RTM pays for tracking non-physiologic patient data between visits, musculoskeletal status, respiratory function, therapy adherence. The clinical case is straightforward. The billing rules are not, and three of them decide whether a program can be billed at all, before a single feature matters.
We build remote therapeutic monitoring software around your requirements from custom RTM solutions to workflows designed around your billing rules.
Talk to Us About Your RTM BuildStreamline patient enrollment, ongoing monitoring, and billing documentation with an RTM workflow designed for your organization's needs.
Set up eligible patients and capture the information needed to start their RTM program.
Track patient progress, communicate with patients, and manage ongoing therapy activities from one workflow.
Track RTM activity, monitoring milestones, and supporting documentation needed for billing workflows.
A workflow built around the mechanics that determine whether an RTM program gets reimbursed, not just whether it runs.
Confirm the patient isn't already enrolled in remote physiologic monitoring elsewhere, capture timestamped consent, and set up their RTM program. No established patient relationship required.
Provision the device or app, walk the patient through how to log symptoms, exercises, and pain scores, and confirm first data transmission, flagged within days if setup stalls, not at month's end.
Track patient-reported and device-captured data between visits: pain levels, exercise completion, functional progress, and respiratory or musculoskeletal status.
Surface the patients who need attention today versus those who can wait for their next visit, and log every interactive communication, call, secure message, async chat, or AI prompt, against the monthly requirement.
Count transmission days continuously against the 2–15 and 16–30 day bands, apply one device code per patient per period, and keep an audit-ready record of consent, communication, and monitoring milestones.
RTM's enrollment rule is the opposite of the one most teams assume, because they carry it over from remote physiologic monitoring.
CMS guidance (MLN901705) is specific: remote physiologic monitoring, but not RTM, requires an established patient relationship. A practice can enroll a patient it hasn't previously treated, which widens the eligible population and changes what intake needs to collect.
Consent: what it needs to include, and whether verbal is sufficient, is one of the most common questions providers ask about RTM, and one of the least addressed by vendor software. Capturing consent as a timestamped, auditable event closes that gap.
A patient who never completes device provisioning, app install, and first data transmission generates no billable period and no clinical data. That has to be flagged within days of stalling, not surfaced for the first time at month-end billing review, while the practice can still recover the patient.
What runs between visits is the program. Therapy adherence, reported pain, and functional progress arrive on days the practice never sees the patient. Alert triage separates the patient who needs a call today from the one who can wait for the next scheduled visit.
Four new RTM codes took effect January 1, 2026. A billing-accurate platform needs to reflect all of them, not just the two most commonly cited.
| Code | Description |
|---|---|
| 98975 | Initial set-up and patient education, one time per episode of care |
| 98976 | Device supply, respiratory system, 16–30 days |
| 98977 | Device supply, musculoskeletal system, 16–30 days |
| 98980 | Treatment management, first 20 minutes in a calendar month |
| 98981 | Treatment management, each additional 20 minutes (add-on code) |
| 98984New CY2026 | Device supply, respiratory system, 2–15 days |
| 98985New CY2026 | Device supply, musculoskeletal system, 2–15 days |
| 98986New CY2026 | Device supply, cognitive behavioral therapy, 2–15 days, contractor-priced; no national rate exists |
| 98979New CY2026 | Treatment management, first 10 minutes |
The 2–15 day device codes pay the same as the 16–30 day codes; they remove a revenue cliff, not a discounted tier. One device supply code applies per patient per 30-day period, regardless of how many conditions are being monitored.
Flags a prior RPM or RTM enrollment at intake, before the device ships.
Continuous, timestamped tracking against the 2–15 and 16–30 day bands, not a month-end reconstruction.
Records which contact, call, secure message, async chat, AI prompt, satisfied the monthly requirement, and when.
An auditable consent event, built to survive a payer audit.
Separates patients needing same-day outreach from those who can wait, so clinical attention scales with caseload.
HL7 v2 / FHIR R4 integration to Epic, Oracle Health, athenahealth, and therapy-specific records.
Tell us where RTM fits in your product, and we'll map the rent, configure, or build path that matches it.
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No. CMS states that remote physiologic monitoring and RTM cannot be billed together, and it declined to change this for 2026 after being asked to. You may bill one of them alongside chronic care management, transitional care management, behavioral health integration, principal care management, or chronic pain management, provided time and effort are not counted twice. A separate rule limits remote monitoring to one billing practitioner per patient per 30-day period.
Coverage is not Medicare only, but it is not uniform either. Several commercial payers publish their own clinical policies for remote therapeutic and physiologic monitoring, with their own criteria for which codes are covered and under what conditions. Treat payer coverage as a per-contract question at implementation rather than a category-level assumption, and build the platform so covered code sets are configurable per payer.
Consent must be obtained and documented before services begin. What matters for software is that the consent is captured as an auditable event carrying a timestamp and the identity of who obtained it, because a checkbox with no history is exactly what an audit will not accept. Confirm the specific form your customers' payers require during implementation.
Yes, provided the monitoring addresses an underlying condition not linked to the procedure covered by the global period. This matters for orthopedic and post-surgical rehabilitation programs, where a blanket exclusion of patients inside a global period would remove a large share of the eligible population unnecessarily.
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