How Does RTM Work?

The healthcare industry has undergone a massive digital transformation in recent years. With the advent of telemedicine and wearable devices, patients can now receive continuous care without ever setting foot in a hospital. One of the most groundbreaking advances in this realm is Remote Therapeutic Monitoring (RTM).

Introduced by the Centers for Medicare & Medicaid Services (CMS) in 2022, RTM is an evolution of Remote Patient Monitoring (RPM) but with a distinct focus—tracking non-physiological data related to therapy adherence, response, and progress, particularly in the management of musculoskeletal, respiratory, and behavioral health conditions.

This article takes a deep dive into how RTM works in healthcare, how it benefits providers and patients, and what the future looks like for this innovative care model.

What Is Remote Therapeutic Monitoring (RTM)?

Remote Therapeutic Monitoring (RTM) is a set of Medicare-reimbursable services that allow healthcare providers to remotely monitor a patient’s therapeutic progress through digital tools, including mobile apps and wearable technologies. Unlike Remote Patient Monitoring (RPM), which focuses on physiological metrics like heart rate or blood pressure, RTM deals with non-physiological data, such as:

• Medication adherence

• Therapy completion

• Pain levels

• Physical activity

• Respiratory function (like inhaler usage)

• Mental health status

RTM is specifically designed for non-physician providers like physical therapists, occupational therapists, clinical psychologists, and nurses, expanding the scope of remote care delivery.

Types of Remote Therapeutic Monitoring in Healthcare

1. Medication Adherence Monitoring: Utilizes digital tools like smart pill bottles and mobile applications to track if patients are taking their medications as prescribed. This data helps healthcare providers identify non-adherence patterns and intervene promptly.​

2. Physical Activity Monitoring: Employs wearable devices and smartphone sensors to monitor patients' physical activity levels, which is crucial for conditions like obesity, diabetes, and cardiovascular diseases. The collected data assists in tailoring personalized exercise programs and tracking progress.​

3. Symptom Tracking: Involves patient-reported outcomes collected through mobile apps or web platforms to monitor symptoms such as pain levels, fatigue, or mood changes. This real-time data enables timely adjustments to treatment plans.​

4. Cognitive and Mental Health Monitoring: Utilizes digital assessments and interactive applications to monitor cognitive functions and mental health status, aiding in the management of conditions like depression, anxiety, and dementia.​

5. Rehabilitation Progress Tracking: Incorporates telerehabilitation platforms that allow therapists to remotely monitor patients' adherence to rehabilitation exercises and recovery progress, particularly beneficial for post-operative care and chronic musculoskeletal conditions. These platforms often include video demonstrations, progress tracking, and direct communication channels between patients and therapists. 

6. Chronic Disease Management: Encompasses the use of mobile health (mHealth) applications and wearable devices to monitor and manage chronic diseases such as diabetes, hypertension, and chronic obstructive pulmonary disease (COPD). These tools facilitate continuous monitoring, patient education, and timely interventions, leading to improved health outcomes. 

RTM vs. RPM: Understanding the Difference

Aspect	RTM	RPM
Focus	Non-physiological data	Physiological data
Common Use Cases	MSK therapy, behavioral health, asthma	Hypertension, diabetes, heart disease
Eligible Providers	Therapists, psychologists	Physicians, nurse practitioners
Device Requirements	Software (e.g., mobile apps)	FDA-cleared monitoring devices
Patient Interaction	Therapy engagement, adherence	Vital sign collection

The Core Components of RTM

For RTM to function effectively, several components must come together seamlessly. Here's how the system works:

1. Digital Therapeutic Tools and Apps

Patients are provided with mobile apps or other digital tools that track therapeutic activities and outcomes. These tools might record:

• Daily pain scores

• Physical therapy completion

• Usage of respiratory devices like inhalers

• Mental health journaling or check-ins

Example: A physical therapy app may prompt a patient to complete daily stretching exercises and record pain levels before and after.

2. Data Collection and Transmission

The data is automatically collected and transmitted to the healthcare provider through secure, HIPAA-compliant platforms. These platforms allow the care team to:

• Monitor trends

• Identify non-compliance

• Adjust treatment plans

3. Provider Review and Interpretation

Licensed clinicians, such as physical therapists or psychologists, regularly review the incoming data. If issues arise—like increased pain or skipped therapy sessions—they can intervene early.

4. Patient Engagement and Education

RTM systems often include interactive educational content to keep patients engaged. Reminders, video tutorials, and gamification features help improve therapy adherence.

5. Documentation and Billing

Providers must document the time spent on RTM activities to ensure proper reimbursement under CMS rules. There are specific CPT codes assigned to RTM, including:

• 98975: Device setup and patient education

• 98976/98977: Supply of monitoring device (musculoskeletal or respiratory)

• 98980: First 20 minutes of interactive communication

• 98981: Each additional 20 minutes

Workflow: How RTM Works Step by Step

Step 1: Patient Enrollment

A clinician identifies a patient with a qualifying condition (e.g., chronic low back pain) and enrolls them into an RTM program.

Step 2: Setup and Education

The patient receives a device or mobile app along with instructions. CPT code 98975 is billed here.

Step 3: Daily Monitoring

The patient inputs therapy data daily, such as pain levels or therapy completion. Data is transmitted in real time.

Step 4: Weekly Review

The provider logs into the dashboard to review patient progress. If needed, they can schedule a call, adjust therapy, or send reminders.

Step 5: Monthly Summary and Billing

After at least 16 days of data collection, and 20 minutes of interactive communication, the provider can bill RTM codes for reimbursement.

Real-World Applications of RTM in Healthcare

1. Musculoskeletal Health

RTM is ideal for physical therapy and rehabilitation. It enables therapists to track exercises, pain levels, and range of motion—all remotely.

Example: After ACL surgery, a patient uses an RTM app to log daily exercises. The therapist adjusts routines based on progress.

2. Respiratory Care

For conditions like asthma or COPD, RTM can monitor inhaler usage, breathing patterns, and trigger factors.

Example: A COPD patient’s inhaler usage increases during allergy season. The RTM system alerts the provider, who prescribes preventive medication.

3. Behavioral and Mental Health

Clinical psychologists use RTM tools to monitor symptoms of anxiety, depression, or PTSD through journaling, activity tracking, and digital therapy assignments.

Example: A patient logs daily mood scores and sleep quality. The psychologist identifies worsening patterns and modifies the treatment plan.

4. Chronic Pain Management

RTM can help manage long-term pain without excessive in-person visits by tracking medication adherence, pain episodes, and response to therapies.

Benefits of RTM

For Patients

• Convenient Care: Patients can receive care from home, especially helpful for mobility-limited or rural populations.

• Better Engagement: Daily reminders and visual progress tracking encourage adherence.

• Faster Interventions: Providers can act quickly if negative trends appear.

For Providers

• Increased Revenue: RTM services are reimbursable by Medicare, offering an additional revenue stream.

• Improved Patient Outcomes: Continuous monitoring helps catch issues early.

• Scalability: Providers can manage more patients simultaneously with automation tools.

For the Healthcare System

• Lower Costs: RTM helps prevent hospitalizations and emergency visits.

• Efficiency: Reduces administrative burden and unnecessary appointments.

• Data-Driven Decisions: Aggregated data helps improve treatment guidelines over time.

RTM Compliance and Security

RTM systems must comply with HIPAA regulations to protect sensitive patient data. This includes:

• Encrypted data transmission

• Secure cloud storage

• Multi-factor authentication

• Access control for care teams

Failure to comply can result in legal consequences and loss of trust.

Challenges and Limitations

Despite its potential, RTM still faces challenges:

1. Technology Barriers

Some patients may struggle with using apps or devices, particularly the elderly or those with limited digital literacy.

2. Reimbursement Complexity

RTM billing codes are relatively new, and many providers are still unsure how to use them effectively or document properly.

3. Data Overload

Too much data without context can overwhelm providers. Systems need to offer actionable insights, not just raw numbers.

4. Limited Awareness

Many therapists and providers are not yet aware of RTM or how it differs from RPM, which limits adoption.

The Future of RTM in Healthcare

RTM is still in its infancy, but the signs are promising. In the next 5–10 years, we can expect:

1. Integration with EHR Systems

Seamless integration with Electronic Health Records will allow better workflow and patient management.

2. AI and Predictive Analytics

RTM platforms will likely include AI features to predict flares, relapses, or therapy failure in advance.

3. Wider Payer Adoption

Private insurers may begin reimbursing for RTM, expanding its reach beyond Medicare.

4. Customized Care Paths

More advanced RTM systems will offer dynamic care plans tailored to each patient’s real-time data.

Use Case: RTM in Physical Therapy

Background: John, a 65-year-old recovering from a rotator cuff surgery.

RTM Setup: He’s enrolled in an RTM program and uses a mobile app to log his exercises and pain level.

Monitoring: The app sends reminders, tracks movement via a sensor band, and flags pain scores above 7.

Provider Action: His therapist notices decreased exercise frequency and contacts John, who reports tightness in the joint. The care plan is modified.

Outcome: John completes his rehab at home with fewer in-person visits, faster recovery, and better compliance.

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Conclusion

Remote Therapeutic Monitoring (RTM) is reshaping the future of outpatient care in the United States. By enabling non-physician providers to track patient progress remotely, RTM promotes continuous, personalized, and proactive therapy management.

It bridges the gap between visits, offers valuable real-time insights, and drives improved outcomes while reducing costs.

Though challenges around education, billing, and data overload remain, the benefits for patients, providers, and the healthcare system are undeniable. As adoption grows and technology matures, RTM will become a central pillar of value-based, patient-centered care.