Remote Therapeutic Monitoring (RTM) in 2026: The Most Underused Revenue Stream in Outpatient Care

Introduction (RTM Revenue Potential: $120–150 Per Patient Monthly)

Remote Therapeutic Monitoring (RTM) represents one of the most overlooked reimbursement opportunities in outpatient medicine today.

Most eligible practices are either:

• Not billing RTM at all
• Or billing it incorrectly

Yet the reimbursement potential is significant:

$120–150 per eligible patient per month

Although CPT codes were finalized in 2022 and reimbursement is now available through Medicare and commercial payers, adoption remains surprisingly low.

What Is RTM and How Is It Different From RPM?

RTM (Remote Therapeutic Monitoring) is designed to track:

• Therapeutic adherence
• Functional outcomes
• Patient-reported progress

It applies primarily to:

• Musculoskeletal conditions
• Respiratory conditions
• Cognitive behavioral health conditions

RTM vs RPM (Important Distinction)

Many clinics confuse RTM with RPM (Remote Patient Monitoring), but they are fundamentally different:

• RPM (CPT 99453–99458) requires physical devices such as:
• Blood pressure cuffs
• Glucometers
• Pulse oximeters
• RTM does NOT require devices

Instead, RTM can rely on:

• Software tracking systems
• Patient-reported outcomes
• Digital check-ins
• Clinical staff documentation

 This means many practices are already doing RTM-level work without realizing it — and without billing for it.

RTM CPT Codes Explained

CPT 98975

Remote therapeutic monitoring setup and patient education

• Billed once per episode of care
• Covers onboarding and patient enrollment

CPT 98976

Device supply code (respiratory system)

• Monthly billing code
• Requires scheduled recording

CPT 98977

Device supply code (musculoskeletal system)

• Monthly billing code
• Most commonly used in:
• Physical therapy
• Orthopedics
• Pain management

CPT 98980

Treatment management (first 20 minutes/month)

• Core billing code
• Requires documented 20 minutes of clinical staff time

CPT 98981

Additional treatment management (each extra 20 minutes/month)

• Billed alongside 98980 when time exceeds threshold

 Clinical staff (including MAs and nurses) can contribute under general supervision, but physician or NPP involvement is required.

Who Is Eligible for RTM?

RTM applies broadly across outpatient specialties, including:

• Musculoskeletal care (PT, orthopedics, sports medicine, pain management)
• Respiratory care (pulmonology, COPD, asthma, sleep medicine)
• Behavioral health (psychiatry, psychology, CBT programs)
• Addiction medicine (including MAT adherence monitoring)
• Post-surgical recovery monitoring

Key Insight:

If you are already tracking patient progress between visits or documenting adherence, you are likely already performing RTM-level care.

 RTM Revenue Breakdown

Typical reimbursement per patient per month:

$120–150 total monthly revenue

Example scaling:

• 25 patients → $3,000–$3,750/month
• 50 patients → $6,000–$7,500/month
• 100 patients → $12,000–$15,000/month
• 200 patients → $24,000–$30,000/month

 This is additional revenue, not replacement billing

 It layers on top of existing visit-based income

Common RTM Billing Questions

Can CPT 98980 and 98981 be billed together?

Yes. If documentation supports it:

• First 20 minutes = 98980
• Additional 20 minutes = 98981
• Time must be timestamped

Can non-physicians bill RTM?

Yes.

• NPs and PAs can bill under their NPI
• Clinical staff time counts toward required thresholds

Is a physical device required?

No.

RTM can include:

• Software tracking
• Patient-reported outcomes
• Digital assessments

Can RTM be billed with telehealth?

Yes.

RTM and telehealth are separate billing mechanisms and can be used in the same month.

 RTM Implementation Workflow

Successful RTM deployment requires structured execution:

1. Identify eligible patients (start with MSK and respiratory)
2. Obtain consent and bill 98975
3. Establish monthly monitoring workflow and documentation system
4. Bill 98977 / 98976 monthly
5. Track and document 20-minute thresholds for 98980
6. Add 98981 when additional time is reached
7. Perform quarterly audits for compliance and denial patterns

 The biggest failure point is inconsistent documentation.

 Payer Coverage in 2026

Medicare Coverage

Medicare reimburses the full RTM code set:

• 98975 → ~$19 (one-time setup)
• 98976 / 98977 → $45–$55
• 98980 → $48–$62
• 98981 → $38–$45

 Combined:

• $100–130 per patient/month baseline
• Up to $150+ with additional time

Commercial Insurance Coverage

Major payers covering RTM include:

• Aetna
• UnitedHealthcare
• Cigna
• Blue Cross Blue Shield plans

Coverage varies by:

• State
• Plan type
• Prior authorization requirements

Medicaid Coverage

• Limited but expanding
• Strongest adoption in value-based care states
• Requires individual plan verification

 Who Can Bill RTM?

RTM supports a broader provider base than RPM:

• Physicians
• Nurse Practitioners (NPs)
• Physician Assistants (PAs)
• Physical Therapists (for CPT 98977)
• Occupational Therapists
• Speech-Language Pathologists
• Behavioral health providers (CPT 98978 where applicable)

 This makes RTM especially valuable for PT and OT practices.

The 16-Day Compliance Rule

A key requirement:

 Patients must transmit data on at least 16 days per 30-day period

Real-world challenge:

Patient engagement declines over time:

• Week 1–2: High engagement
• Week 3–4: Drop-off in usage

Without intervention:

• Compliance drops to 60–70%
• Revenue loss: 30–40% of eligible billing

High-performing practices:

• Maintain 85–90% compliance
• Use reminders and engagement workflows

 RTM as a Clinical Quality System (Not Just Billing)

The most successful RTM programs are not purely financial systems.

They function as:

• Continuous care monitoring tools
• Early warning systems for patient decline
• Engagement platforms between visits

When patients see that clinicians actively review their data:

• Engagement increases
• Dropout decreases
• Outcomes improve

 Better clinical care directly leads to higher RTM revenue.

 Final Insight

RTM is not simply a reimbursement code set.

It is a combined:

• Clinical care model
• Patient engagement system
• Revenue expansion strategy

And in 2026, it remains one of the most underused but high-impact opportunities in outpatient medicine.

FAQ – Remote Therapeutic Monitoring (RTM)

1. What is Remote Therapeutic Monitoring (RTM)?

RTM is a healthcare billing model that tracks patient adherence and outcomes using software-based tools and patient-reported data, mainly for musculoskeletal, respiratory, and behavioral conditions.

2. What is the difference between RTM and RPM?

RTM focuses on therapeutic monitoring without requiring physical devices, while RPM (Remote Patient Monitoring) relies on medical devices like blood pressure cuffs or glucose monitors.

3. How much can practices earn from RTM billing?

On average, RTM generates around $120–150 per patient per month, depending on CPT codes billed and payer reimbursement rates.

4. Which CPT codes are used for RTM billing?

Common RTM CPT codes include 98975, 98976, 98977, 98980, and 98981, covering setup, device supply, and treatment management services.

5. Does RTM require a medical device?

No. RTM can be done using software platforms, patient-reported outcomes, and digital monitoring tools without any physical device requirement.