CMS introduced Remote Therapeutic Monitoring in 2022 to reimburse the clinical work that happens between patient visits — exercise adherence, pain monitoring, respiratory data, and therapeutic outcomes. Three years later, most therapy practices either don’t bill it, bill it incompletely, or confuse it with RPM. Clientele RCM manages your complete RTM billing cycle — from enrollment through monthly recurring reimbursement.
per month recurring (CPT mix)
per month recurring
per month recurring
RTM reimbursement is slightly lower per code than RPM because RTM data is software-based rather than FDA-device-based. However, the patient pool for RTM is significantly larger in therapy practices — and many patients qualify for both RPM and RTM simultaneously (billed separately, with conditions).
Most therapy practices with software platforms that collect therapeutic data between visits have everything they need to bill RTM — and aren’t billing it. The platform vendor set up data collection; nobody set up the billing workflow behind it.
CPT 98975 is a one-time setup code — not a monthly code. It is billed once per device type per patient. Many practices bill it monthly, creating compliance risk and overpayment liability.
98976 covers musculoskeletal therapeutic data. 98977 covers respiratory data. They cannot be used interchangeably. A respiratory practice billing 98976 — or billing both when only one data type is collected — creates compliance and denial risk.
Like RPM’s 99454, RTM’s 98976 and 98977 require 16+ days of data collection in the billing period. Practices without per-patient tracking routinely bill for non-qualifying periods — creating audit exposure.
98980 (first 20 minutes) and 98981 (additional 20 minutes) of clinical staff treatment management require structured documentation — who, what, how long. Reviewing app data without documenting the review cannot be billed. This is where most RTM revenue is left uncollected.
We identify eligible patients from your active therapy caseload. RTM eligibility is broader than RPM — there is no specific chronic condition requirement. We verify eligibility, obtain physician order documentation, and manage the consent workflow before the first billing period.
We manage 98975 billing — verifying setup and education documentation before billing. 98975 is a one-time code per device/software type. We track which patients have been billed and prevent the most common RTM error: monthly billing of a one-time code.
Every month, we track each enrolled patient’s data collection days by data type. Patients below 16 days are excluded from that month’s device supply billing and flagged for clinical outreach.
We work with your clinical team to establish structured documentation for RTM treatment management time. Templates built to CMS audit standards. Time must be clinical staff time under physician direction.
Eligibility verified, data days confirmed by type, documentation reviewed, claims submitted. Then: payment posting (with commercial RTM coverage tracking), denial management, and monthly RTM performance reporting.
KEY REQUIREMENT.
Device time confirmed, FDA cleared, patient education completed, and documented, Consent in medical record.
KEY REQUIREMENT.
16+ Days of Automatic device Data Transmission in the billing period (manual patient entry does not qualify.)
KEY REQUIREMENT.
20+ Minutes documented clinical stop time; must include interactive communication with patient or caregiver at least once monthly; staff member name and credential documented.
KEY REQUIREMENT.
Each additional 20-minute increment separately documented. Same requirements as 99457 for each period
KEY REQUIREMENT.
Each additional 20-minute increment separately documented. Same requirements as 99457 for each period
CMS allows both RTM and RPM to be billed for the same patient in the same calendar month, provided:
Must be ordered by a physician or qualified NPP. Order documented in medical record before the first RTM billing period.
CMS requires documented patient consent for RTM enrollment, in the medical record before billing begins.
Device/software must collect therapeutic data 16+ days in the billing period. Tracked per-patient, per-code, per-month.
At least one interactive communication with patient or caregiver each billing month for treatment management codes. Must be documented.
98980/98981 must be billed by qualified clinical staff (PT, OT, SLP, RT) under physician direction — not by the physician directly under this code set.
CMS has flagged RTM as an area of increased scrutiny given rapid adoption since 2022. Documentation must withstand audit review.
Unlike RPM, which has broad commercial payer coverage, RTM commercial coverage is still evolving. As of 2026:
Before building any RTM program, we verify coverage for every payer in the practice’s patient mix. We don’t enroll patients in RTM billing for payers with no coverage — that creates denial risk without revenue upside. Many vendors oversell commercial coverage; the result is mass denials and the wrong conclusion that “RTM doesn’t work.” Payer-first enrollment is how RTM actually works.
We'll screen your patient panel, identify who qualifies, and show you what the billing gap looks like in dollars. No obligation.
