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What Is Remote Therapeutic Monitoring (RTM)? A Complete Guide
A complete guide to Remote Therapeutic Monitoring — what it is, how it differs from RPM, which conditions qualify, the five CPT codes (98975-98981), and how providers bill Medicare for RTM services.
Remote Therapeutic Monitoring (RTM) is a Medicare-reimbursable program that uses digital health tools to collect non-physiologic, therapy-related data — such as pain levels, medication adherence, and respiratory therapy outcomes — from patients between office visits. Unlike RPM, RTM allows self-reported patient data and does not require FDA-cleared devices. Providers bill RTM using CPT codes 98975 through 98981, generating an estimated ~$100+ per patient per month.
What Is Remote Therapeutic Monitoring?
Remote Therapeutic Monitoring (RTM) is a Medicare-reimbursable healthcare program that uses digital health tools to collect non-physiologic, therapy-related data from patients between office visits. Introduced by CMS starting January 2022, RTM was designed to extend the benefits of remote monitoring beyond the vital-sign data collected by Remote Patient Monitoring (RPM) — covering therapy adherence, pain management, respiratory rehabilitation, and musculoskeletal recovery outcomes.
In practical terms, RTM works like this: a patient recovering from a total knee replacement receives access to a digital health app. Each day, the patient reports their pain level, logs whether they completed their physical therapy exercises, and records their range of motion progress. Clinical staff review the data, identify trends — such as worsening pain or declining therapy adherence — and intervene before a minor setback becomes a complication.
The critical distinction from RPM is the type of data being monitored. RPM collects physiologic data — blood pressure, weight, glucose — generated automatically by FDA-cleared devices. RTM collects non-physiologic data — pain scores, therapy completion, symptom diaries — that can include patient self-reports through digital platforms. This fundamental difference shapes everything about how RTM programs are structured, billed, and implemented.
Why RTM Was Created
Before January 2022, Medicare's remote monitoring reimbursement framework was limited to physiologic data collected by FDA-cleared devices under RPM. This left significant gaps for specialties that manage conditions requiring therapeutic monitoring rather than vital-sign tracking.
Orthopedic surgeons monitoring post-surgical recovery had no billing pathway for the therapy adherence data they reviewed between visits. Pulmonologists tracking respiratory rehabilitation outcomes could not bill for reviewing patient-reported symptom diaries. Physical medicine practices managing chronic pain through therapeutic protocols had no remote monitoring reimbursement mechanism.
RTM was introduced to fill these gaps — creating a parallel reimbursement framework for therapy-related data that mirrors RPM's structure but accommodates the fundamentally different nature of therapeutic monitoring.
How RTM Differs from RPM
Understanding the differences between RTM and RPM is essential for correct billing, proper patient enrollment, and program compliance.
Data Type: Non-Physiologic vs. Physiologic
RPM monitors physiologic vital signs: blood pressure, blood glucose, weight, oxygen saturation, heart rate, and temperature. This data is generated automatically by FDA-cleared medical devices.
RTM monitors non-physiologic, therapy-related outcomes: pain scores, medication adherence, therapy exercise completion, respiratory symptom patterns, functional assessments, and range of motion progress. This data can be self-reported by patients through digital platforms.
Device Requirements: Digital Platforms vs. FDA-Cleared Devices
RPM requires FDA-cleared medical devices capable of electronically recording and transmitting data. These devices — blood pressure monitors, glucose meters, weight scales, pulse oximeters — represent a meaningful upfront investment.
RTM does not require FDA-cleared devices. Data can be collected through digital health applications, patient-facing apps, web-based questionnaires, and connected rehabilitation tools. This significantly lowers the technology barrier and reduces implementation costs.
Self-Reported Data: Allowed vs. Not Allowed
This is one of the most important practical differences. RPM data must be device-generated — a patient cannot call in and report their blood pressure reading for RPM billing purposes. RTM explicitly allows self-reported patient data, meaning a patient can log their pain score, confirm therapy completion, or report symptoms through a digital platform, and that data qualifies for RTM billing.
CPT Code Structure
| Component | RTM Code | RPM Code |
|---|---|---|
| Initial Setup | 98975 (~$19) | 99453 (~$19) |
| Device/Platform Supply | 98976 or 98977 (~$50/mo) | 99454 (~$55/mo) |
| Clinical Time — First 20 min | 98980 (~$48/mo) | 99457 (~$48/mo) |
| Clinical Time — Additional 20 min | 98981 (~$38/mo) | 99458 (~$38/mo) |
RTM has two device supply codes (98976 for respiratory and 98977 for musculoskeletal), while RPM uses a single code (99454) regardless of condition.
RTM CPT Codes and Medicare Reimbursement
RTM billing is structured around five CPT codes. All reimbursement amounts below are estimates based on CMS published fee schedules and may vary by region, payer, and clinical circumstances.
CPT 98975 — Initial Setup and Patient Education
Estimated Reimbursement: ~$19 (one-time per treatment episode)
Covers the initial configuration of the RTM data collection platform, patient education on how to report data, and establishment of the monitoring protocol. Billed once when the patient is enrolled in the RTM program. The ordering provider must have an established patient-provider relationship.
CPT 98976 — Device Supply: Respiratory System
Estimated Reimbursement: ~$50 per month
Covers the supply and operation of a monitoring device or digital platform for respiratory system conditions over a 30-day period. The patient must record data on at least 16 out of 30 calendar days. Qualifying conditions include COPD, asthma, post-COVID respiratory recovery, and pulmonary rehabilitation. Data can include self-reported respiratory symptoms, inhaler usage, peak flow readings, and therapy completion.
CPT 98977 — Device Supply: Musculoskeletal System
Estimated Reimbursement: ~$50 per month
Covers the supply and operation of a monitoring device or digital platform for musculoskeletal system conditions over a 30-day period. The same 16-day data threshold applies. Qualifying conditions include post-surgical recovery (total knee or hip replacement), chronic pain syndromes, physical therapy adherence, and chronic musculoskeletal disorders. Data can include self-reported pain levels, range of motion measurements, exercise adherence, and functional outcome scores.
CPT 98980 — Treatment Management: First 20 Minutes
Estimated Reimbursement: ~$48 per month
Covers the first 20 minutes of clinical staff time per month spent reviewing RTM data, managing the treatment plan, and communicating with the patient about therapy progress. Clinical staff perform this work under the general supervision of the billing provider. Time must be documented with date, duration, and description of activities.
CPT 98981 — Treatment Management: Additional 20 Minutes
Estimated Reimbursement: ~$38 per month
Covers each additional 20-minute increment of clinical staff time beyond the first 20 minutes. Can only be billed after 98980 has been satisfied. Same documentation requirements apply. This code is frequently underutilized — for complex patients in active rehabilitation, clinical staff often exceed 20 minutes per month.
Total Estimated Monthly Revenue
| CPT Code | Description | Estimated Rate | Frequency |
|---|---|---|---|
| 98975 | Initial setup | ~$19 | One-time |
| 98976 or 98977 | Platform supply (respiratory or MSK) | ~$50 | Monthly |
| 98980 | Treatment management (first 20 min) | ~$48 | Monthly |
| 98981 | Treatment management (additional 20 min) | ~$38 | Monthly |
Estimated recurring monthly revenue: ~$98–$136 per patient
The range depends on whether 98981 is consistently billed. The device supply code is condition-specific — 98976 for respiratory conditions and 98977 for musculoskeletal conditions.
Qualifying Conditions for RTM
RTM covers two primary categories of conditions, each tied to a specific device supply code.
Respiratory Conditions (CPT 98976)
- COPD — Monitoring respiratory therapy adherence, inhaler usage patterns, symptom severity, and exacerbation frequency
- Asthma — Tracking medication adherence, peak flow variability, trigger identification, and asthma action plan compliance
- Post-COVID respiratory recovery — Monitoring pulmonary rehabilitation progress, dyspnea levels, and functional recovery milestones
- Pulmonary rehabilitation — Tracking exercise program completion, symptom trends, and therapy adherence
- Other chronic respiratory conditions — Any respiratory condition with an active therapeutic component amenable to remote monitoring
Musculoskeletal Conditions (CPT 98977)
- Total knee replacement recovery — Monitoring post-operative pain levels, range of motion progress, physical therapy adherence, and functional milestones
- Total hip replacement recovery — Tracking rehabilitation progress, weight-bearing status, and functional outcome scores
- Chronic pain syndromes — Monitoring pain scores, medication adherence, functional impact, and therapeutic engagement
- Rotator cuff repair recovery — Tracking rehabilitation exercise completion, pain trends, and range of motion progress
- Physical therapy adherence — Monitoring home exercise program completion for any orthopedic or musculoskeletal condition
- Chronic musculoskeletal conditions — Osteoarthritis, chronic low back pain, fibromyalgia, and other conditions with active therapeutic monitoring needs
The common thread across all qualifying conditions is the presence of an active therapeutic component being monitored. RTM tracks therapy outcomes and adherence — not just disease status.
How RTM Works: Implementation Steps
Step 1: Identify Your Patient Population
Review your existing patient panel for conditions with active therapeutic monitoring needs. Orthopedic practices should focus on post-surgical recovery patients. Pulmonology and primary care practices should identify COPD and asthma patients with ongoing therapy plans. Physical medicine practices should target chronic pain patients with active treatment protocols.
Step 2: Select a Digital Health Platform
Choose a platform that supports patient self-reporting, tracks the 16-day data collection threshold, and integrates with your documentation workflow. Because RTM does not require FDA-cleared devices, the technology options are broader and generally less expensive than RPM device platforms. Look for platforms that offer patient-facing apps with automated reminders, structured data collection forms, and clinical review dashboards. See how RTM integrates with PointClickCare for automated therapy documentation in skilled nursing facilities.
Step 3: Enroll Patients and Establish Protocols
Obtain patient consent, configure the monitoring platform for each patient's condition, and educate the patient on how to report data. Define which data points will be collected — pain scores, therapy adherence, symptom diaries, functional assessments — and establish clinical response protocols for concerning trends.
Step 4: Monitor Data and Manage Therapy
Clinical staff review incoming data on the monitoring platform, looking for patterns that require intervention: worsening pain trends, declining therapy adherence, new symptoms, or failure to meet rehabilitation milestones. When concerning patterns emerge, staff communicate with the patient and the supervising provider to adjust the treatment plan.
Step 5: Document and Bill
Track clinical staff time meticulously. RTM billing requires the same documentation discipline as RPM — date, duration, and description of activities for every treatment management interaction. Ensure patients meet the 16-day data threshold before billing device supply codes. Use structured time-logging workflows to capture all billable clinical time.
Revenue Potential: RTM Program Modeling
RTM provides a meaningful revenue opportunity, particularly for practices that already manage the qualifying conditions but have no current billing pathway for between-visit therapeutic monitoring.
Practice-Level Projections
| Active RTM Patients | Estimated Monthly Revenue | Estimated Annual Revenue |
|---|---|---|
| 25 | ~$2,500 | ~$30,000 |
| 50 | ~$5,000 | ~$60,000 |
| 100 | ~$10,000 | ~$120,000 |
| 200 | ~$20,000 | ~$240,000 |
These figures assume an average of approximately ~$100 per patient per month in recurring codes. Actual revenue will vary based on billing efficiency, patient compliance with the 16-day data threshold, and consistent capture of treatment management time.
Stacking RTM with RPM
For patients with both physiologic and therapeutic monitoring needs, RTM and RPM can be billed concurrently. A patient with COPD (RTM for respiratory therapy monitoring via 98976) and hypertension (RPM for blood pressure monitoring via 99454) could generate an estimated ~$200+ per month in combined remote monitoring revenue. The clinical time for each program must be tracked and documented separately.
How RTM Fits with Other Medicare Programs
RTM is part of Medicare's broader chronic care reimbursement framework and can be combined with other programs for qualifying patients.
RTM + RPM
As noted above, RTM and RPM can be billed together when monitoring different data types for the same patient. RTM covers non-physiologic therapy data; RPM covers physiologic vital signs. The programs use different CPT code families and require separate time documentation.
RTM + CCM
Chronic Care Management (CCM) reimburses for non-face-to-face care coordination — medication reconciliation, specialist communication, and care plan management. A patient enrolled in RTM for post-surgical monitoring could also qualify for CCM if they have two or more chronic conditions. Clinical time must be tracked separately for each program.
RTM + PCM
Principal Care Management (PCM) targets patients with a single high-complexity chronic condition. RTM therapy data can inform PCM clinical decision-making, and both can be billed when documentation supports distinct services.
Conclusion
Remote Therapeutic Monitoring extends Medicare's remote monitoring framework to the non-physiologic, therapy-related data that RPM was never designed to cover. For orthopedic practices managing post-surgical recovery, pulmonology practices monitoring respiratory rehabilitation, physical medicine practices tracking chronic pain management, and primary care practices coordinating therapeutic outcomes, RTM provides a direct reimbursement pathway for work that was previously uncompensated.
The program's advantages are practical: self-reported patient data is accepted, FDA-cleared devices are not required, and digital health platforms can serve as the data collection tool — lowering implementation costs compared to RPM. With an estimated ~$100+ per patient per month in recurring revenue, the ability to stack RTM with RPM and other programs for qualifying patients, and a growing base of eligible conditions in respiratory and musculoskeletal care, RTM represents an increasingly important component of comprehensive remote monitoring programs.
For a detailed breakdown of each CPT code's billing requirements, documentation standards, and common compliance mistakes, see our RTM Billing Guide.
Disclaimer: This article is for informational purposes only and does not constitute medical, legal, or billing advice. CPT code reimbursement amounts are estimates based on CMS published fee schedules and may vary by region, payer, and clinical circumstances. Always consult qualified healthcare and billing professionals for guidance specific to your practice.
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Why It Matters
Key Benefits
See how this approach drives measurable improvements across your organization.
Self-Reported Data Accepted
RTM allows patient self-reported data through digital platforms — pain scores, therapy adherence, symptom diaries — eliminating the need for specialized medical devices.
Lower Implementation Cost
Because RTM does not require FDA-cleared devices, practices can launch programs using digital health apps and patient-facing platforms at a fraction of RPM's startup cost.
Expanded Condition Coverage
RTM extends remote monitoring reimbursement to respiratory and musculoskeletal conditions — COPD rehab, post-surgical recovery, chronic pain — that RPM cannot cover.
Stackable with RPM
RTM and RPM can be billed for the same patient when monitoring different conditions, creating layered per-patient revenue beyond physiologic monitoring alone.
Growing Specialty Demand
Orthopedic, pulmonology, and physical medicine practices increasingly adopt RTM to monitor post-surgical recovery and therapy adherence between visits.
Therapy Outcome Tracking
RTM provides structured, reimbursable tracking of therapy outcomes — giving clinicians longitudinal data on whether treatment plans are working between office visits.
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Common Questions
Frequently Asked Questions
Get answers to the most common questions about this topic.
The core difference is the type of data collected. RPM collects physiologic data generated automatically by FDA-cleared medical devices — blood pressure, weight, glucose, oxygen saturation. RTM collects non-physiologic, therapy-related data that can include patient self-reports — pain scores, medication adherence, therapy exercise completion, and respiratory symptom diaries. RTM uses CPT codes 98975-98981, while RPM uses 99453-99458. Both require 16 days of data per 30-day period, but RTM data can come from patient self-reports through digital platforms, not just automated device readings.
RTM covers two primary condition categories. Respiratory conditions (billed under 98976) include COPD, asthma, post-COVID respiratory recovery, and pulmonary rehabilitation. Musculoskeletal conditions (billed under 98977) include post-surgical recovery from total knee or hip replacement, chronic pain syndromes, physical therapy adherence, and chronic musculoskeletal disorders like osteoarthritis. The condition must have an active therapeutic component being monitored — RTM tracks therapy outcomes, not just disease status.
Yes. RTM and RPM can be billed concurrently for the same patient when the programs monitor different data types. For example, a patient with COPD (RTM for respiratory therapy adherence) and hypertension (RPM for blood pressure monitoring) could qualify for both programs. The monitored data must be distinct — you cannot bill RTM and RPM for the same clinical parameter. Each program's time documentation must be tracked separately.
No. Unlike RPM, RTM does not require FDA-cleared medical devices. RTM data can be collected through digital health applications, patient-facing apps, web-based questionnaires, and other digital platforms. This is one of the key advantages of RTM — the lower technology barrier makes it accessible to practices that do not have device-based monitoring infrastructure. Patients can self-report pain scores, therapy adherence, and symptom data through simple digital tools.
RTM uses five CPT codes generating an estimated ~$100+ per patient per month. CPT 98975 covers initial setup (~$19, one-time). CPT 98976 or 98977 covers device/platform supply for respiratory or musculoskeletal conditions (~$50/month). CPT 98980 covers the first 20 minutes of treatment management (~$48/month). CPT 98981 covers each additional 20-minute increment (~$38/month). These are estimates based on CMS published fee schedules and actual rates vary by region, payer, and clinical circumstances.
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