Is RTM Worth It for a Small Physical Therapy Clinic?
By Joe McKeating, Founder of Orva. Updated October 2026.
Short answer. For most small PT clinics, yes. Remote Therapeutic Monitoring is worth it when three things are true. You treat Medicare or other covered patients who would benefit from support between visits, your therapists can spend about 20 minutes a month on each enrolled patient, and you use a platform patients will open every day. When those hold, RTM adds a defined, reimbursable service of roughly $100 or more per patient per month at 2026 Medicare rates. When they don't, it adds work without much return.
This guide is for owners of clinics with one to a few locations who are deciding whether RTM is worth starting. It covers what RTM pays in 2026, what it costs you in time, when it pays off, when it doesn't, and what the proposed 2027 changes mean before you commit.
What RTM pays in 2026
RTM is billed with six musculoskeletal codes. Two of them are new for 2026 and let clinics bill for shorter monitoring periods and less management time. These are 2026 non-facility national averages.
98975, initial setup and patient education, once per episode, about $22
98977, device supply with 16 to 30 days of data in a 30-day period, about $51
98985, device supply with 2 to 15 days of data (new in 2026), about $51
98979, treatment management for 10 to 19 minutes in a month (new in 2026), about $26
98980, treatment management for the first 20 minutes in a month, about $54
98981, each additional 20 minutes of management, about $41
Actual amounts vary by locality. Medicare pays 80 percent of the allowed amount and the patient owes the remaining 20 percent after the deductible. When a PTA furnishes the service, the CQ modifier applies and Medicare pays 85 percent of the fee schedule amount.
The management codes require at least one real-time interactive communication with the patient during the month. For most clinics, an in-person conversation during a visit is the simplest way to meet it, and a phone call works just as well.
What one patient is worth in a typical month
A common month for a Medicare patient looks like this. The patient logs their program on 16 or more days, and the therapist spends at least 20 minutes reviewing their data, adjusting the program and talking with them.
98977 for the device supply, about $51
98980 for the first 20 minutes of management, about $54
98975 once, in the first month, about $22
That is about $105 per patient for each month they stay engaged, plus about $22 when they start. A clinic that enrolls 10 Medicare patients a month and keeps each engaged for two months would generate about $2,300 in allowed amounts from those 10 patients. Not every patient hits every threshold every month, and the 2026 codes for shorter periods and less time keep partial months billable instead of lost. Our RTM calculator lets you run the numbers with your own volume.
What RTM costs you
The reimbursement is for real work, and that work is where small clinics either make RTM pay or give up on it.
Therapist time. About 20 minutes per patient per month for the management codes. The real-time interaction can happen in person during a scheduled visit, as long as those minutes aren't also counted toward another billed service.
The platform. Software that delivers the program, tracks days of data and logs management time. Pricing models vary widely, so compare the cost per enrolled patient against the roughly $105 a month each patient can bring in.
Billing and documentation. Tracking the 16-day and 20-minute thresholds by hand is where most denials start. A platform that counts days and minutes automatically removes most of that risk.
When RTM is worth it for a small clinic
You see enough Medicare or covered commercial patients to enroll at least a handful each month.
Your caseload includes patients who need support between visits, such as post-surgical rehab, chronic low back pain or patients who travel far for care.
Your therapists are willing to review patient data and adjust programs each month. The clinics that do best make a program change for every patient every month.
Patients use the app. Engagement is what produces the 16 days of data, so a patient experience people will open daily matters more than any feature list.
When RTM isn't worth it
Very few covered patients. If almost no one on your schedule has Medicare or a commercial plan that covers RTM, the billing side won't add up. A between-visit program can still be worth offering as a cash-pay service.
No clinician time. If no one can spend 20 minutes a month per patient, you will not meet the management requirements.
Relying on outsourced callers. Many RTM programs rely on a vendor's staff to make calls and log time. CMS has proposed ending Medicare payment for that model starting in 2027, as covered below.
What may change in 2027
In July 2026, CMS published its proposed 2027 Physician Fee Schedule. It is a proposal, not a final rule, and it would take effect January 1, 2027 if finalized. For RTM, CMS proposed the following.
Medicare would pay for RTM only when the clinical monitoring is performed by direct employees of the billing practice, under general supervision. Contractor-furnished monitoring would not be paid.
RTM would be limited to established patients, and monitoring would start with a separately reportable initiating visit.
CMS proposed lowering the valuation of RTM services, which would apply to every clinic, including those that keep monitoring in-house.
For a small clinic deciding today, the takeaway is simple. Choose a model where your own therapists deliver the care and a platform supports them. That model fits both the 2026 rules and the direction CMS has proposed. We will update this guide when the final rule is published.
How to start small
Pick one patient group. Start with post-surgical or chronic patients who need the most support between visits.
Set a monthly rhythm. Review data weekly, make a program change monthly and use a regular visit for the real-time interaction.
Let software count. Days of data, management minutes and code eligibility should be tracked for you, not in a spreadsheet.
Check your payers. Confirm which commercial plans in your area cover RTM before you enroll their members.
Measure after 60 days. Compare enrolled patients, months billed and therapist time against what you expected.
Frequently asked questions
How many patients does a small clinic need for RTM to be worth it?
There is no fixed minimum. At about $105 per engaged Medicare patient per month, even a handful of enrolled patients can cover a per-patient platform cost and the therapist time involved. The bigger question is whether those patients stay engaged long enough to meet the data and time thresholds.
Can PTAs deliver RTM?
Yes. PTAs can furnish RTM services. Claims for those services carry the CQ modifier, and Medicare pays 85 percent of the fee schedule amount.
Do commercial insurers pay for RTM?
Many do, but coverage and rates vary by plan and region. Check each major payer's policy before enrolling their members.
Is RTM worth it for a cash-pay clinic?
The billing side doesn't apply, but the care model can. Some cash-pay clinics offer between-visit monitoring as part of a package or a monthly fee, and patients pay for the added access to their therapist.
What is the difference between RTM and RPM?
RTM covers therapy-related data such as musculoskeletal function and program adherence, and PTs can bill it. RPM covers physiologic data such as blood pressure and is billed by physicians and other practitioners. Our RTM vs. RPM guide covers the details.
See how RTM would work in your clinic
Orva is built for PT clinics that deliver RTM with their own therapists. Clinics can start a 7-day free trial with no credit card required. Start your free trial or run the RTM calculator.