What Remote Therapeutic Monitoring is
Remote Therapeutic Monitoring (RTM) is a category of health care services defined and reimbursed by the Centers for Medicare and Medicaid Services that allows physical therapists, occupational therapists, and other qualified providers to monitor and manage patients' home exercise programs and therapeutic activities between in-person appointments.
In simpler terms: your patient goes home, does their exercises, logs their activity or pain levels through an app, and you get paid to review that data, check in with them, and adjust their program. The monitoring happens remotely. The reimbursement is real.
CMS introduced RTM codes in 2022, separate from the Remote Patient Monitoring codes that had existed for primary care since 2019. The distinction matters. RTM was specifically designed for musculoskeletal and respiratory therapy conditions, which means physical and occupational therapists can bill directly for it under their own NPI without needing physician involvement.
The simplest way to think about RTM: you are already monitoring your patients' progress between visits through phone calls, portal messages, or informal check-ins. RTM is the CMS-approved framework that lets you document that monitoring and get reimbursed for it.
RTM is not a new clinical service. It is a billing framework that captures reimbursement for clinical work that most PT practices are already doing informally. What matters is changing how you think about adoption. The question is not, "what new thing do we have to do?" but "how do we document what we are already doing and get paid for it?"
How RTM works in a real clinic
The RTM workflow has four components. Understanding each one is essential before choosing a platform or billing model.
- Patient enrollment and device supply. The patient is set up on an RTM-capable platform, typically a smartphone app, and given instructions on how to log their home exercise activity, pain levels, and adherence. CMS requires that this setup be documented and that the patient use the device for at least 16 days in a calendar month for device supply code 98977. The new 2026 code now also covers patients who use the device for 2 to 15 days.
- Patient engagement between visits. The patient logs exercise program completions, rates their pain or difficulty, and communicates with the clinical team through the platform. The platform automatically tracks the number of days the patient engages. This data feeds the device supply codes and informs treatment management decisions.
- Clinical monitoring and treatment management. A qualified provider reviews the patient's engagement data, responds to messages, and manages the therapeutic plan. Time spent on these activities is tracked and documented. CMS requires at least 10 minutes of interactive communication per month to bill treatment management codes.
- Billing and documentation. At the end of the billing month, the platform generates the documentation needed to support the CPT codes generated. Claims are submitted under the treating provider's NPI.
A practical example: a patient is discharged from twice-weekly visits but still has four weeks of home exercise remaining. You enroll them in RTM at discharge. Over the next month, they log 22 days of home exercise activity, you spend 12 minutes reviewing their data and sending two adjustment messages, and they report elevated pain on day 14. That patient would typically generate setup, device supply, and treatment management reimbursement for one month, with no additional in-person visits required.
2026 CPT codes and reimbursement rates
CMS finalized significant changes to RTM coding for 2026, adding two new codes that expand the billable population for patients who do not meet the original 16-day device supply or 20-minute treatment management thresholds. Understanding all six codes and how they interact is essential for maximizing reimbursement without compliance exposure.
| CPT Code | Description | Key Threshold | 2026 Rate |
|---|---|---|---|
| 98975 | RTM initial setup and patient education | Initial setup per patient, per device | $21.71 |
| 98977 | RTM device supply, musculoskeletal system | 16-30 days of device use in a calendar month | $39.75 |
| 98985 New 2026 | RTM device supply, musculoskeletal system | 2-15 days of device use in a calendar month | $39.75 |
| 98979 New 2026 | RTM treatment management, first 10-19 minutes | 10-19 minutes of interactive communication | $26.05 |
| 98980 | RTM treatment management, first 20 minutes | 20+ minutes of interactive communication | $53.77 |
| 98981 | RTM treatment management, each additional 20 minutes | Each additional 20 minutes beyond 98980 | $41.80 |
2026 Medicare national non-facility Physician Fee Schedule rates. Actual reimbursement varies by payer, geographic locality, and contract terms. Rates current as of January 2026.
What the new 2026 codes mean in practice
The addition of 98985 and 98979 is more significant than it first appears. Before 2026, a patient who used the app for 14 days in a month generated zero device supply reimbursement. Now, 98985 captures reimbursement for any patient who engages for 2 to 15 days. For practices with patients who travel, get sick, or simply have lower compliance months, this means previously unbillable engagement now generates revenue.
Similarly, 98979 fills the gap between no treatment management billing and the 20-minute threshold required for 98980. A provider who spends 12 minutes on monitoring and communication for a patient in a given month previously had two options: bill nothing, or spend additional time to reach the 20-minute threshold. The new code removes that awkward choice.
Compliance note: CPT codes 98979 and 98980 are mutually exclusive. You bill one or the other for a given patient in a given month, not both. The 98981 add-on code applies only when total time exceeds 20 minutes and is used in addition to 98980, not 98979.
Who can bill for RTM
RTM codes can be billed by a broad range of providers, which is one of the reasons the category is expanding quickly in outpatient rehabilitation settings.
- Physical therapists (PTs) can bill directly under their own NPI
- Occupational therapists (OTs) can bill directly under their own NPI
- Speech language pathologists can use RTM for respiratory conditions
- Physicians and non-physician practitioners are broadly eligible
- Physical therapist assistants (PTAs) can perform RTM services under general supervision of a PT, but the treatment management codes are subject to the PTA payment reduction
- Occupational therapy assistants (OTAs) follow the same rule as PTAs
For practices that use PTAs or OTAs to perform the monitoring touchpoints, the 85% payment reduction on treatment management codes applies. The device supply codes are not subject to the assistant reduction. This distinction matters when modeling expected reimbursement.
A common misconception: RTM does not require a physician order in most outpatient settings where the PT or OT already has direct access authorization. If a patient can self-refer to your clinic, they can generally be enrolled in RTM without a separate physician referral. Verify this against your state practice act and payer contracts.
RTM vs. Remote Patient Monitoring — what’s the difference
The two categories are frequently confused, and the distinction matters both clinically and for billing compliance.
Remote Patient Monitoring (RPM) was introduced by CMS for chronic disease management in primary care settings. It was designed for conditions like hypertension, diabetes, and congestive heart failure, where physiologic data is collected.
Remote Therapeutic Monitoring (RTM) was introduced specifically for musculoskeletal and respiratory therapy conditions. It captures therapeutic activity data such as exercise adherence, pain ratings, functional status, and therapy engagement.
| Factor | RTM | RPM |
|---|---|---|
| Introduced by CMS | 2022 | 2019 |
| Primary use case | Musculoskeletal and respiratory therapy | Chronic disease management |
| Data type monitored | Therapeutic activity, exercise, pain, function | Physiologic data like BP and glucose |
| PTs and OTs can bill independently | Yes | No |
| Physician order required | Generally no, varies by payer | Generally yes |
The practical implication for PT practices: you want RTM codes, not RPM codes. If a vendor is pitching you an RPM solution for your physical therapy clinic, that is either a mislabeled product or a compliance problem waiting to happen.
The two benefits of RTM adoption
RTM generates two categories of return simultaneously, and it is important to understand both because they compound each other in ways that make the financial case stronger over time.
Financial benefit: additive reimbursement without additional visits
RTM reimbursement is additive to your existing visit-based billing. You are not substituting RTM for in-person visits. You are capturing revenue for monitoring activity that happens between visits and after discharge.
For a practice with 30 active RTM patients generating a typical mix of device supply and treatment management codes, monthly net reimbursement typically falls in the range of $2,550 to $4,050 after platform costs, depending on payer mix and monitoring time.
Clinical benefit: better outcomes through higher adherence
Home exercise program adherence is the strongest single predictor of functional outcomes in outpatient rehabilitation. Patients who complete their prescribed home programs recover faster, maintain gains longer, and are less likely to return for additional episodes of care. RTM changes that by letting the provider see engagement data and intervene when adherence drops.
Preliminary data from 2,230 patients at the home clinic that built MovementRx showed 40% higher home exercise adherence among RTM patients compared to non-RTM patients at the same clinic, controlling for baseline differences.
Why both benefits matter together: practices that adopt RTM purely for revenue often find that outcomes improve as a byproduct. Practices that adopt RTM for clinical reasons find the financial case compelling. The two benefits are not in tension. They compound.
Honest challenges to consider before adopting RTM
RTM has a strong financial and clinical case. It also has real implementation challenges that vendors tend to understate. Here is an honest accounting of what to expect.
Patient engagement is not automatic
The financial projections for RTM assume a certain level of patient engagement. In practice, some patients do not engage consistently, especially in the first month before habits are established. A practice that enrolls 50 patients but only achieves meaningful engagement from 30 will see its billing from a pool of 30.
Someone has to own the monitoring workflow
RTM requires a person or a team to review patient data, respond to messages, and document treatment management time. That role can happen automatically only if the workflow is deliberately designed.
Payer coverage varies and continues to evolve
Medicare covers RTM codes clearly. Most major commercial payers have accepted RTM coverage policies, but specifics vary by plan and region. A strong platform should provide documentation requirements that differ from Medicare.
The compliance infrastructure has to be right from the start
RTM is a billing category, which means payers are actively auditing it. Documentation gaps, missing consent forms, insufficient time logs, and activity counts that do not match billing dates are common audit findings.
RTM platform comparison
The RTM software market has grown quickly since CMS introduced the codes in 2022. The platforms below represent the most frequently evaluated options in the physical and occupational therapy space as of 2026.
| Platform | Best For | Pricing | Notable Strengths | Limitations to Consider |
|---|---|---|---|---|
| MovementRx | Private practices and health systems wanting transparent RTM pricing, CPT logic, and clinical outcome data | Software-Only $15/patient/mo or Full-Service revenue share | Transparent pricing, built by practicing DPTs, preliminary outcomes data, audit-tested compliance, virtual monitoring team option | Smaller brand recognition than older enterprise systems |
| MedBridge | Practices already using MedBridge for HEP and continuing education | Not published publicly | Large and established platform in the PT space | RTM add-on can feel like HEP extension rather than a purpose-built RTM workflow |
| Limber Health | Practices prioritizing patient-facing digital engagement | Not published publicly | Strong patient app experience and remote care tooling | VC-funded model can mean less transparency in pricing and workflow ownership |
| Force Therapeutics | Health systems and surgical programs needing episode-of-care engagement | Enterprise quote | Strong health system relationships and surgical pathway experience | Designed primarily for surgical and hospital workflows, not general outpatient PT |
| Physitrack | Practices seeking a global HEP platform with RTM capability | Subscription-based pricing | Widely deployed internationally with broad exercise library | RTM billing focused on US market as add-on, not always product identity |
The most important question when evaluating any RTM platform is not which has the most features. It is which has the compliance infrastructure to withstand a payer audit and the transparency to tell you exactly what it costs before you sign a contract.
Software-Only vs. Full-Service: which model is right for your practice
Most RTM platforms offer some version of two delivery models. Understanding the real difference between them and which one fits your practice is the most practical decision you will make in the RTM adoption process.
Software-Only
Your clinical staff owns the monitoring workflow. The platform provides the patient app, documentation tools, time tracking, and billing reports. You pay a flat fee per active patient per month and keep the RTM reimbursement.
This is the highest-margin model for practices that have staff capacity to manage the monitoring workflow. The question is whether someone can own 5 to 30 hours of monthly monitoring time for every 30 active RTM patients on your panel.
Full-Service
A licensed virtual PTA or OTA team provided by the RTM platform handles all monitoring, documentation, and clinical escalation. You bill under your NPI and remit a percentage of collected reimbursement. You keep the remainder with zero additional staff time.
The hybrid path
Many practices launch on Full-Service to start generating RTM revenue immediately, then transition to Software-Only as their internal RTM coordinator completes training and the workflow stabilizes.
How to get started with Remote Therapeutic Monitoring
For practices that have read this far and want to move from understanding to action, the path forward has five components.
- Verify your payer coverage.Check your top five payers against current RTM coverage policies before projecting revenue.
- Choose your delivery model.Be honest about your staff capacity and whether Software-Only, Full-Service, or a hybrid path fits your clinic.
- Select a platform with audit-ready documentation.Ask any platform vendor to show an audit export before you sign.
- Start with a focused patient cohort.Enroll a defined patient group first so you can validate workflow before scaling.
- Build your monitoring workflow before you enroll patients.Know who reviews data, who messages patients, and who handles escalation.