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2026/04/29•HEMSCap Content Writer
Remote Therapeutic Monitoring (RTM) in 2026: Billing Guide, CPT Codes, Revenue, and Eligibility
Introduction
$120–150 Per Eligible Patient Per Month: Why RTM Matters
Remote Therapeutic Monitoring (RTM) remains one of the most underused revenue opportunities in outpatient medicine. CPT codes were finalized in 2022, and reimbursement is available across commercial payers and Medicare. However, many practices that qualify are still not billing correctly or not billing at all.
With potential reimbursement of $120–150 per eligible patient per month, RTM can create a valuable recurring revenue stream while supporting better patient engagement and outcomes.
What Is RTM and How Is It Different From RPM?
RTM stands for Remote Therapeutic Monitoring. It is designed for monitoring therapeutic adherence and outcomes for:
- Musculoskeletal conditions
- Respiratory conditions
- Cognitive behavioral conditions
RTM is different from Remote Patient Monitoring (RPM).
RPM (CPT 99453–99458) requires physiological measurement devices such as:
- Blood pressure cuffs
- Glucometers
- Pulse oximeters
RTM does not require hardware. It can be delivered through:
- Patient-reported outcomes
- Software-based tracking
- Clinical staff engagement
This distinction is important because many practices assumed RTM required device investment and ignored the opportunity. In reality, if your team already checks in on patients between visits, tracks adherence, or documents patient-reported outcomes, you may already be doing the work 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 the patient to the monitoring program
CPT 98976
Device supply with scheduled recording for the respiratory system.
- Monthly supply code
CPT 98977
Device supply with scheduled recording for the musculoskeletal system.
- Monthly supply code
- Commonly used by physical therapy, orthopedics, and pain management practices
CPT 98980
Treatment management services, first 20 minutes of clinical staff time per calendar month.
- Primary ongoing billing code
- Requires 20 minutes documented per month per patient
CPT 98981
Treatment management services, each additional 20 minutes per calendar month.
- Can be billed in addition to 98980 when time is documented
Codes 98980 and 98981 require a physician or NPP to review and participate in management, but the 20 minutes may be accumulated by clinical staff under general supervision.
Who Qualifies for RTM?
RTM can be used across many outpatient specialties. Eligible patient groups include:
- Musculoskeletal patients — physical therapy, orthopedics, pain management, sports medicine
- Respiratory patients — pulmonology, primary care managing COPD or asthma, sleep medicine
- Cognitive behavioral therapy patients — psychiatry, psychology, behavioral health
- Addiction medicine patients on medication-assisted treatment (MAT)
- Post-surgical patients requiring therapeutic monitoring during recovery
If there is a clinical reason to monitor therapeutic adherence between visits and the activity is documented, the patient may qualify.
RTM Revenue Math
Reimbursement varies by payer and geography, but common combined monthly revenue per enrolled patient (98977 + 98980) runs $120–150 under Medicare and similar commercial rates.
Example Monthly Revenue
- 25 enrolled patients: $3,000–3,750/month
- 50 enrolled patients: $6,000–7,500/month
- 100 enrolled patients: $12,000–15,000/month
- 200 enrolled patients: $24,000–30,000/month
This is additional revenue on top of existing visit-based billing.
Common RTM Billing Questions
Can I bill 98980 and 98981 in the same month?
Yes. If both time thresholds are met:
- First 20 minutes = 98980
- Each additional 20 minutes = 98981
Documentation should include timestamps.
Can non-physicians bill RTM?
Yes. Nurse practitioners and physician assistants may bill under their own NPI with general physician supervision. Clinical staff time can count toward the 20-minute threshold.
Does the patient need a physical device?
Not necessarily. RTM supports software-based monitoring and patient-reported outcomes.
Is RTM compatible with telehealth billing?
Yes. RTM and telehealth are separate billing events and may occur in the same month.
How to Implement RTM Successfully
A strong RTM workflow usually follows this sequence:
- Identify eligible patients in your current panel
- Start with musculoskeletal and respiratory populations
- Enroll patients with documented consent and bill 98975
- Create a monthly monitoring workflow
- Bill 98977 (or 98976) monthly for the supply component
- Bill 98980 when 20 minutes of staff time is documented
- Add 98981 when the second 20 minutes is reached
- Audit quarterly for billing accuracy and denial trends
The biggest implementation risk is weak documentation. Time logs should include start time, end time, and activity type.
Payer Coverage in 2026
Medicare Coverage
Medicare covers the full RTM code set under the Medicare Physician Fee Schedule. Rates are geographically adjusted but generally include:
- 98975: $19
- 98976 / 98977: $45 to $55
- 98980: approximately $48 to $62
- 98981: approximately $38 to $45
The combination of 98977 + 98980 creates baseline monthly RTM revenue of $100 to $130 per patient under Medicare, while 98981 can add another $38 to $45 in months with additional documented management time.
Commercial Payers
Coverage expanded significantly after RTM codes were introduced in 2022. Major payers with published RTM coverage policies as of 2026 include:
- Aetna
- UnitedHealthcare
- Cigna
- Most regional Blue Cross Blue Shield plans
Coverage specifics vary by plan.
Medicaid Coverage
A growing number of Medicaid managed care plans cover RTM, especially in value-based care states. Coverage has expanded steadily since 2023.
Who Can Bill RTM?
RTM may be billed by:
- Physicians
- NPs
- PAs
- Physical therapists billing under their own NPI for musculoskeletal RTM (CPT 98977)
- Occupational therapists
- Speech-language pathologists
- Licensed clinical social workers and behavioral health providers for CPT 98978
This is a major advantage over RPM, which is more limited in provider eligibility.
The 16-Day Compliance Requirement
Patients must transmit monitoring data on at least 16 of the 30 days in the billing period.
This is one of the most common reasons practices miss reimbursement.
Many patients engage heavily in week one, then participation declines later in the month. Without follow-up, a patient may reach day 20 with only 11 to 12 days of data logged — below the 16-day threshold.
High-Performing Practices
Practices that use reminders and re-engagement workflows often maintain 85 to 90 percent compliance rates.
Practices without systems commonly see only 60 to 70 percent compliance, losing 30 to 40 percent of potential device supply revenue.
RTM as a Clinical Quality Improvement Tool
The best RTM programs are not focused only on billing. They use monitoring data to:
- Catch concerning trends early
- Follow up when pain scores rise
- Adjust treatment plans between visits
- Improve adherence and outcomes
When patients know their data is being reviewed, engagement improves. Better engagement supports stronger retention and more consistent RTM revenue over time.
Final Thoughts
Remote Therapeutic Monitoring combines clinical value with recurring reimbursement. For many outpatient practices, RTM represents a missed opportunity that can improve care while generating $120–150 per eligible patient per month.
Practices that execute RTM well are not only improving billing performance — they are building a stronger clinical care model for 2026 and beyond.
FAQ – Remote Therapeutic Monitoring (RTM)
1. Who is eligible for Remote Therapeutic Monitoring (RTM)?
RTM is commonly used for patients with musculoskeletal, respiratory, and behavioral health conditions who need monitoring between visits.
2. How much does RTM reimburse per patient?
Many practices receive $120–150 per eligible patient per month, depending on payer rates and billed CPT codes.
3. Does RTM require a medical device?
No. RTM can use software platforms, digital questionnaires, and patient-reported outcome tools without requiring physical devices.
4. Can physical therapists bill RTM services?
Yes. Physical therapists may bill eligible RTM services, especially for musculoskeletal monitoring under applicable CPT codes.
5. How many days of data are needed for RTM billing?
Patients generally need monitoring data on at least 16 of the 30 days in the billing period to meet common compliance requirements.
