There are three major MTM CPT Codes, based on the medication review time and when the required face-to-face review will take place.
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
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.
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How Can HealthArc Help You?
Want a demo, or just have a question about running medication therapy management in your practice? Send us a few details and a care program specialist will get back to you shortly.
- Automated MTM time tracking & billing
- 99605, 99606 & 99607 tracked for you
- Two-way EHR integration
- Managed care team, or your own
- Runs alongside CCM and RPM on one platform
- Live in about 30 days
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