Remote Therapeutic Monitoring (RTM) allows physical therapy clinics to bill for monitoring patient-reported, non-physiological data between visits: pain levels, functional status, exercise completion, response to treatment, and more. CMS introduced the first RTM billing codes in 2022 for musculoskeletal and respiratory conditions, added cognitive behavioral therapy in 2024, and expanded the code set again in 2026 with lower billing thresholds that opened the program to shorter episodes of care. 

For PT clinics, RTM converts work the care team already does, prescribing a home exercise program and following up on whether the patient completes it, into a reimbursable service with its own CPT codes. 

How does Remote Therapeutic Monitoring work in physical therapy clinics? 

An RTM program runs in three stages. In setup, the clinic decides which patients to enroll, obtains consent, onboards the patient onto the app, and teaches them what to report. In data submission, the patient completes short assessments on a defined schedule, usually daily, covering pain, exercise completion, function, and more. In treatment management, the care team reviews incoming data, responds when a threshold is crossed, adjusts the treatment plan, and logs the time spent. Each stage has its own billing code. 

No wearable is required. Medicare treats FDA-listed software as the medical device for RTM, so the app itself qualifies. Our RTM product page covers the full program mechanics. 

Adherence studies put the share of patients who follow their prescribed plans somewhere between 30 and 50 percent. The rest drift, plateau, and arrive for the next appointment with little progress to show. Between visits, the clinic has no way of knowing which patient is following the treatment plan. RTM makes that visible, and clinics get reimbursed for the program. 

Can physical therapists bill RTM directly? 

Yes. This is what sets RTM apart from most Medicare remote-care programs. Physical therapists are on the CMS list of eligible RTM billers, alongside occupational therapists and speech-language pathologists. You bill under your own NPI. No physician has to order the service or co-sign anything. 

When a therapist furnishes RTM, the services fall under the therapy plan of care and carry the GP modifier, the same two-letter claim tag you already use on your other PT services (GO for OT, GN for SLP). RTM also extends well beyond rehab. Clinics in pain management, behavioral health, and respiratory care run RTM programs on the same code set. 

What changed for RTM on January 1, 2026? 

RTM billing codes come in two families. Device codes pay for supplying the app and collecting the data, and they require the patient to submit data on a minimum number of days per month. Treatment management codes pay for your team's time reviewing the data, and they require a minimum number of minutes per month. 

Until this year, those minimums were steep. A patient had to submit data on at least 16 of 30 days, or the clinic billed nothing for the device supply. Your team had to log at least 20 minutes, or the time paid nothing. 

The 2026 Final Rule lowered both floors. A new device code pays after just 2 days of data in a 30-day period, and a new treatment management code pays for the first 10 to 19 minutes of clinical time. Patients who only need two or three weeks of monitoring after surgery now fit the program. A month where your therapist spent 15 minutes on a stable patient is billable now too. 

The full 2026 RTM code set, with billing frequencies and reimbursement rates, is in our complete RTM guide. 

How much does RTM pay per patient? 

Up to $180 per enrolled patient per month. The device supply code bills $51.44 for a month of collected data, and the first 20 minutes of treatment management bills $54.11. Each additional 20-minute block adds $41.42, and the one-time setup code adds $21.71 at enrollment. 

A clinic with 100 enrolled patients adds roughly $18,000 in monthly Remote Therapeutic Monitoring revenue, most of it for clinical work the care team was already doing before it was billable. 

What is the difference between RTM and RPM? 

Remote Patient Monitoring (RPM) covers physiological data, such as blood pressure or glucose, and requires a connected device that transmits readings automatically. Remote Therapeutic Monitoring covers non-physiological data the patient reports themselves, and software counts as the device. RPM mostly runs through physician billing. RTM was written with therapists on the eligible provider list. 

The data that drives rehab decisions, pain, function, and exercise compliance, is patient-reported, so most PT caseloads fit RTM. You cannot bill RTM and RPM for the same patient in the same month. 

Does RTM improve outcomes? 

A retrospective case-control study published in 2025 compared MSK patients who received in-person physical therapy with RTM against matched patients who received in-person care alone. The RTM group had better functional outcomes and stronger plan-of-care adherence. Patients who report pain and function daily stay connected to their plan, and therapists catch deterioration in days instead of at the next visit. We covered the broader outcomes data in how RTM improves patient outcomes compared to traditional methods. 

Which patients should you enroll first? 

Patients with a defined episode of care and a home exercise program attached to it. Post-surgical patients are a good example: a patient recovering from a rotator cuff repair has a clear start date, a protocol the therapist already prescribes, and a recovery window where daily pain and function data changes clinical decisions. Low back pain patients are another strong group, because their episodes run longer and their home program compliance is harder to see from the clinic. 

This is also not a decision you make alone. During launch, the implementation team at Actuvi, profiles your patient panel with you and helps clinics identify the patients who will benefit most from monitoring. 

Can PTAs do the RTM work? 

Yes. PTAs can furnish RTM treatment management under general supervision. 

When a PTA performs the service, add the CQ modifier to the treatment management codes. Like the GP modifier, it is a claim tag, and this one tells Medicare an assistant furnished the service. When a COTA performs it, use the CO modifier. The modifiers go on treatment management only, never on the setup or device codes. 

CMS designated the 10-minute management code and the 2-to-15-day device codes as “sometimes therapy” codes. They count toward the annual therapy threshold, the yearly spending level where Medicare starts asking for extra justification on outpatient therapy claims. They are exempt from the Multiple Procedure Payment Reduction, the discount Medicare applies when several therapy procedures land on the same day. And when an assistant furnishes them, the CQ or CO modifier is required. 

Frequently asked questions about RTM

Do patients need a smartphone? Most patients use the app on their own phone, and the Actuvi AI Agent can deliver assessments over SMS for patients who never open apps. For patients who cannot use a phone at all, Guardian Access lets a family member or caregiver submit data on their behalf. 

Does RTM count toward the Medicare therapy threshold? The sometimes-therapy codes count toward the annual threshold, and the Multiple Procedure Payment Reduction does not apply to them. 

What do commercial payers and Medicare Advantage pay? Medicare Advantage plans generally follow Medicare's coverage. A growing number of commercial payers and state Medicaid programs reimburse RTM, but coverage varies by payer and state, so verify before enrolling a non-Medicare patient. 

Is RTM the same as telehealth? No. Telehealth replaces an in-person visit with a video session. RTM covers the monitoring work between visits, and it runs alongside regular in-person therapy for the same patient. 

Can more than one provider bill RTM for the same patient? No. The device and treatment management codes are billable by one provider per patient per period. If a second provider submits a claim for the same patient in the same window, the first claim in wins and the second is denied. Coordinate before enrolling a patient who may already be monitored elsewhere. 

Does time spent during an in-person visit count toward treatment management? No. Treatment management minutes cover work done outside the visit, such as reviewing submitted data and adjusting the treatment plan. Time already billed under a therapy code cannot be counted again as RTM time. 

How long can a patient stay on RTM? As long as monitoring remains medically necessary and documented.  

More answers, including state-specific and payer-specific questions, are in our RTM FAQ, 2026 edition.