Frequently Asked Questions

What is remote therapeutic monitoring (RTM)?

RTM is a new clinical modality for treating patients that revolves around the collection of clinically relevant nonphysiologic data from patients about their therapy adherence or treatment effect of care plans that relate to the musculoskeletal (MSK) system, the respiratory system, or cognitive behavioral therapy.

The term “nonphysiologic” is just a fancy way of saying that these data do not include objectively measurable properties of the body—like weight or serum glucose. When monitoring physiologic data, a related but distinct modality called remote physiologic monitoring (RPM) applies instead.

How is RTM reimbursed for outpatient therapy clinics?

RTM reimbursement obtains via the RTM CPT codes that Medicare began paying in 2022. Think of these codes in two different categories: (1) patient data codes; and, (2) provider time codes.

The patient data codes provide reimbursement when patients transmit clinically relevant, nonphysiologic data on at least two days in a 30-day period. There is a generic setup code (98975) and then two device codes for each system supported by RTM codes:

98985: Musculoskeletal system, transmissions on 2–15 days in 30-day period
98977: Musculoskeletal system, transmissions on 16–30 days in 30-day period
98984: Respiratory system, transmissions on 2–15 days in 30-day period
98976: Respiratory system, transmissions on 16–30 days in 30-day period
98986: Cognitive behavioral therapy, transmissions on 2–15 days in 30-day period
98978: Cognitive behavioral therapy, transmissions on 16–30 days in 30-day period

The provider time codes allow reimbursement when providers spend time rendering skilled work directly attributable to a patient in supporting the program. This includes the time spent configuring and updating the home exercise program (HEP), time spent monitoring patient data and writing clinical notes, and time spent interacting with the patient in-between clinic visits (e.g., phone calls). Reimbursement begins after rendering 10 minutes in a calendar month (98979), increases after rendering 20 minutes (98980), and increases further still with each additional 20 minutes (98981).

Which providers can bill RTM?

The RTM codes were developed with outpatient therapy providers in mind, specifically physical therapists. However, many providers can use RTM. These include but are not limited to:

Physical therapists
Occupational therapists
Speech-language pathology therapists
Physicians
Physician assistants

Both physical therapy assistants (PTAs) and occupational therapy assistants (OTAs) can monitor patients on behalf of a PT or OT, respectively; however, they are not permitted to conduct RTM independently. When therapy assistants (like PTAs or OTAs) work on behalf of therapists (PTs and OTs), general supervision requirements apply, which is less stringent than direct supervision.

Can providers use auxiliary staff to monitor on their behalf?

Physicians who conduct RTM can have auxiliary staff perform monitoring duties on their behalf provided that the staff have clear instructions from the physician about how to perform their monitoring duties.

When therapists conduct RTM, on the other hand, they must have appropriate therapy personnel conduct monitoring on their behalf. This means a PT could have a PTA perform the monitoring duties, but a PT could not use an OTA or unlicensed staff for this purpose.

How does RTM fit into existing workflows?

RTM can be incorporated into outpatient therapy workflows with minimal disruption when the RTM program is elaborated around existing clinical practices, such as the home exercise program.

Therapy providers are already expected to provide exercise assignments to patients for independent performance, so the time it takes to perform the assignment is already “baked in” to clinical workflows. The only “extra work” created by RTM involves the submission of claims, which can be eliminated via EMR integration.

ptMantra supports FHIR-based APIs for EMR integration to facilitate patient and provider registration, clinical note exchange, and claims submission.

How much professional time is needed from clinicians for RTM?

Providers qualify for time-based reimbursement after 10 minutes of treatment management services (TMS) in a calendar month. TMS is a fancy way of saying the duration of skilled services directly attributable to an individual patient (e.g., a phone call with the patient about the program). There is additional reimbursement opportunity after spending 20 minutes and again with each additional 20-minute period.

How much administrative time is needed from support staff for RTM?

Support staff have minimal requirements for RTM. This might involve front desk support for patient registration or biller support for manual claims submission. These inputs can be greatly reduced via EMR integration.

Which patients are ideal candidates for RTM / ptMantra?

Any patient with a musculoskeletal condition that is provided a home exercise program is a candidate for RTM, provided they have a smartphone or tablet. Patients who lack the ability to download the ptMantra app can still be provided paper packets via ptMantra, however the tracking and documentation needed for RTM would not apply to these patients.

How does RTM improve patient adherence?

It is important to know which patients are doing their exercise homework, to what extent, and how these exercises are experienced by them in terms of exercise form, pain, and difficulty.

ptMantra promotes patient adherence in two distinct ways. By making it easy for patients to understand how to do their exercises (via 3D animations), when to do their exercises (via app notifications), and that their exercise adherence is being monitored by their therapist (Hawthorn Effect), patient adherence is not only revealed by ptMantra but also influenced by ptMantra.

Does RTM replace in-person visits?

Think of RTM as adding clinical value in between in-person visits. RTM does not displace any in-person visits, such as when there are annual therapy visit caps asserted by the insurance benefit. However, when insurance caps are predicated in terms of annual therapy spend, RTM could displace in-person visits.

That said, often with RTM providers find that they can reduce the number of in-person visits needed to deliver appropriate care to their patients. This is particularly true for traveling therapists, who can safely reduce the number of in-home visits given the enhanced visibility they enjoy via the RTM program.

Is there any patient liability for RTM?

There may be patient liability for RTM services depending on the patient’s insurance plan and their medical spend year-to-date. For example, those with traditional Medicare coverage will be responsible for 20% of the reimbursement after meeting the annual deductible for Part B services ($283 in 2026). Some patients will not have any cost exposure, as happens when RTM is covered and the patient has met their out-of-pocket maximum for the year. Regarding patients who are uninusred or whose insurance plan does not cover RTM, they would be responsible for paying the full RTM charges.

Ready to get started?