Deep Dive into CPT Code 98977: The Core Reimbursement Engine for Ongoing RTM in Physical Therapy

As Remote Therapeutic Monitoring (RTM) solidifies its role in musculoskeletal (MSK) care, CPT code 98977 stands out as the recurring revenue driver. This code reimburses the supply of digital devices for scheduled data collection and transmission, capturing therapy adherence, pain levels, and functional responses at home. Billable every 30 days with a key 16-day data threshold, 98977 transforms passive HEPs into active, reimbursable hybrid care. In late 2025, mastering its intricacies is crucial for PTs to avoid denials and maximize $43+ per patient monthly. Let’s unpack it thoroughly.

What Exactly is CPT Code 98977?

Per the AMA’s 2022 introduction (refined annually), CPT 98977 is: Remote therapeutic monitoring (e.g., therapy adherence, therapy response); device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days.

It’s a “supply” code, covering the ongoing provision of FDA-cleared software-as-a-medical-device (SaMD) that automatically logs and transmits non-physiological MSK data—like HEP completions, pain scales, or motion metrics—without manual physiologic sensors. No clinician time is billed here; it’s for the device’s “rental” and data flow.

For PTs, this means apps tracking video HEP adherence or self-reported outcomes qualify, enabling proactive interventions via alerts.

98977 Billing Requirements: The 16-Day Threshold and Beyond

98977 isn’t billed per use—it’s episodic, with rigid CMS rules:

• Once Every 30 Days: Per patient, per practitioner, for the musculoskeletal system only (pair with 98976 for respiratory if needed).
• 16 Days of Data in 30 Days: At least 16 separate days of transmitted data to AND/OR From the patients device (e.g., adherence logs or pain entries) within the billing period. Data must be collected on at least one device; no rounding up—15 days means no bill.
• Ordered and Supervised: By a physician or qualified provider (PTs included); general supervision allows PTAs to assist.
• FDA-Cleared Device: Must meet Section 201(h) FD&C Act; patient-owned phones/apps count if integrated into compliant software.
• No Overlaps: Can’t bill with RPM device codes (e.g., 99454) or duplicate RTM for the same period/system.
• Episode-Based: Continues across months if care persists; starts from first transmission.

The 16-day rule is the biggest hurdle: Data must transmit automatically or via patient input on 16 unique days—no aggregating minutes.

98977 Documentation: Audit-Proofing Your Claims

Denials often stem from vague records. CMS demands proof of supply, data flow, and necessity:

• Device Supply: Name (e.g., “MovementRx MSK app”), FDA status, supply date, and how it’s provided (no cost to patient).
• Data Transmission Log: Exact dates of 16+ days; what was collected (e.g., “HEP videos completed: 18 days; pain logs: 20 days”).
• Medical Necessity: Tie to diagnosis (e.g., M54.5 low back pain) and plan (e.g., “RTM for HEP adherence post-lumbar strain”).
• Alerts/Recordings: Note scheduled features (daily reminders) and any programmed alerts triggered.
• No Duplicates: Confirm one practitioner bills per period.

Tip: Auto-generated reports from platforms like MovementRx timestamp everything—export and attach to claims.

98977 Reimbursement Rates in 2025

National non-facility average: ~$43.02 (varies by locality; e.g., higher in urban areas). Use CMS PFS Look-Up Tool for your MAC rate—pure profit since no hardware costs. Pair with 98980/98981 for management time to hit $100+ monthly.

Real-World PT Scenarios: Success and Pitfalls of 98977

Scenario 1: Ideal Compliance Post-hip replacement patient uses MovementRx app. It stays logged in, passively syncing HEP views and auto-prompting pain logs. Over 30 days: 25 days of data (adherence + self-reports). Bill 98977 on day 31—easy $43, with alerts flagging low adherence on day 10 for early chat.

Scenario 2: The 16-Day Trap Competitor app requires daily login. Busy patient logs in only 14 days (forgets weekends). No 98977—lost revenue. Tip: Choose always-on platforms; MovementRx’s persistent session captures passive data (e.g., app-open triggers or background syncs), hitting 16+ days effortlessly even with minimal interaction.

Scenario 3: Chronic Back Pain Hybrid Care Patient logs pain/HEP 20 days via auto-reminders. Predictive analytics alert PT to risk on day 15. Bill 98977 + management codes; outcomes improve 30%, adherence 80%+.

Pitfall Example: Manual-entry-only app—patient skips logins, data stalls at 12 days. Denial city. Always-on tools like MovementRx constantly gather (e.g., device pings or passive tracking) without forcing logins, ensuring transmissions.

Common Pitfalls and Pro Tips

• Software Not Tracking Data To/From Patients device without a login, MovementRx Solves this! 
  • Most RTM software available requires the patient to login each time they interact with the app. This is a barrier for most patients. Which reduces their compliance with the home program.  Which also lowers the likelihood that you will capture 16 days of data transmission.  The rules of the code describe that data transmission must occur to OR from the patients device. MovementRx sends data daily to the patients device in several ways and also receives data daily from the device BECAUSE IT STAYS LOGGED IN!
• Under 16 Days: Most denials here—patients forget logins in rigid apps. Fix: Persistent-login software for seamless data like MovementRX which stays logged in always.
• Poor Docs: “Device supplied” isn’t enough. Detail transmissions.
• Overlaps/Duplicates: Bill too soon or with in-clinic codes—denied.
• Patient Dropout: Boost with reminders; track early.
• Tip: Start period from first data day; use dashboards for real-time 16-day counts. No PTA reduction for 98977.

Why Nail 98977? Scaling RTM Profits

This code funds the data backbone, enabling predictive insights and 20-50% revenue boosts. Most PTs miss the 16-day nuance, but always-logged platforms like MovementRx automate compliance—no login barriers, constant transmissions for reliable billing.

Ready to hit 16 days every time? MovementRx’s patent-pending tools handle passive data flow, auto-docs, and alerts—zero upfront. Demo at mymovementrx.com and turn home data into steady reimbursements.

Last updated: November 03, 2025. Verify rates via CMS PFS Tool; future 2026 changes may ease

If you’re interested in the upcoming 2026 changes I would encourage you to read this article. 

When we are looking for guidance on compliance with anything insurance related we lean on Rick Gawanda and you should too!