonia, unspecified	ccmpcmrtm	not risk adjusted
G25.0	Essential tremor	ccmpcmrtm	not risk adjusted
G25.1	Drug-induced tremor	ccmpcmrtm	not risk adjusted
G25.2	Other specified forms of tremor	ccmpcmrtm	not risk adjusted
G25.3	Myoclonus	ccmpcmrtm	not risk adjusted
G25.4	Drug-induced chorea	ccmpcmrtm	not risk adjusted
G25.5	Other chorea	ccmpcmrtm	not risk adjusted
G25.61	Drug induced tics	ccmpcmrtm	not risk adjusted
G25.69	Other tics of organic origin	ccmpcmrtm	not risk adjusted
G25.70	Drug induced movement disorder, unspecified	ccmpcmrtm	not risk adjusted
G25.71	Drug induced akathisia	ccmpcmrtm	not risk adjusted
G25.79	Other drug induced movement disorders	ccmpcmrtm	not risk adjusted
G25.81	Restless legs syndrome	ccmpcmrtm	not risk adjusted
G25.82	Stiff-man syndrome	ccmpcmrtm	not risk adjusted
G25.83	Benign shuddering attacks	ccmpcmrtm	not risk adjusted
G25.89	Other specified extrapyramidal and movement disorders	ccmpcmrtm	not risk adjusted
G25.9	Extrapyramidal and movement disorder, unspecified	ccmpcmrtm	not risk adjusted

Multiple sclerosis and demyelinating disease

G35, G36, G3721 codesccmpcmrtm

Function and fatigue tracking, with therapy adherence under RTM.

CMS other chronic or potentially disabling condition · CCW category: Multiple Sclerosis and Transverse Myelitis · Devices: Patient-reported outcome app (RTM), Contactless activity and fall radar

G35 alone is no longer valid as of FY2026. Code to G35.A through G35.D.

Code	Official ICD-10-CM description	Programs	Risk adjustment
G35.A	Relapsing-remitting multiple sclerosis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.B0	Primary progressive multiple sclerosis, unspecified	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.B1	Active primary progressive multiple sclerosis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.B2	Non-active primary progressive multiple sclerosis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.C0	Secondary progressive multiple sclerosis, unspecified	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.C1	Active secondary progressive multiple sclerosis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.C2	Non-active secondary progressive multiple sclerosis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G35.D	Multiple sclerosis, unspecified	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G36.0	Neuromyelitis optica [Devic]	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G36.1	Acute and subacute hemorrhagic leukoencephalitis [Hurst]	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G36.8	Other specified acute disseminated demyelination	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G36.9	Acute disseminated demyelination, unspecified	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.0	Diffuse sclerosis of central nervous system	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.1	Central demyelination of corpus callosum	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.2	Central pontine myelinolysis	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.3	Acute transverse myelitis in demyelinating disease of central nervous system	ccmpcmrtm	HCC 182 · Spinal Cord Disorders/Injuries
G37.4	Subacute necrotizing myelitis of central nervous system	ccmpcmrtm	HCC 182 · Spinal Cord Disorders/Injuries
G37.5	Concentric sclerosis [Balo] of central nervous system	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.81	Myelin oligodendrocyte glycoprotein antibody disease	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.89	Other specified demyelinating diseases of central nervous system	ccmpcmrtm	HCC 198 · Multiple Sclerosis
G37.9	Demyelinating disease of central nervous system, unspecified	ccmpcmrtm	HCC 198 · Multiple Sclerosis

Migraine and other chronic headache

G43, G4488 codesccmrtm

Headache diary, trigger tracking and abortive-medication frequency.

CMS other chronic or potentially disabling condition · CCW category: Migraine and Other Chronic Headache · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
G43.001	Migraine without aura, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.009	Migraine without aura, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.011	Migraine without aura, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.019	Migraine without aura, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.101	Migraine with aura, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.109	Migraine with aura, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.111	Migraine with aura, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.119	Migraine with aura, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.401	Hemiplegic migraine, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.409	Hemiplegic migraine, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.411	Hemiplegic migraine, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.419	Hemiplegic migraine, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.501	Persistent migraine aura without cerebral infarction, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.509	Persistent migraine aura without cerebral infarction, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.511	Persistent migraine aura without cerebral infarction, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.519	Persistent migraine aura without cerebral infarction, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.601	Persistent migraine aura with cerebral infarction, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.609	Persistent migraine aura with cerebral infarction, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.611	Persistent migraine aura with cerebral infarction, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.619	Persistent migraine aura with cerebral infarction, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.701	Chronic migraine without aura, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.709	Chronic migraine without aura, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.711	Chronic migraine without aura, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.719	Chronic migraine without aura, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.801	Other migraine, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.809	Other migraine, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.811	Other migraine, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.819	Other migraine, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.821	Menstrual migraine, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.829	Menstrual migraine, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.831	Menstrual migraine, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.839	Menstrual migraine, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.901	Migraine, unspecified, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.909	Migraine, unspecified, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.911	Migraine, unspecified, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.919	Migraine, unspecified, intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.A0	Cyclical vomiting, in migraine, not intractable	ccmrtm	not risk adjusted
G43.A1	Cyclical vomiting, in migraine, intractable	ccmrtm	not risk adjusted
G43.B0	Ophthalmoplegic migraine, not intractable	ccmrtm	not risk adjusted
G43.B1	Ophthalmoplegic migraine, intractable	ccmrtm	not risk adjusted
G43.C0	Periodic headache syndromes in child or adult, not intractable	ccmrtm	not risk adjusted
G43.C1	Periodic headache syndromes in child or adult, intractable	ccmrtm	not risk adjusted
G43.D0	Abdominal migraine, not intractable	ccmrtm	not risk adjusted
G43.D1	Abdominal migraine, intractable	ccmrtm	not risk adjusted
G43.E01	Chronic migraine with aura, not intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.E09	Chronic migraine with aura, not intractable, without status migrainosus	ccmrtm	not risk adjusted
G43.E11	Chronic migraine with aura, intractable, with status migrainosus	ccmrtm	not risk adjusted
G43.E19	Chronic migraine with aura, intractable, without status migrainosus	ccmrtm	not risk adjusted
G44.001	Cluster headache syndrome, unspecified, intractable	ccmrtm	not risk adjusted
G44.009	Cluster headache syndrome, unspecified, not intractable	ccmrtm	not risk adjusted
G44.011	Episodic cluster headache, intractable	ccmrtm	not risk adjusted
G44.019	Episodic cluster headache, not intractable	ccmrtm	not risk adjusted
G44.021	Chronic cluster headache, intractable	ccmrtm	not risk adjusted
G44.029	Chronic cluster headache, not intractable	ccmrtm	not risk adjusted
G44.031	Episodic paroxysmal hemicrania, intractable	ccmrtm	not risk adjusted
G44.039	Episodic paroxysmal hemicrania, not intractable	ccmrtm	not risk adjusted
G44.041	Chronic paroxysmal hemicrania, intractable	ccmrtm	not risk adjusted
G44.049	Chronic paroxysmal hemicrania, not intractable	ccmrtm	not risk adjusted
G44.051	Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), intractable	ccmrtm	not risk adjusted
G44.059	Short lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT), not intractable	ccmrtm	not risk adjusted
G44.091	Other trigeminal autonomic cephalgias (TAC), intractable	ccmrtm	not risk adjusted
G44.099	Other trigeminal autonomic cephalgias (TAC), not intractable	ccmrtm	not risk adjusted
G44.1	Vascular headache, not elsewhere classified	ccmrtm	not risk adjusted
G44.201	Tension-type headache, unspecified, intractable	ccmrtm	not risk adjusted
G44.209	Tension-type headache, unspecified, not intractable	ccmrtm	not risk adjusted
G44.211	Episodic tension-type headache, intractable	ccmrtm	not risk adjusted
G44.219	Episodic tension-type headache, not intractable	ccmrtm	not risk adjusted
G44.221	Chronic tension-type headache, intractable	ccmrtm	not risk adjusted
G44.229	Chronic tension-type headache, not intractable	ccmrtm	not risk adjusted
G44.301	Post-traumatic headache, unspecified, intractable	ccmrtm	not risk adjusted
G44.309	Post-traumatic headache, unspecified, not intractable	ccmrtm	not risk adjusted
G44.311	Acute post-traumatic headache, intractable	ccmrtm	not risk adjusted
G44.319	Acute post-traumatic headache, not intractable	ccmrtm	not risk adjusted
G44.321	Chronic post-traumatic headache, intractable	ccmrtm	not risk adjusted
G44.329	Chronic post-traumatic headache, not intractable	ccmrtm	not risk adjusted
G44.40	Drug-induced headache, not elsewhere classified, not intractable	ccmrtm	not risk adjusted
G44.41	Drug-induced headache, not elsewhere classified, intractable	ccmrtm	not risk adjusted
G44.51	Hemicrania continua	ccmrtm	not risk adjusted
G44.52	New daily persistent headache (NDPH)	ccmrtm	not risk adjusted
G44.53	Primary thunderclap headache	ccmrtm	not risk adjusted
G44.59	Other complicated headache syndrome	ccmrtm	not risk adjusted
G44.81	Hypnic headache	ccmrtm	not risk adjusted
G44.82	Headache associated with sexual activity	ccmrtm	not risk adjusted
G44.83	Primary cough headache	ccmrtm	not risk adjusted
G44.84	Primary exertional headache	ccmrtm	not risk adjusted
G44.85	Primary stabbing headache	ccmrtm	not risk adjusted
G44.86	Cervicogenic headache	ccmrtm	not risk adjusted
G44.89	Other headache syndrome	ccmrtm	not risk adjusted

Polyneuropathy and nerve disorders

G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65107 codes in familyccmpcmrtm

Pain and function scores, most often alongside diabetes management.

Added by CCN Health · Devices: Patient-reported outcome app (RTM)

This family runs to 107 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G54, G56, G57, G58, G59, G60, G61, G62, G63, G64, G65.

Paralysis, cerebral palsy and spinal cord injury

G80, G81, G82, G83, G9562 codes in familyccmpcmrtm

Function, mobility and pressure-injury surveillance.

CMS other chronic or potentially disabling condition · CCW category: Cerebral Palsy · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)

This family runs to 62 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G80, G81, G82, G83, G95.

Muscular dystrophy and myopathies

G71, G72, G7340 codes in familyccmpcmrtm

Function tracking, with respiratory surveillance where the diaphragm is involved.

CMS other chronic or potentially disabling condition · CCW category: Muscular Dystrophy · Devices: Patient-reported outcome app (RTM), Pulse oximeter

This family runs to 40 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within G71, G72, G73.

Musculoskeletal and pain

Osteoarthritis

M15, M16, M17, M18, M1998 codesrtmccm

Pain scores, range of motion and home-exercise adherence. This is the core RTM use case.

CMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)

Code	Official ICD-10-CM description	Programs	Risk adjustment
M15.0	Primary generalized (osteo)arthritis	rtmccm	not risk adjusted
M15.1	Heberden's nodes (with arthropathy)	rtmccm	not risk adjusted
M15.2	Bouchard's nodes (with arthropathy)	rtmccm	not risk adjusted
M15.3	Secondary multiple arthritis	rtmccm	not risk adjusted
M15.4	Erosive (osteo)arthritis	rtmccm	not risk adjusted
M15.8	Other polyosteoarthritis	rtmccm	not risk adjusted
M15.9	Polyosteoarthritis, unspecified	rtmccm	not risk adjusted
M16.0	Bilateral primary osteoarthritis of hip	rtmccm	not risk adjusted
M16.10	Unilateral primary osteoarthritis, unspecified hip	rtmccm	not risk adjusted
M16.11	Unilateral primary osteoarthritis, right hip	rtmccm	not risk adjusted
M16.12	Unilateral primary osteoarthritis, left hip	rtmccm	not risk adjusted
M16.2	Bilateral osteoarthritis resulting from hip dysplasia	rtmccm	not risk adjusted
M16.30	Unilateral osteoarthritis resulting from hip dysplasia, unspecified hip	rtmccm	not risk adjusted
M16.31	Unilateral osteoarthritis resulting from hip dysplasia, right hip	rtmccm	not risk adjusted
M16.32	Unilateral osteoarthritis resulting from hip dysplasia, left hip	rtmccm	not risk adjusted
M16.4	Bilateral post-traumatic osteoarthritis of hip	rtmccm	not risk adjusted
M16.50	Unilateral post-traumatic osteoarthritis, unspecified hip	rtmccm	not risk adjusted
M16.51	Unilateral post-traumatic osteoarthritis, right hip	rtmccm	not risk adjusted
M16.52	Unilateral post-traumatic osteoarthritis, left hip	rtmccm	not risk adjusted
M16.6	Other bilateral secondary osteoarthritis of hip	rtmccm	not risk adjusted
M16.7	Other unilateral secondary osteoarthritis of hip	rtmccm	not risk adjusted
M16.9	Osteoarthritis of hip, unspecified	rtmccm	not risk adjusted
M17.0	Bilateral primary osteoarthritis of knee	rtmccm	not risk adjusted
M17.10	Unilateral primary osteoarthritis, unspecified knee	rtmccm	not risk adjusted
M17.11	Unilateral primary osteoarthritis, right knee	rtmccm	not risk adjusted
M17.12	Unilateral primary osteoarthritis, left knee	rtmccm	not risk adjusted
M17.2	Bilateral post-traumatic osteoarthritis of knee	rtmccm	not risk adjusted
M17.30	Unilateral post-traumatic osteoarthritis, unspecified knee	rtmccm	not risk adjusted
M17.31	Unilateral post-traumatic osteoarthritis, right knee	rtmccm	not risk adjusted
M17.32	Unilateral post-traumatic osteoarthritis, left knee	rtmccm	not risk adjusted
M17.4	Other bilateral secondary osteoarthritis of knee	rtmccm	not risk adjusted
M17.5	Other unilateral secondary osteoarthritis of knee	rtmccm	not risk adjusted
M17.9	Osteoarthritis of knee, unspecified	rtmccm	not risk adjusted
M18.0	Bilateral primary osteoarthritis of first carpometacarpal joints	rtmccm	not risk adjusted
M18.10	Unilateral primary osteoarthritis of first carpometacarpal joint, unspecified hand	rtmccm	not risk adjusted
M18.11	Unilateral primary osteoarthritis of first carpometacarpal joint, right hand	rtmccm	not risk adjusted
M18.12	Unilateral primary osteoarthritis of first carpometacarpal joint, left hand	rtmccm	not risk adjusted
M18.2	Bilateral post-traumatic osteoarthritis of first carpometacarpal joints	rtmccm	not risk adjusted
M18.30	Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, unspecified hand	rtmccm	not risk adjusted
M18.31	Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, right hand	rtmccm	not risk adjusted
M18.32	Unilateral post-traumatic osteoarthritis of first carpometacarpal joint, left hand	rtmccm	not risk adjusted
M18.4	Other bilateral secondary osteoarthritis of first carpometacarpal joints	rtmccm	not risk adjusted
M18.50	Other unilateral secondary osteoarthritis of first carpometacarpal joint, unspecified hand	rtmccm	not risk adjusted
M18.51	Other unilateral secondary osteoarthritis of first carpometacarpal joint, right hand	rtmccm	not risk adjusted
M18.52	Other unilateral secondary osteoarthritis of first carpometacarpal joint, left hand	rtmccm	not risk adjusted
M18.9	Osteoarthritis of first carpometacarpal joint, unspecified	rtmccm	not risk adjusted
M19.011	Primary osteoarthritis, right shoulder	rtmccm	not risk adjusted
M19.012	Primary osteoarthritis, left shoulder	rtmccm	not risk adjusted
M19.019	Primary osteoarthritis, unspecified shoulder	rtmccm	not risk adjusted
M19.021	Primary osteoarthritis, right elbow	rtmccm	not risk adjusted
M19.022	Primary osteoarthritis, left elbow	rtmccm	not risk adjusted
M19.029	Primary osteoarthritis, unspecified elbow	rtmccm	not risk adjusted
M19.031	Primary osteoarthritis, right wrist	rtmccm	not risk adjusted
M19.032	Primary osteoarthritis, left wrist	rtmccm	not risk adjusted
M19.039	Primary osteoarthritis, unspecified wrist	rtmccm	not risk adjusted
M19.041	Primary osteoarthritis, right hand	rtmccm	not risk adjusted
M19.042	Primary osteoarthritis, left hand	rtmccm	not risk adjusted
M19.049	Primary osteoarthritis, unspecified hand	rtmccm	not risk adjusted
M19.071	Primary osteoarthritis, right ankle and foot	rtmccm	not risk adjusted
M19.072	Primary osteoarthritis, left ankle and foot	rtmccm	not risk adjusted
M19.079	Primary osteoarthritis, unspecified ankle and foot	rtmccm	not risk adjusted
M19.09	Primary osteoarthritis, other specified site	rtmccm	not risk adjusted
M19.111	Post-traumatic osteoarthritis, right shoulder	rtmccm	not risk adjusted
M19.112	Post-traumatic osteoarthritis, left shoulder	rtmccm	not risk adjusted
M19.119	Post-traumatic osteoarthritis, unspecified shoulder	rtmccm	not risk adjusted
M19.121	Post-traumatic osteoarthritis, right elbow	rtmccm	not risk adjusted
M19.122	Post-traumatic osteoarthritis, left elbow	rtmccm	not risk adjusted
M19.129	Post-traumatic osteoarthritis, unspecified elbow	rtmccm	not risk adjusted
M19.131	Post-traumatic osteoarthritis, right wrist	rtmccm	not risk adjusted
M19.132	Post-traumatic osteoarthritis, left wrist	rtmccm	not risk adjusted
M19.139	Post-traumatic osteoarthritis, unspecified wrist	rtmccm	not risk adjusted
M19.141	Post-traumatic osteoarthritis, right hand	rtmccm	not risk adjusted
M19.142	Post-traumatic osteoarthritis, left hand	rtmccm	not risk adjusted
M19.149	Post-traumatic osteoarthritis, unspecified hand	rtmccm	not risk adjusted
M19.171	Post-traumatic osteoarthritis, right ankle and foot	rtmccm	not risk adjusted
M19.172	Post-traumatic osteoarthritis, left ankle and foot	rtmccm	not risk adjusted
M19.179	Post-traumatic osteoarthritis, unspecified ankle and foot	rtmccm	not risk adjusted
M19.19	Post-traumatic osteoarthritis, other specified site	rtmccm	not risk adjusted
M19.211	Secondary osteoarthritis, right shoulder	rtmccm	not risk adjusted
M19.212	Secondary osteoarthritis, left shoulder	rtmccm	not risk adjusted
M19.219	Secondary osteoarthritis, unspecified shoulder	rtmccm	not risk adjusted
M19.221	Secondary osteoarthritis, right elbow	rtmccm	not risk adjusted
M19.222	Secondary osteoarthritis, left elbow	rtmccm	not risk adjusted
M19.229	Secondary osteoarthritis, unspecified elbow	rtmccm	not risk adjusted
M19.231	Secondary osteoarthritis, right wrist	rtmccm	not risk adjusted
M19.232	Secondary osteoarthritis, left wrist	rtmccm	not risk adjusted
M19.239	Secondary osteoarthritis, unspecified wrist	rtmccm	not risk adjusted
M19.241	Secondary osteoarthritis, right hand	rtmccm	not risk adjusted
M19.242	Secondary osteoarthritis, left hand	rtmccm	not risk adjusted
M19.249	Secondary osteoarthritis, unspecified hand	rtmccm	not risk adjusted
M19.271	Secondary osteoarthritis, right ankle and foot	rtmccm	not risk adjusted
M19.272	Secondary osteoarthritis, left ankle and foot	rtmccm	not risk adjusted
M19.279	Secondary osteoarthritis, unspecified ankle and foot	rtmccm	not risk adjusted
M19.29	Secondary osteoarthritis, other specified site	rtmccm	not risk adjusted
M19.90	Unspecified osteoarthritis, unspecified site	rtmccm	not risk adjusted
M19.91	Primary osteoarthritis, unspecified site	rtmccm	not risk adjusted
M19.92	Post-traumatic osteoarthritis, unspecified site	rtmccm	not risk adjusted
M19.93	Secondary osteoarthritis, unspecified site	rtmccm	not risk adjusted

Rheumatoid and inflammatory arthritis

M05, M06, M08, M12, M13, M45, M46743 codes in familyrtmccmpcm

Disease-activity scores, function and therapy adherence.

CMS chronic condition · CCW category: Rheumatoid Arthritis/Osteoarthritis · Devices: Patient-reported outcome app (RTM)

This family runs to 743 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M05, M06, M08, M12, M13, M45, M46.

Low back pain and dorsalgia

M54, M51.1, M51.3, M47.81, M43.166 codesrtmccm

Pain, function and home-exercise adherence, the standard RTM programme.

Added by CCN Health · Devices: Patient-reported outcome app (RTM)

M54.5 was deleted on 2021-10-01. Code to M54.50, M54.51 (vertebrogenic) or M54.59.

Code	Official ICD-10-CM description	Programs	Risk adjustment
M43.10	Spondylolisthesis, site unspecified	rtmccm	not risk adjusted
M43.11	Spondylolisthesis, occipito-atlanto-axial region	rtmccm	not risk adjusted
M43.12	Spondylolisthesis, cervical region	rtmccm	not risk adjusted
M43.13	Spondylolisthesis, cervicothoracic region	rtmccm	not risk adjusted
M43.14	Spondylolisthesis, thoracic region	rtmccm	not risk adjusted
M43.15	Spondylolisthesis, thoracolumbar region	rtmccm	not risk adjusted
M43.16	Spondylolisthesis, lumbar region	rtmccm	not risk adjusted
M43.17	Spondylolisthesis, lumbosacral region	rtmccm	not risk adjusted
M43.18	Spondylolisthesis, sacral and sacrococcygeal region	rtmccm	not risk adjusted
M43.19	Spondylolisthesis, multiple sites in spine	rtmccm	not risk adjusted
M47.811	Spondylosis without myelopathy or radiculopathy, occipito-atlanto-axial region	rtmccm	not risk adjusted
M47.812	Spondylosis without myelopathy or radiculopathy, cervical region	rtmccm	not risk adjusted
M47.813	Spondylosis without myelopathy or radiculopathy, cervicothoracic region	rtmccm	not risk adjusted
M47.814	Spondylosis without myelopathy or radiculopathy, thoracic region	rtmccm	not risk adjusted
M47.815	Spondylosis without myelopathy or radiculopathy, thoracolumbar region	rtmccm	not risk adjusted
M47.816	Spondylosis without myelopathy or radiculopathy, lumbar region	rtmccm	not risk adjusted
M47.817	Spondylosis without myelopathy or radiculopathy, lumbosacral region	rtmccm	not risk adjusted
M47.818	Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region	rtmccm	not risk adjusted
M47.819	Spondylosis without myelopathy or radiculopathy, site unspecified	rtmccm	not risk adjusted
M51.14	Intervertebral disc disorders with radiculopathy, thoracic region	rtmccm	not risk adjusted
M51.15	Intervertebral disc disorders with radiculopathy, thoracolumbar region	rtmccm	not risk adjusted
M51.16	Intervertebral disc disorders with radiculopathy, lumbar region	rtmccm	not risk adjusted
M51.17	Intervertebral disc disorders with radiculopathy, lumbosacral region	rtmccm	not risk adjusted
M51.34	Other intervertebral disc degeneration, thoracic region	rtmccm	not risk adjusted
M51.35	Other intervertebral disc degeneration, thoracolumbar region	rtmccm	not risk adjusted
M51.360	Other intervertebral disc degeneration, lumbar region with discogenic back pain only	rtmccm	not risk adjusted
M51.361	Other intervertebral disc degeneration, lumbar region with lower extremity pain only	rtmccm	not risk adjusted
M51.362	Other intervertebral disc degeneration, lumbar region with discogenic back pain and lower extremity pain	rtmccm	not risk adjusted
M51.369	Other intervertebral disc degeneration, lumbar region without mention of lumbar back pain or lower extremity pain	rtmccm	not risk adjusted
M51.370	Other intervertebral disc degeneration, lumbosacral region with discogenic back pain only	rtmccm	not risk adjusted
M51.371	Other intervertebral disc degeneration, lumbosacral region with lower extremity pain only	rtmccm	not risk adjusted
M51.372	Other intervertebral disc degeneration, lumbosacral region with discogenic back pain and lower extremity pain	rtmccm	not risk adjusted
M51.379	Other intervertebral disc degeneration, lumbosacral region without mention of lumbar back pain or lower extremity pain	rtmccm	not risk adjusted
M54.00	Panniculitis affecting regions of neck and back, site unspecified	rtmccm	not risk adjusted
M54.01	Panniculitis affecting regions of neck and back, occipito-atlanto-axial region	rtmccm	not risk adjusted
M54.02	Panniculitis affecting regions of neck and back, cervical region	rtmccm	not risk adjusted
M54.03	Panniculitis affecting regions of neck and back, cervicothoracic region	rtmccm	not risk adjusted
M54.04	Panniculitis affecting regions of neck and back, thoracic region	rtmccm	not risk adjusted
M54.05	Panniculitis affecting regions of neck and back, thoracolumbar region	rtmccm	not risk adjusted
M54.06	Panniculitis affecting regions of neck and back, lumbar region	rtmccm	not risk adjusted
M54.07	Panniculitis affecting regions of neck and back, lumbosacral region	rtmccm	not risk adjusted
M54.08	Panniculitis affecting regions of neck and back, sacral and sacrococcygeal region	rtmccm	not risk adjusted
M54.09	Panniculitis affecting regions, neck and back, multiple sites in spine	rtmccm	not risk adjusted
M54.10	Radiculopathy, site unspecified	rtmccm	not risk adjusted
M54.11	Radiculopathy, occipito-atlanto-axial region	rtmccm	not risk adjusted
M54.12	Radiculopathy, cervical region	rtmccm	not risk adjusted
M54.13	Radiculopathy, cervicothoracic region	rtmccm	not risk adjusted
M54.14	Radiculopathy, thoracic region	rtmccm	not risk adjusted
M54.15	Radiculopathy, thoracolumbar region	rtmccm	not risk adjusted
M54.16	Radiculopathy, lumbar region	rtmccm	not risk adjusted
M54.17	Radiculopathy, lumbosacral region	rtmccm	not risk adjusted
M54.18	Radiculopathy, sacral and sacrococcygeal region	rtmccm	not risk adjusted
M54.2	Cervicalgia	rtmccm	not risk adjusted
M54.30	Sciatica, unspecified side	rtmccm	not risk adjusted
M54.31	Sciatica, right side	rtmccm	not risk adjusted
M54.32	Sciatica, left side	rtmccm	not risk adjusted
M54.40	Lumbago with sciatica, unspecified side	rtmccm	not risk adjusted
M54.41	Lumbago with sciatica, right side	rtmccm	not risk adjusted
M54.42	Lumbago with sciatica, left side	rtmccm	not risk adjusted
M54.50	Low back pain, unspecified	rtmccm	not risk adjusted
M54.51	Vertebrogenic low back pain	rtmccm	not risk adjusted
M54.59	Other low back pain	rtmccm	not risk adjusted
M54.6	Pain in thoracic spine	rtmccm	not risk adjusted
M54.81	Occipital neuralgia	rtmccm	not risk adjusted
M54.89	Other dorsalgia	rtmccm	not risk adjusted
M54.9	Dorsalgia, unspecified	rtmccm	not risk adjusted

Chronic pain and fibromyalgia

M79.7, G89.2, G89.4, R52, G93.310 codesrtmccmbhi

Pain scores, sleep and function, with behavioural support where indicated.

CMS other chronic or potentially disabling condition · CCW category: Fibromyalgia, Chronic Pain and Fatigue · Devices: Patient-reported outcome app (RTM)

G89.4 (chronic pain syndrome) and G89.29 (other chronic pain) are secondary codes. Code the underlying condition alongside.

Code	Official ICD-10-CM description	Programs	Risk adjustment
G89.21	Chronic pain due to trauma	rtmccmbhi	not risk adjusted
G89.22	Chronic post-thoracotomy pain	rtmccmbhi	not risk adjusted
G89.28	Other chronic postprocedural pain	rtmccmbhi	not risk adjusted
G89.29	Other chronic pain	rtmccmbhi	not risk adjusted
G89.4	Chronic pain syndrome	rtmccmbhi	not risk adjusted
G93.31	Postviral fatigue syndrome	rtmccmbhi	not risk adjusted
G93.32	Myalgic encephalomyelitis/chronic fatigue syndrome	rtmccmbhi	not risk adjusted
G93.39	Other post infection and related fatigue syndromes	rtmccmbhi	not risk adjusted
M79.7	Fibromyalgia	rtmccmbhi	not risk adjusted
R52	Pain, unspecified	rtmccmbhi	not risk adjusted

Osteoporosis

M80, M81, M85496 codes in familyccmrtm

Fall risk and activity, with therapy adherence for balance and strength programmes.

CMS chronic condition · CCW category: Osteoporosis With or Without Pathological Fracture · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)

This family runs to 496 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M80, M81, M85.

Gout and crystal arthropathies

M1A, M10, M11460 codes in familyccmrtm

Flare frequency and urate-lowering therapy adherence.

Added by CCN Health · Devices: Patient-reported outcome app (RTM)

This family runs to 460 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M1A, M10, M11.

Mobility impairment and acquired deformity

M20, M21, M24, M25, R26, Z74.0, Z99.3596 codes in familyrtmccm

Gait, activity level and fall events.

CMS other chronic or potentially disabling condition · CCW category: Mobility Impairments · Devices: Contactless activity and fall radar, Patient-reported outcome app (RTM)

This family runs to 596 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within M20, M21, M24, M25, R26, Z74.0, Z99.3.

Other chronic and potentially disabling

Inflammatory bowel disease

K50, K51, K52.378 codes in familyccmpcmrtm

Symptom and weight tracking against disease-activity indices.

Added by CCN Health · Devices: Connected weight scale, Patient-reported outcome app (RTM)

This family runs to 78 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within K50, K51, K52.3.

Pressure ulcers and chronic ulcers

L89, L97, L98.4407 codes in familyccmpcmrtm

Repositioning and mobility surveillance alongside structured wound assessment.

CMS other chronic or potentially disabling condition · CCW category: Pressure Ulcers and Chronic Ulcers · Devices: Contactless activity and fall radar

This family runs to 407 codes that differ mainly by anatomic site and laterality, which does not change whether the condition supports care management. The codes are not listed one by one here. Code to the site and side documented in the record, within L89, L97, L98.4.

By Specialty

RTM codes by medical specialty.

Pulmonology

36 qualifying codes

Geriatrics

161 qualifying codes

Internal Medicine

266 qualifying codes

Behavioral Health

98 qualifying codes

Orthopedics

164 qualifying codes

Physical Medicine & Rehab

240 qualifying codes

FAQ

RTM eligibility questions.

Which ICD-10 codes are used for RTM?

CMS publishes no list of ICD-10 codes that qualify a patient for RTM, so the test is the condition rather than the code. The condition must be musculoskeletal or respiratory, and what you monitor is therapy adherence, function or pain response rather than a vital sign. The codes below are every billable ICD-10-CM code for the conditions RTM manages, taken from the official FY2026 code set.

How does CCN Health help with RTM patient eligibility?

CCN Health reviews your patient population to identify conditions that support RTM, handles enrollment documentation, and manages ongoing RTM services including clinical monitoring, care coordination, and Medicare billing.

Can RTM be billed alongside other Medicare programs?

Yes, RTM can be billed alongside other Medicare care management programs for the same patient, provided each service addresses distinct clinical needs with separate time documentation.

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Code set. Every code on this page is drawn from the official ICD-10-CM ICD-10-CM FY2026 (valid 2025-10-01 through 2026-09-30) released by CDC/NCHS, and only codes flagged valid for submission are listed. ICD-10-CM is published by the federal government and is in the public domain, so the descriptions here are the official long descriptors reproduced verbatim rather than summarized. The next code set, ICD-10-CM FY2027 (valid from 2026-10-01), is already reflected in the change flags.

Eligibility is not a code list. CMS does not publish a list of ICD-10 codes that qualify a patient for RPM, CCM, PCM, BHI, or RTM. Eligibility turns on the condition and on documented medical necessity. The programs shown against each condition are CCN Health’s clinical assessment of which programs that condition can support, not a statement of CMS approval.

Risk adjustment. HCC labels and category assignments come from the CMS-HCC V28 model for the 2026 payment year. Risk adjustment depends on the full encounter record, not on a single code, and the flags here are a prompt to check specificity rather than a payment guarantee.

CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and other data only are copyright 2026 American Medical Association. All rights reserved. CPT is provided “as is” without warranty of any kind.

Sources. ICD-10-CM files, CDC/NCHS (cdc.gov); CMS Chronic Conditions Data Warehouse condition categories (ccwdata.org); CMS-HCC risk adjustment model software and ICD-10 mappings (cms.gov); AHRQ Clinical Classifications Software Refined (ahrq.gov).

Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Diagnosis coding must reflect the documentation in the medical record. Verify all codes against the official CMS and CDC/NCHS publications and your contracted payer agreements before billing.

RTM ICD-10Codes.

What RTM actually requires

Every code, by condition.

Endocrine and metabolic

Cystic fibrosis and metabolic developmental disorders

Respiratory

COPD, emphysema and bronchiectasis

Asthma

Neurologic and cognitive

Parkinson's disease and secondary parkinsonism

Multiple sclerosis and demyelinating disease

Migraine and other chronic headache

Polyneuropathy and nerve disorders

Paralysis, cerebral palsy and spinal cord injury

Muscular dystrophy and myopathies

Musculoskeletal and pain

Osteoarthritis

Rheumatoid and inflammatory arthritis

Low back pain and dorsalgia

Chronic pain and fibromyalgia

Osteoporosis

Gout and crystal arthropathies

Mobility impairment and acquired deformity

Other chronic and potentially disabling

Inflammatory bowel disease

Pressure ulcers and chronic ulcers

RTM codes by medical specialty.

Pulmonology

Geriatrics

Internal Medicine

Behavioral Health

Orthopedics

Physical Medicine & Rehab

RTM eligibility questions.

Which ICD-10 codes are used for RTM?

How does CCN Health help with RTM patient eligibility?

Can RTM be billed alongside other Medicare programs?

Ready to enroll patients?

More to explore.

Care Programs

EHR Integrations

Practice EHRs

Care Settings

Specialties

Monitoring Types

Devices

States

Partnerships

Blog

Announcements

Glossary

Conditions

Comparisons

Alternatives

ICD-10 Directory

Success Stories

Sources & Compliance

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RTM ICD-10
Codes.