Remote Therapeutic Monitoring (RTM) Codes for PTs

Remote Therapeutic Monitoring (RTM) represents a significant revenue opportunity for physical therapy practices in 2025—potentially generating $50-$166 per patient per month while improving patient outcomes through consistent tracking of therapy adherence and musculoskeletal progress.

Unlike Remote Patient Monitoring (RPM), which physical therapists cannot bill under Medicare, RTM was specifically designed to allow non-physician providers—including PTs and OTs—to bill for remote monitoring of non-physiological data like exercise adherence, range of motion measurements, and functional status.

This comprehensive guide explains RTM CPT codes 98975, 98977, and 98980, reimbursement rates, the critical 16-day data collection requirement, compliance rules, and how to integrate RTM into your physical therapy practice profitably and compliantly.

What Is Remote Therapeutic Monitoring (RTM)?

Remote Therapeutic Monitoring (RTM) is the collection and analysis of non-physiological patient-generated health data (such as therapeutic exercise adherence, medication compliance, and functional status) to remotely monitor patients between in-person visits.

RTM vs. RPM: Critical Differences for Physical Therapists

The distinction between RTM and RPM is crucial—physical therapists can bill RTM but NOT RPM.

Key takeaway: If you’re monitoring a patient’s exercise adherence or range of motion, use RTM codes. If you’re monitoring their blood pressure or heart rate, that’s RPM—which PTs cannot bill.

Examples of RTM in Physical Therapy Practice

Scenario 1: Post-Operative Knee Replacement Patient

• Patient receives app-based home exercise program
• Patient logs daily exercise completion and knee ROM measurements via smartphone app
• PT reviews data weekly and adjusts exercise progression remotely
• RTM applicable: Yes—tracking exercise compliance and ROM (non-physiological data)

Scenario 2: Chronic Low Back Pain Patient

• Patient wears activity tracker monitoring daily step count and functional mobility
• Patient completes weekly surveys on pain levels and functional status
• PT reviews trends and provides remote coaching on activity pacing
• RTM applicable: Yes—tracking functional activity and self-reported outcomes

Scenario 3: Post-Stroke Balance Training Patient

• Patient performs balance exercises at home using app that tracks completion
• PT monitors exercise frequency and duration remotely
• Monthly video check-ins to adjust program
• RTM applicable: Yes—tracking exercise adherence (non-physiological)

Scenario 4: Cardiac Rehab Patient (NOT RTM)

• Patient wears heart rate monitor during exercise
• PT monitors heart rate, blood pressure, and oxygen saturation remotely
• RTM applicable: No—this is physiological monitoring (RPM), which PTs cannot bill

RTM CPT Codes and Reimbursement Rates

The American Medical Association (AMA) created five RTM CPT codes in 2022. Physical therapists primarily use four of these codes:

CPT 98975: Setup and Patient Education

Description: Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment.

When to bill:

• One time per episode of care (typically at beginning of RTM program)
• Only when at least 16 days of data have been collected in the first 30-day period

Services included:

• Initial device setup and configuration
• Patient education on how to use monitoring equipment or app
• Training on data transmission and reporting

2025 Medicare reimbursement: $19.73 (national average, varies by MAC locality)

Example: Patient begins post-operative shoulder replacement RTM program. PT spends 15 minutes teaching patient how to use smartphone app to log exercises and ROM measurements, and configures alerts for missed exercises.

CPT 98976: Device Supply (Practitioner Supplies Device)

Description: Device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor the respiratory system, each 30 days.

When to bill:

• Once every 30 days
• When practitioner supplies the monitoring device to the patient
• Only when at least 16 days of data have been collected in that 30-day period

2025 Medicare reimbursement: ~$55.72 (national average)

Important: Most PT practices do not supply specialized respiratory monitoring devices, so this code is less commonly used than 98977.

CPT 98977: Device Supply for Musculoskeletal Monitoring

Description: Device(s) supply with scheduled (e.g., daily) recording(s) and/or programmed alert(s) transmission to monitor the musculoskeletal system, each 30 days.

When to bill:

• Once every 30 days
• When practitioner supplies the monitoring device to the patient (wearable tracker, specialized app, ROM measurement device)
• Only when at least 16 days of data have been collected in that 30-day period

2025 Medicare reimbursement: $43.02 (national average)

Example: PT provides patient with wearable activity tracker that transmits data to clinic portal. Tracker logs daily step count, exercise duration, and movement quality. Patient wears device for 20 days out of 30-day period. PT bills 98977 for device supply.

Note: If the patient uses their own device (e.g., their personal Fitbit or smartphone app), you cannot bill 98977. You can only bill this code when you supply the device.

CPT 98980: Treatment Management (First 20 Minutes)

Description: Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; first 20 minutes.

When to bill:

• Once per calendar month
• Requires at least one interactive communication with patient (phone call, video visit, or secure messaging conversation)
• Must spend at least 20 minutes of treatment management time reviewing data, analyzing trends, and communicating with patient

Services included:

• Reviewing transmitted monitoring data
• Analyzing trends and patterns
• Interactive communication with patient or caregiver (phone, video, or secure messaging)
• Adjusting treatment plan based on data
• Documenting management decisions

2025 Medicare reimbursement: $49.78 (national average)

Example: PT reviews 3 weeks of exercise adherence data for post-operative ACL patient. Data shows patient completing exercises 5-6 days/week but skipping balance training. PT calls patient (12-minute phone consultation) to discuss barriers to balance training, provides modifications, and documents plan adjustments. Total treatment management time: 25 minutes. Bills 98980.

Critical requirement: The 16-day data requirement does not apply to 98980. You can bill 98980 as long as you have sufficient data to support treatment management, even if fewer than 16 days of data were collected (though you won’t be able to bill 98975/98977 without 16 days).

CPT 98981: Treatment Management (Each Additional 20 Minutes)

Description: Remote therapeutic monitoring treatment management services, physician or other qualified health care professional time in a calendar month requiring at least one interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure).

When to bill:

• Add-on code (must be billed with 98980)
• Only when you’ve spent at least 40 minutes total treatment management time in the calendar month

2025 Medicare reimbursement: $40.84 (national average)

Example: PT reviews complex multi-joint injury patient’s RTM data (15 minutes), conducts phone consultation (18 minutes), and documents detailed plan modifications (12 minutes). Total time: 45 minutes. Bills 98980 (first 20 minutes) + 98981 (second 20 minutes).

Note: Time is cumulative across the entire calendar month. You don’t need 40 minutes in a single session—you can accumulate 40+ minutes across multiple data reviews and communications.

Maximum Monthly RTM Reimbursement

If you supply the device and provide sufficient treatment management time, maximum monthly RTM revenue per patient is:

Initial month:

• 98975 (setup): $19.73
• 98977 (device supply): $43.02
• 98980 (first 20 min treatment management): $49.78
• 98981 (additional 20 min treatment management): $40.84
• Total: $153.37

Subsequent months:

• 98977 (device supply): $43.02
• 98980 (first 20 min treatment management): $49.78
• 98981 (additional 20 min treatment management): $40.84
• Total: $133.64 per month

If patient uses their own device (no 98977):

• 98980 + 98981 = $90.62 per month

The 16-Day Data Requirement: Critical Compliance Rule

The 16-day rule is the most important compliance requirement for RTM billing.

What Is the 16-Day Rule?

You can only bill CPT codes 98975, 98976, and 98977 if the patient transmits data for at least 16 days out of a 30-day period.

Important clarifications:

• 16 days means 16 separate calendar days—not 16 data transmissions
• Data must be automatically transmitted from the device/app to your monitoring system
• Manual data entry by staff doesn’t count
• The 16-day requirement does NOT apply to treatment management codes (98980/98981)

Example Scenarios

Scenario 1: Compliant RTM

• Patient logs exercises in app 18 days out of 30-day period
• Data automatically transmits to clinic portal
• Can bill: 98975 (if initial setup month) and 98977 (device supply)

Scenario 2: Non-Compliant RTM

• Patient logs exercises only 12 days out of 30-day period
• Data automatically transmits to clinic portal
• Cannot bill: 98975 or 98977 (fewer than 16 days of data)
• Can still bill: 98980 (treatment management) if you reviewed data and communicated with patient

Scenario 3: Manual Entry (Non-Compliant)

• Patient emails you exercise log each day
• You manually enter data into spreadsheet
• Data collected for 20 days
• Cannot bill: Any RTM codes—data must be automatically transmitted, not manually entered

Technology Requirements for RTM

To meet the 16-day rule, your RTM technology must:

✅ Automatically capture and transmit data from patient’s device/app to your system ✅ Time-stamp data to verify transmission dates ✅ Store data securely in HIPAA-compliant system ✅ Generate reports showing data transmission dates (for audit defense) ✅ Track compliance and alert when patients fall below 16-day threshold

Proactive Chart’s RTM solution:

• Integrated with popular patient exercise apps and wearable devices
• Automatic data sync to patient chart
• Real-time compliance dashboard showing data transmission days
• Alerts when patients approach 16-day threshold (e.g., “Patient at 10 days with 5 days remaining in billing cycle”)
• One-click RTM billing with automatic validation

RTM Documentation Requirements

Your clinical documentation must support RTM billing in case of audit.

Required Documentation Elements

For 98975 (Setup and Education):

• Date and duration of setup session
• Description of device/app provided
• Patient education topics covered (how to use device, when to transmit data, troubleshooting)
• Patient’s understanding and ability to use equipment

Example documentation:

“1/5/2025 - 15 minutes spent on RTM setup. Patient educated on use of Proactive Chart Home Exercise App for logging daily exercises and ROM measurements. Demonstrated proper technique for app-based goniometer for shoulder ROM tracking. Patient demonstrated competency with app navigation and data transmission. Patient verbalized understanding of daily logging expectations.”

For 98977 (Device Supply):

• Description of device supplied (brand, model, purpose)
• Date device provided to patient
• Monitoring parameters configured (e.g., daily step goals, exercise frequency alerts)
• Verification of automatic data transmission setup

Example documentation:

“1/5/2025 - Supplied patient with Fitbit Inspire 3 activity tracker for monitoring daily activity levels and exercise adherence. Device configured to sync with clinic portal. Programmed alerts for activity goals (7,000 steps/day, 30 minutes moderate activity). Verified successful data transmission from device to portal.”

For 98980/98981 (Treatment Management):

• Date(s) of data review
• Summary of data trends observed
• Date, type, and duration of interactive communication with patient
• Clinical decisions made based on data
• Plan modifications
• Total time spent on treatment management activities (must be documented explicitly)

Example documentation:

“1/20/2025 - RTM Treatment Management (25 minutes total):

Data Review (10 min): Reviewed 3 weeks of exercise adherence data (1/1-1/20). Patient completed prescribed exercises 18 out of 20 days (90% adherence). ROM data shows gradual improvement: shoulder flexion increased from 145° to 165° over 3-week period. Step count averages 6,200 steps/day (goal: 7,000).

Interactive Communication (12 min): Phone consultation with patient to discuss progress. Patient reports decreased pain (7/10 to 3/10) and improved sleep. Identified barrier to reaching step goal: weather-related outdoor walking limitations.

Treatment Plan Modifications (3 min): Progressed resistance band exercises from red (light) to blue (medium) band based on ROM improvements. Added indoor walking alternatives (mall walking, treadmill) to address step count goal. Updated app with new exercise parameters.

Total RTM treatment management time this month: 25 minutes. Billing 98980 (first 20 minutes).”

Critical documentation rule: You must document total time spent on treatment management activities to justify 98980/98981. Simply noting “data reviewed” without time documentation will not support billing.

RTM Compliance Requirements

1. Patient Consent

Required: Obtain patient consent before initiating RTM services.

Consent must include:

• Explanation of RTM services and how data will be collected
• Patient’s right to discontinue RTM at any time
• Cost-sharing expectations (copays/coinsurance if applicable)
• Data privacy and security protections

Best practice: Use a written RTM consent form signed by the patient at program enrollment.

2. Only One Provider Can Bill RTM Per 30-Day Period

Medicare rule: Only one practitioner is allowed to bill RTM codes for the same patient during a 30-day period.

What this means:

• If multiple therapists in your practice see the same patient, designate one therapist as the RTM billing provider for that month
• You cannot split RTM billing (e.g., one PT bills 98977 and another PT bills 98980)—all RTM codes must be billed by the same provider

3. RTM and RPM Cannot Be Billed Together

Medicare rule: RTM cannot be billed for the same patient in the same month as RPM.

Example conflict:

• Physician bills RPM codes (99454, 99457) for monitoring patient’s blood pressure
• PT attempts to bill RTM codes (98977, 98980) for monitoring same patient’s exercise adherence
• Result: One set of codes will be denied

Solution: Coordinate with other providers treating the patient to determine who will bill remote monitoring codes each month.

4. Established Patient Relationship NOT Required for RTM

Unlike RPM (which requires an established relationship), RTM does not require a prior in-person visit before billing RTM codes.

What this means:

• You can initiate RTM with new patients who have never been seen in person (e.g., telehealth-only patients or patients discharged from inpatient rehab who transition to home-based RTM)

Best practice: While not required, an initial evaluation (in-person or telehealth) establishes medical necessity and improves clinical outcomes.

5. Interactive Communication Required for 98980/98981

To bill 98980/98981, you must have at least one interactive communication with the patient during the calendar month.

Acceptable forms of interactive communication:

• ✅ Phone call
• ✅ Video call (telehealth)
• ✅ Secure messaging (two-way conversation with real-time or near-real-time exchange)
• ❌ One-way emails or messages (not interactive)
• ❌ Automated alerts or reminders sent to patient (not interactive)

Example:

• You review patient’s data and send a secure message: “Great job on your exercise compliance this week! I noticed your ROM is improving. Let’s increase resistance on your shoulder exercises.”
• Patient responds: “Thank you! The new exercises feel good. Should I continue the same frequency?”
• You reply: “Yes, continue current frequency. Check in next week.”
• This counts as interactive communication supporting 98980 billing.

When to Use RTM in Physical Therapy Practice

RTM is ideal for specific patient populations and clinical scenarios.

Best Candidates for RTM

Post-operative patients:

• Total joint replacements (knee, hip, shoulder)
• ACL reconstruction
• Rotator cuff repair
• Spinal surgery

Rationale: Consistent monitoring of home exercise adherence and ROM progress during critical post-op healing periods improves outcomes and reduces complications.

Chronic pain patients:

• Low back pain
• Neck pain
• Fibromyalgia
• Chronic regional pain syndrome (CRPS)

Rationale: RTM supports activity pacing, functional goal tracking, and self-management strategies critical for chronic pain rehabilitation.

Patients with transportation barriers:

• Rural patients with limited access to clinic
• Elderly patients who can’t drive
• Patients with work schedules conflicting with clinic hours

Rationale: RTM extends access to care between in-person visits, reducing missed appointments and maintaining continuity.

Patients discharged from in-person PT:

• Transitioning to home exercise maintenance programs
• At risk for recurrence or regression without ongoing monitoring

Rationale: RTM provides accountability and coaching during the critical transition from supervised therapy to independent home program.

When NOT to Use RTM

Patients requiring frequent hands-on manual therapy:

• RTM cannot replace skilled manual interventions—use for supplemental monitoring between in-person visits

Patients lacking technology access:

• Patients without smartphones, tablets, or reliable internet cannot participate in app-based RTM

Acute injuries requiring close monitoring:

• Complex fractures, recent surgeries with complication risk, or conditions requiring frequent clinical examination may not be appropriate for remote-only monitoring

RTM Revenue Potential: Business Case for Physical Therapy Practices

Let’s analyze the financial impact of adding RTM to your practice.

Scenario 1: Small Practice (10 RTM Patients/Month)

Assumptions:

• 10 patients enrolled in RTM program
• Patients use their own devices (no 98977 billing)
• Average 25 minutes/month treatment management time per patient (billing 98980 only)

Monthly RTM revenue:

• 10 patients × $49.78 (98980) = $497.80/month
• Annual RTM revenue: $5,973.60

Time investment:

• 10 patients × 25 min/month = 250 min (4.2 hours/month)
• Effective hourly rate: $118.52/hour

Scenario 2: Medium Practice (30 RTM Patients/Month, Device Supply)

Assumptions:

• 30 patients enrolled in RTM
• Practice supplies wearable devices (billing 98977)
• Average 40 minutes/month treatment management time per patient (billing 98980 + 98981)

Monthly RTM revenue:

• 30 patients × ($43.02 [device supply] + $49.78 [first 20 min] + $40.84 [additional 20 min])
• 30 × $133.64 = $4,009.20/month
• Annual RTM revenue: $48,110.40

Time investment:

• 30 patients × 40 min/month = 1,200 min (20 hours/month)
• Effective hourly rate: $200.46/hour

Device cost consideration:

• Wearable tracker cost: ~$50-$100 per device
• Amortized over 12-month program: ~$4-$8/month
• Net revenue remains highly profitable

Scenario 3: Large Practice (50 RTM Patients/Month, Optimized Program)

Assumptions:

• 50 patients enrolled in RTM
• Mix: 30 supply devices (98977), 20 use own devices
• Average 35 minutes/month treatment management per patient (some billing 98980 only, some billing 98980+98981)

Monthly RTM revenue:

• 30 device-supplied patients × $133.64 = $4,009.20
• 20 own-device patients × $49.78 = $995.60
• Total: $5,004.80/month
• Annual RTM revenue: $60,057.60

Time investment:

• 50 patients × 35 min/month = 1,750 min (29.2 hours/month)
• Effective hourly rate: $171.40/hour

Staffing model: Can be managed by 1 full-time PT or distributed across multiple PTs (each managing 10-15 RTM patients alongside regular caseload).

How to Launch an RTM Program in Your Practice

Step 1: Select RTM Technology Platform

Requirements:

• HIPAA-compliant data transmission and storage
• Automatic data sync from patient devices/apps
• Ability to track 16-day compliance
• Reporting tools for treatment management documentation
• Integration with your EMR system (or built-in RTM module)

Proactive Chart includes:

• Integrated RTM platform (no third-party tools needed)
• Patient app for exercise logging, ROM tracking, and symptom reporting
• Automatic data sync to patient chart
• 16-day compliance dashboard
• One-click RTM billing with validation

Alternative options:

• Medbridge RTM
• WebPT Remote Therapeutic Monitoring
• Zimmer Biomet mymobility
• Specialized wearable devices with clinic portals

Step 2: Develop Clinical Protocols

Define which patients qualify for RTM:

• Post-operative patients (specific procedures)
• Chronic pain patients meeting certain criteria
• Patients discharging from in-person PT with high recurrence risk

Create standardized workflows:

• RTM enrollment process (consent, device setup, patient education)
• Data review schedule (weekly vs. bi-weekly)
• Communication protocols (when to call patient vs. send message)
• Discharge criteria (when to discontinue RTM)

Step 3: Train Staff

Education topics:

• RTM vs. RPM differences
• 16-day data requirement
• Documentation requirements
• Billing code selection
• Technology platform usage

Best practice: Designate an “RTM champion” on your team who becomes the expert and trains others.

Step 4: Educate Referring Physicians

Key messages:

• RTM extends rehabilitation beyond clinic walls
• Improves adherence and outcomes (share evidence)
• Does not require physician involvement (PTs bill independently)
• Provides physicians with objective data on patient progress

Marketing materials:

• One-page RTM program overview for physician offices
• Case studies showing patient outcomes
• Sample data reports physicians will receive

Step 5: Enroll Patients and Launch

Enrollment conversation:

• Explain RTM benefits (convenience, accountability, better outcomes)
• Address technology concerns (provide hands-on training)
• Review cost-sharing expectations
• Obtain written consent

Soft launch: Start with 5-10 pilot patients, refine processes, then scale.

Proactive Chart’s RTM Solution

Proactive Chart makes RTM seamless and profitable:

✅ Integrated patient app - Exercise logging, ROM tracking, symptom reporting ✅ Automatic data sync - No manual data entry required ✅ 16-day compliance dashboard - Real-time tracking prevents billing errors ✅ Smart alerts - Notifies you when patients miss exercises or fall below compliance threshold ✅ One-click billing - Automatically suggests RTM codes based on documentation and data days ✅ Audit-ready reports - Generates data transmission reports for compliance defense ✅ Treatment management timer - Tracks time spent reviewing data and communicating with patients

No manual tracking. No billing errors. Maximum RTM revenue.

Conclusion: RTM Is a Game-Changer for PT Practices

Remote Therapeutic Monitoring offers physical therapy practices a powerful combination: improved patient outcomes through consistent engagement AND significant additional revenue ($50-$166 per patient per month).

With proper technology, clear documentation, and compliance with the 16-day rule, RTM becomes a natural extension of quality patient care—not an administrative burden.

Key takeaways:

• RTM codes: 98975 (setup), 98977 (device supply), 98980/98981 (treatment management)
• 16-day rule: Must collect data for 16+ days to bill supply codes
• Revenue potential: $50-$166 per patient per month
• PTs can bill RTM independently (unlike RPM, which PTs cannot bill)
• Technology is essential for automatic data transmission and compliance tracking

Ready to add RTM to your practice and increase revenue while improving outcomes? Learn how Proactive Chart’s integrated RTM solution simplifies implementation and maximizes reimbursement. Schedule a demo today.

References:

• American Physical Therapy Association. (2023). APTA Practice Advisory: Remote Therapeutic Monitoring Codes Under Medicare. APTA.org.
• Centers for Medicare & Medicaid Services. (2025). Medicare Physician Fee Schedule Final Rule CY 2025. Federal Register.
• American Medical Association. (2025). Current Procedural Terminology (CPT) 2025 Professional Edition.
• CMS Manual System. (2023). Remote Therapeutic Monitoring Services. CMS.gov.

Disclaimer: RTM billing rules are subject to payer-specific policies. This article provides general guidance based on Medicare rules. Always verify requirements with specific payers and consult qualified billing specialists for practice-specific advice. Reimbursement rates vary by MAC locality.