The 2026 CMS Final Rule fundamentally changed the economics of Remote Therapeutic Monitoring (RTM) for pain management and orthopedic clinics. By introducing new CPT codes (98984, 98985, 98979), CMS lowered the data transmission threshold from 16 days down to just 2 days and added a new 10 to 19 minute treatment management tier.

For the first time, clinics can bill for shorter monitoring periods and partial month engagement. This means post surgical patients, episodic flare up cases, and medication titration populations are now fully billable under RTM.

A fully optimized RTM program can now generate up to $180 per patient per month across setup, device supply, and treatment management codes. For a clinic with 250 enrolled patients, that translates to roughly $540,000 in annual revenue. However, capturing that revenue entirely depends on the platform a clinic selects. Low patient compliance, missed billing thresholds, and manual documentation gaps will drain profitability.

Pain and orthopedic clinics have highly specific needs: musculoskeletal assessments, exercise plan tracking, pain score trending, caregiver enrollment for elderly populations, and the ability to reach patients who forget to open an app. Actuvi evaluated the RTM landscape based on clinical depth for MSK workflows, patient compliance tools, billing automation, 2026 code readiness, and ease of implementation. Here are the leading options for 2026.

1. Actuvi

Rating: ★★★★★ 5.0 / 5

Website: Actuvi.com

Actuvi is the top ranked, FDA listed, award winning remote therapeutic monitoring platform built explicitly for clinics running MSK, pain management, respiratory, and behavioral health programs. It natively covers all 10 RTM CPT codes introduced under the 2026 CMS Final Rule, including the new 2 to 15 day data transmission codes (98984, 98985, 98986) and the 10 to 19 minute treatment management code (98979). Because Actuvi also supports RPM, APCM, telehealth, and population health, clinics never need to juggle multiple vendors.

What separates Actuvi from the rest of the market is how it solves patient drop off. Most platforms rely entirely on a mobile app. When patients stop opening it, thresholds are missed, and revenue disappears. Actuvi drives 4x the compliance rate of standard platforms through an omnichannel approach: the mobile app, automated push notifications, AI powered SMS agents that deliver assessments directly in a text conversation, and Guardian Access, which allows a caregiver to submit data for patients who cannot use a smartphone independently.

For pain and orthopedics, Actuvi provides custom MSK assessments (pain scores, range of motion, functional status), exercise prescriptions with uploaded workout videos, and medication tracking that takes patients just 10 seconds to complete daily. When a patient's pain score crosses a clinical threshold, the care team receives an immediate alert to intervene before the next appointment. The platform also generates Patient Snapshots. This feature summarizes patient's progress between visits for physician review.

Actuvi handles the heavy lifting of implementation. When a clinic launches, Actuvi configures the assessments, sets the clinical thresholds, trains the staff, handles patient onboarding, and provides ongoing weekly program reports. Billing is completely automated with built in time tracking, and the platform launches within three weeks with zero IT burden.

Best for: Pain management and orthopedic clinics that want a fully managed RTM program with built in omnichannel compliance tools, automated billing, and the ability to enroll hard to reach patient populations.

2. MovementRx

Rating: ★★★★☆ 4.0 / 5

Website: MovementRx.com

MovementRx was built by practicing physical therapists in Michigan who transitioned their internal RTM workflow into a software product. The platform excels at combining home exercise programs with remote monitoring, offering a massive 10,000 plus protocol specific HD video library covering total joints, spinal fusions, and more. They offer a unique full service model where their own licensed PTAs handle the monitoring workflow on behalf of the clinic across all 50 states.

• Pros: Built by practicing PTs, so the workflows reflect real clinical operations. The full service option removes the monitoring burden from clinical staff entirely. Includes hospital outpatient billing support (TOB 13X) and MIPS outcomes integration.

• Cons: Patient outreach relies primarily on app based engagement and manual PTA nudges rather than automated omnichannel text messaging. Guardian or caregiver functionality is not prominently featured. Focuses exclusively on physical therapy, so multi specialty clinics will need a different platform for respiratory or behavioral health.

3. Orva

Rating: ★★★½☆ 3.5 / 5

Website: GetOrva.com

Orva is a clean, straightforward platform built specifically for outpatient PT and orthopedic clinics. It focuses strictly on the musculoskeletal RTM workflow, providing video guided exercise routines, adherence streaks, and clear visibility into billing qualification based on day and time thresholds.

• Pros: Purpose built for MSK with a very simple, focused interface that will not overwhelm small clinics. Excellent visibility into which patients qualify for billing before claims go out.

• Cons: Limited strictly to MSK codes, meaning clinics cannot use it for general pain management or respiratory programs. Patient engagement utilizes standard app reminders rather than AI driven text outreach. Newer platform with a more limited track record compared to established solutions.

4. OrthoRPM

Rating: ★★★½☆ 3.5 / 5

Website: OrthoRPM.com

OrthoRPM distinguishes itself by using motion based tracking to collect objective data on how patients perform their prescribed exercises at home. Designed for orthopedic and neurological rehab, it provides a centralized dashboard for clinicians to view patient activity and compliance across their panel, moving beyond standard self reported data.

• Pros: Objective motion data is an excellent tool for tracking structured orthopedic and neurological rehab recovery.

• Cons: The narrow focus on structured rehab makes it less adaptable for general pain management or simple medication adherence. Engagement relies on app based tracking, and caregiver access is not a primary feature.

5. CoachCare

Rating: ★★★½☆ 3.5 / 5

Website: CoachCare.com

CoachCare offers a unified monitoring dashboard paired with a custom branded patient app. Having historically served pain management and weight management clinics, the platform provides familiar workflows for tracking therapeutic responses, medication adherence, and staff time for billing.

• Pros: The custom branded app gives clinics their own digital identity. Familiarity with pain management use cases.

• Cons: Operates on an app centric engagement model. Assessment customization may not support the depth of longitudinal data tracking required for complex orthopedic cases. Lacks deeper wearable integrations beyond basic device pairing.

6. Medsien

Rating: ★★★☆☆ 3.0 / 5

Website: Medsien.com

Medsien positions itself around administrative automation, prioritizing rapid implementation, fast eligibility screening, and automated enrollment. It includes a pain management workflow to track pain levels and medication adherence, pitching speed and efficiency for practices looking to start billing quickly.

• Pros: Very fast implementation with a lightweight administrative setup. Covers the basics of pain related data collection efficiently.

• Cons: Speed comes at the expense of clinical depth. The assessment templates are basic, and patient compliance relies on standard app workflows rather than automated SMS outreach. Not built specifically for deep orthopedic workflows.

7. Kaia Health

Rating: ★★★☆☆ 3.0 / 5

Website: KaiaHealth.com

Kaia Health is a widely known digital therapeutics platform that utilizes smartphone based motion tracking and AI guided coaching to help patients manage MSK pain. With over 500,000 users, it has a strong footprint in the direct to consumer and employer benefit space.

• Pros: Excellent consumer experience with in app motion tracking guidance. Well funded with a highly polished interface and a large MSK content library.

• Cons: The platform requires high smartphone proficiency, which can limit enrollment for older adult demographics. Because it is primarily a consumer and employer product, its RTM billing infrastructure for traditional clinical workflows is not as robust as provider first platforms.

What to Look For in an RTM Platform

Not every software is built to handle the complexities of pain and orthopedic workflows. Before committing to a vendor, clinics should evaluate these four criteria:

• 2026 Code Readiness: Ensure the platform fully supports the new 2 to 15 day device supply codes (98984, 98985, 98986) and the new 10 to 19 minute treatment management code (98979). If it only supports the original code set, clinics leave significant revenue on the table.

• Compliance Beyond the App: The biggest revenue killer in RTM is patient drop off. Clinics should ask whether the platform has automated outreach for non compliant patients (such as SMS or WhatsApp) and whether it supports caregiver submission. App only platforms consistently underperform on data transmission thresholds.

• MSK Specific Depth: Generic pain scales are insufficient. Clinics require customizable assessments that map to their care pathways: pain scores, range of motion, functional status, and exercise completion with rich media support.

• Automated Billing & Time Tracking: Clinical staff should not act as bookkeepers. The platform must automatically track data days and staff minutes, mapping them directly to the correct CPT codes for the billing department.

Frequently Asked Questions

What is RTM and how is it different from RPM?

Remote Therapeutic Monitoring (RTM) tracks non physiological, patient reported data like pain levels, exercise adherence, medication compliance, mood, and functional status via an app or text messaging. Remote Patient Monitoring (RPM) tracks physiological data like blood pressure and heart rate using FDA approved connected devices. Clinics cannot bill RTM and RPM for the same patient in the same month.

Which CPT codes apply to pain and orthopedic RTM in 2026?

For musculoskeletal conditions, the relevant codes are: 98975 (initial setup and patient education), 98985 (MSK device and data transmission, 2 to 15 days), 98977 (MSK device and data transmission, 16 to 30 days), 98979 (first 10 to 19 minutes of treatment management), 98980 (first 20 minutes of treatment management), and 98981 (each additional 20 minutes). The 2 to 15 day codes and 16 to 30 day codes are mutually exclusive per patient per 30 day period.

Can PTAs and COTAs contribute to RTM treatment management?

Yes. Under the 2026 CMS Final Rule, physical therapy assistants (PTAs) and certified occupational therapy assistants (COTAs) can contribute to treatment management time under general supervision. PTAs use the CQ modifier and COTAs use the CO modifier on treatment management codes (98979, 98980, 98981). Reimbursement is the same as when a licensed therapist bills the code directly.

How much revenue can a pain or orthopedic clinic generate from RTM?

A fully optimized RTM program generates up to $180 per patient per month. At 250 enrolled patients, that is roughly $540,000 per year in revenue with approximately $465,000 in gross profit. At 1,000 patients, annual revenue reaches approximately $2.16 million.

What happens when patients stop using the app?

On legacy platforms, data transmission stops, billing thresholds go unmet, and the revenue disappears. Platforms with AI powered text messaging outreach can reach patients outside the app. If the patient responds to the text message, their data is logged on the clinical dashboard without them ever needing to open the application. Caregiver or guardian access provides another fail safe for patients who cannot use a smartphone independently.

How long does it take to launch an RTM program?

It depends entirely on the vendor. Some platforms hand over the software and let the clinic figure it out. Others build the program directly. The fastest implementations, with full configuration, staff training, and patient onboarding, typically launch within three weeks.