HealthArc’s MTM platform is focused on medication reconciliation, providing direct patient counseling, therapy optimization, and collaboration with the patient’s care givers.

Brief Overview of the Latest Medication Therapy Management (MTM) CPT Codes for 2026

There are three major MTM CPT Codes, based on the medication review time and when the required face-to-face review will take place.

CPT 99605 – Initial MTM Service (New Patient)

Occurs during the first episode of an MTM encounter
Includes up to 15 minutes of medication review, either face-to-face or via telehealth
Includes assessment, education, and a plan of action relating to medications

CPT 99606 – Initial MTM Service (Established Patient)

Identical services to CPT 99605
Refers to an established patient receiving MTM services
Includes up to 15 minutes of time spent with the patient

CPT 99607 – Each Additional 15 Minutes (Add-on)

Used when the time spent providing MTM services exceeds the initial 15 minutes
Can be billed with CPT 99605 or CPT 99606 multiple times
Can be billed on a monthly basis.
The medical record must include documentation of these services

Who Can Bill for MTM Services?

MTM services may be provided, reported, and billed by:

Pharmacists
Medical Doctors (MDs)
Nurse Practitioners (NPs)
Physician Assistants (PAs)

Each region has different scope-of-practice rules, and each insurer has different reimbursement requirements.

Latest Medicare Reimbursement for MTM Services in 2026

Medicare reimbursement for the commonly billed MTM codes:

99605: approximately $50–$75 per visit
99606: approximately $50–$75 per visit
99607: $20–$30 for each additional 15 minutes

Note: Rates vary by region and billing practitioner. Medicare Part D, Medicare Advantage, and a number of commercial insurers reimburse for MTM services. All reimbursements must adhere to CMS guidelines.