RTM, explained
What is Remote Therapeutic Monitoring?
RTM is a set of CMS billing codes — available since January 2022 — that reimburse clinics for monitoring a patient's home program between visits. This guide explains what RTM is, the CPT codes involved, how the monthly workflow runs, and how it gets paid.
Educational overview · Reflects national CMS fee-schedule averages · Not billing or legal advice
The basics
RTM, in plain English
Remote Therapeutic Monitoring lets therapists track a patient's progress on their home program between visits and be reimbursed for the clinical time that goes into reviewing it. It is frequently confused with RPM (Remote Patient Monitoring), but they are different programs with different rules, providers, and codes.
RTM
Therapy & adherence- Data monitored
- Non-physiological — musculoskeletal function and therapy adherence
- Device needed
- The patient's own phone — no special hardware
- Who can bill
- PTs, OTs and SLPs bill directly
- CPT family
- CPT 98975–98986
RPM
Physiological- Data monitored
- Physiological — heart rate, blood pressure, weight, SpO₂
- Device needed
- Dedicated sensors and wearable devices
- Who can bill
- MDs, NPs and PAs — physician oversight required
- CPT family
- CPT 99453–99458
What RTM covers
Home programs
The structured at-home plan — exercises and activities — a PT, OT or SLP prescribes for the weeks between visits.
Therapy adherence
Knowing which patients are actually doing their exercises at home — and who's falling behind before the next visit.
The rule clinics get wrong
RTM is not a visit
This is the single most common misunderstanding, and it costs clinics both ways — teams under-enroll because they think RTM burns authorized visits, and payers occasionally deny for the same wrong reason. Four separate CMS rules are worth knowing cold:
RTM is not telehealth
A telehealth session counts as a visit under outpatient therapy. RTM does not — it is a separate category of service with its own codes and rules.
It does not count as a visit
RTM does not consume an authorized visit, and it does not count toward the 10-visit progress report requirement.
It does count toward the dollar threshold
RTM does apply to the annual therapy dollar threshold, so it belongs in your threshold tracking even though it is not a visit.
MPPR does not apply
The multiple procedure payment reduction does not touch RTM codes — they are not reduced when billed alongside same-day therapy services.
In practice: some commercial and Medicaid payers have incorrectly counted RTM against authorized visit limits or visit benefit maximums. If you see that on a remittance, it is worth appealing rather than absorbing — APTA and AOTA are both actively working the issue.
The codes
The core RTM billing codes
Three codes do most of the work: a one-time setup, a monthly device-supply code, and a monthly treatment-management code. Rates below are 2026 national CMS fee-schedule rates.
The onboarding visit where the patient (or parent) is shown how to record data on their own. Billed once per episode, after at least 2 days of monitoring have occurred — either on the day of the second transmission or at the end of the 30-day period.
Once per episode of care · 2-day floor
Covers the monitoring platform the patient uses at home. The patient must log and transmit data on at least 16 separate days within the 30-day period, which runs from the RTM start date — not the calendar month.
Each 30-day period · requires 16+ days of data
The clinician time spent reviewing incoming data, sending feedback and adjusting the plan — at least 20 minutes plus one live, synchronous conversation with the patient or caregiver during the calendar month.
Calendar month · requires 20+ min of review
The RTM family also includes add-on and rescue codes: 98981 adds each additional full 20 minutes of management time ($41.42), and — new for 2026 — 98985 covers periods where the patient logs only 2–15 days, paid at parity with 98977, while 98979 covers calendar months with 10–19 minutes of review ($26.39). Partial-adherence months stay billable. Two further codes, 98978 and 98986 (cognitive behavioral therapy), are contractor-priced — your MAC sets the amount, so there is no national rate to quote. Payer adoption of the new codes varies; confirm rates on the CMS fee schedule.
Rates shown are 2026 national non-facility amounts, derived from the CMS relative-value file for 2026 (total RVU × the $33.4009 conversion factor) and confirmed against the CMS fee-schedule lookup across every Medicare locality. Note that several widely circulated summaries still quote the device-supply codes at roughly $40 — those figures come from the November 2025 final rule addendum and were superseded by the relative-value file CMS released for payment.
What your clinic actually gets will differ. Geographic adjustment moves 98977 from about $44.07 in the lowest-paying localities to $73.87 in the highest, with a median of $52.32 — the code's relative value is identical everywhere, so the spread is purely regional. The national figure sits mid-pack, with roughly 46% of localities below it. Check your own locality on the CMS fee schedule.
Put it together
What the recurring combination looks like
Each active RTM patient combines 98977 (device supply) and 98980 (treatment management) — about $105.55 / month at national averages, plus a one-time $21.71 setup (98975) in the first month. Drag the estimator to see what that could mean at your clinic's volume.
Eligibility, documentation, and actual reimbursement vary by payer and region — not a guarantee of payment. Verify rates on the CMS fee schedule.
PT, OT, and SLP Clinics: Calculate your uncaptured RTM revenue.
Drag to estimate — every clinic and payer is different.
Illustration only, based on national CMS fee-schedule averages of $51.44 (98977) + $54.11 (98980) per active patient. Not a guarantee of payment.
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The other side of the claim
What will the family actually pay?
RTM is a billable medical service, not a free extra — somebody owes a share of every claim. The family should hear that number from you at consent rather than from a statement in month three. What they owe depends entirely on the payer.
Part B pays 80% of the allowed amount; the beneficiary owes the other 20%, after the annual deductible of $283 in 2026. On the recurring pair that is $10.29 on 98977 plus $10.82 on 98980, plus $4.34 the month you bill setup. Many beneficiaries carry supplemental coverage that absorbs it; plenty do not.
42 CFR 410.152The column that matters for most pediatric caseloads. Federal rules prohibit cost sharing for most children under 18 — exemptions are defined by eligibility group rather than age alone — and total premiums plus cost sharing for a household are capped at 5% of family income. Separate CHIP programs may charge something, under a parallel 5% cap. State plans vary; confirm yours.
42 CFR 447.56RTM lands against whatever the contract says — a deductible, coinsurance, or a flat copay per claim. A family on a high-deductible plan can owe the entire allowed amount until that deductible is met. This is where surprise bills come from, so ask during the same payer check you run before enrolling.
Because coinsurance is a percentage of the locality-adjusted amount, the family's share tracks geography exactly the way your payment does — the device-supply code alone runs roughly $8.81 to $14.77 per period depending on where you are.
Why this is retention work, not just disclosure. In pediatrics you are asking a parent to log data nearly every day. A parent who discovers in month three that their own logging generated a bill will disenroll — and they will tell the front desk exactly why. Saying the number out loud during setup costs one sentence.
In practice
How RTM works, month to month
Five steps, repeated each month — from enrollment to billing.
Consent & enroll
~2 min at intakeGet consent during a normal intake visit.
Set up & educate
Bill 98975Install the app and show the family how to log.
Family follows along
Need 16+ daysEffort, pain & completion logged from a text link.
Clinician reviews
Need 20+ minReview the data, send feedback, adjust the plan.
Bill monthly
Submit & repeatGenerate a one-click report and submit the claim.
↻ The cycle repeats every month a patient stays enrolled.
Consent & enroll
~2 min at intakeObtain consent for remote monitoring and explain what is collected and how it helps. This fits inside a normal intake visit.
Set up & educate
Bill 98975Help the family install the app and walk through the prescribed exercises, then show them how to log adherence in seconds.
Family follows along
Need 16+ daysEach session — completion, effort and pain — is logged in seconds from a text-message link. Qualifying days are tracked automatically toward 98977.
Clinician reviews
Need 20+ minReview logged effort, pain and completion in the dashboard, send feedback and adjust the plan. Review time counts toward the 20-minute 98980 threshold.
Bill monthly
Submit & repeatWhen a code is ready, generate a one-click compliance report and submit the claim — then the loop begins again next month.
Before you enroll
Six rules worth knowing cold
The thresholds get all the attention, but denials more often trace back to these. None of them are hard to satisfy — they just have to be true before the first claim goes out.
An active plan of care is required
RTM is billable under Medicare only while the plan of care is current — certification and recertification included. Monitoring can continue briefly after in-person visits end, such as through a discharge transition, but only while that plan of care remains valid.
Licensure follows the patient
The therapist or assistant must be licensed in the state where the patient is physically located at the time of service. Because RTM is remote by definition, this comes up far more often than it does in clinic-based care — the PT Compact covers 35 states as of January 2026, and a handful more have enacted legislation without yet issuing privileges.
PT and OT cannot both bill RTM
Medicare will not pay RTM to both disciplines for the same beneficiary, even across separate episodes of care. Only one discipline can be paid at a time, so a child seeing both PT and OT needs someone to own the RTM billing. Professional associations are lobbying CMS to change this.
The device only needs to meet the FDA definition
Software qualifies if it meets the FDA definition of a medical device under section 201(h) of the Food, Drug, and Cosmetic Act. It does not need to be FDA-approved, cleared, or registered — a materially lower bar than most vendors imply.
Assistants can furnish RTM, with modifiers
PTAs and OTAs may furnish RTM under general supervision in private practice. The CQ and CO modifiers attach to 98975, 98979, 98980 and 98981 — never to the device-supply codes, because those represent the patient transmitting data rather than work the assistant performed.
It is billable outside private practice
RTM works in hospital outpatient departments and rehab agencies too, not just private practice. Professional claims carry place of service 11 for clinic or 12 for the patient’s home; institutional claims use revenue code 420 for PT, 430 for OT, and 440 for SLP.
One more distinction worth internalising: the 30-day device-supply period and the calendar month for management codes are different clocks. The 30-day period runs from the RTM start date; management time resets on the first of each month. A patient who starts on the 26th will often have a management code billable on the 31st, before the first device-supply period has even closed.
Why it matters
Fair reimbursement for care between visits
When families stay engaged with a home program, adherence improves and outcomes tend to follow. RTM is a way for clinics to be fairly reimbursed for the monitoring that supports that — clinical work that often goes uncaptured today. RTM is newer in pediatrics, so it is worth approaching thoughtfully: document carefully, confirm payer eligibility, and treat any figures as estimates rather than promises.
Established codes, not workarounds
RTM has been part of the CMS fee schedule since January 2022. These are recognized CPT codes — not billing tricks.
Pays for care you likely already give
Most teams already follow up on home programs by phone, text or memory. RTM reimburses that work when it is documented.
No extra hardware
Patients use the phone they already own, so there is no device to buy, ship or maintain.
RTM does not guarantee payment. Coverage, documentation requirements, and reimbursement vary by payer and region, and pediatric coverage in particular continues to evolve. This page is educational and is not billing, coding, or legal advice.
How Sulo helps
RTM without the busywork
Sulo is built for pediatric PT, OT and SLP teams. It captures the home-program engagement that RTM is based on, and documents the qualifying days and minutes automatically.
Speech-to-exercise builder
Say an exercise out loud and it’s built in seconds — no typing. Then drag and drop your exercises, library items, PDF handouts, or links into a complete pediatric plan.
Frictionless parent adherence
Parents log completion, effort and pain in seconds from a text-message link — no app fatigue, no chasing updates.
Automated compliance tracking
Every qualifying day and minute is tracked in the background, with alerts before a patient slips below the 16-day or 20-minute thresholds.
Audit-ready billing exports
One-click CSV exports compatible with EMRs like WebPT, Jane and Prompt. Each interaction and review minute is timestamped for chart review.
Ready to put RTM to work?
See RTM running in a real pediatric workflow
Sulo handles the engagement, compliance tracking, and audit-ready exports — so your team can focus on care while RTM is captured cleanly in the background.
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