Billing & codes
My patient has responded >16 times - why haven't I received a notification to bill yet?
The threshold counts unique days of responses, not the number of responses — ten replies in one day still count as one day. The 30 day cycle also has to complete before the code is generated, so the notification arrives after the cycle closes
How will I be notified to bill for an RTM code(s)?
Patients ready to bill appear on the Billing page in SaRA (Ready to Bill tab). You can also receive a billing notification email — each team member can turn billing emails on or off in their Account Settings
When should I expect to be notified?
Within 48 hours of your patient becoming eligible
My patient responded multiple times in one day but I only see the count increase by one - why is that?
The count for RTM billing justification is based on unique days of responses not number of responses. If a patient responds once a day or ten times a day - both situations count as one day of data exchange
I’m co-treating this patient, who will get the email?
The patient's primary provider receives billing notifications and is expected to bill. The primary provider is set at enrollment, but it can be changed at any time using Edit Patient Care Team on the patient's profile — it is not frozen to whoever enrolled the patient
Do RTM charges count towards the Medicare cap?
Yes they do
My EMR asks for location of RTM services - where should I say?
In clinic
What codes can I bill in the first 30 day cycle? The second?
What if a patient only responds 15 days in the 30 day period?
2026 added low-engagement codes, so cycles with fewer than 16 response days can still be billable — see RTM CPT codes & billing thresholds (2026)
My patient hit 16 days in their second cycle but not the first - what can I bill?
Are RTM codes timed or untimed?
What goes in my documentation to justify billing RTM codes?
I’m a PTA - can I bill RTM codes?
Does the patient need to use a wearable device?
Does a texting conversation count as a synchronous interaction for 98980/1?
Using SaRA day-to-day
Do emojis count as a response?
Yes
What time of day do patients get their daily message?
If a send time is set for the patient (or your clinic has a default send time), the message goes out at that time in the patient's own timezone
If no send time is set, the message goes out at a random time between 10am and 3pm Central
What name should I use for my patient? Does it need to match their insurance card?
Use the name that the patient prefers to be called. Whatever name you input into SaRA will be the name the patient is addressed by in their daily messages
What questions/topics are being asked in the flow I selected?
Find examples here