Remote Therapeutic Monitoring

RTM for orthopedic and rehab clinics

A patient experience people will actually use, with six-code billing logic built in for 2026.

  • Structured home exercise programming with day-threshold and time-threshold visibility
  • Support for 98975, 98985, 98977, 98979, 98980, and 98981 in one workflow
  • Cleaner documentation, clearer month-end closeout, and less manual reconciliation
  • Built for outpatient PT and orthopedic clinics, not adapted from generic remote monitoring
2026 update
Six-code workflow

98975, 98985, 98977, 98979, 98980, and 98981 tracked in one system.

Operational focus
Cleaner month-end closeout

Know which patients qualify, what is missing, and what still needs action before claims go out.

Patient side
A recovery experience patients actually use

Orva combines adherence visibility, structured routines, and between-visit engagement in one workflow.


What RTM actually is

Remote Therapeutic Monitoring lets clinics bill for qualifying work that happens between visits. In musculoskeletal care, that usually means tracking whether the patient is following the plan, whether the clinician is actively managing the case, and whether the documentation supports the code path being billed.

That is why RTM is not just a messaging feature and not just a billing feature. It sits at the intersection of patient engagement, clinical follow-through, and claim-ready operational discipline.

For outpatient PT and orthopedic clinics, the value is straightforward. RTM gives the clinic a reason to stay engaged between visits, a mechanism to do that work consistently, and a compliant way to capture reimbursement when the requirements are met.


What changed in 2026

The six-code musculoskeletal RTM framework is clearer now than it was before. The device-supply side is split between a lower-threshold path and a higher-threshold path. The treatment-management side now has a 10-minute entry point in addition to the 20-minute structure clinics already knew.

2026 matters because clinics no longer need to force every engaged patient into the old 16-day and 20-minute thresholds. There is now a cleaner billing home for shorter but still meaningful activity.

Code framework

How the six-code workflow fits together

Code
What it covers
Threshold
How clinics should think about it
98975
Initial set-up and patient education
Once per episode
This is the start of the workflow. The patient is enrolled, oriented, and actually taught how to use the monitoring experience.
98985
Musculoskeletal device supply
2 to 15 days in a 30-day period
This lower-threshold path matters for shorter episodes and partially engaged patients who still generate legitimate billable monitoring activity.
98977
Musculoskeletal device supply
16 to 30 days in a 30-day period
This is the higher device-supply threshold and remains the target for strongly engaged full-month patients.
98979
RTM treatment management
First 10 minutes in a calendar month, with at least one real-time interactive communication
This creates a cleaner path for months that involve real management work but do not reach the older 20-minute threshold.
98980
RTM treatment management
First 20 minutes in a calendar month, with at least one real-time interactive communication
This remains the core full-threshold management code when the clinic is materially managing the patient between visits.
98981
Additional RTM treatment management
Each additional 20 minutes after 98980
This is the add-on path for higher-touch cases. It does not exist by itself. It follows the full 98980 base path.
98975
CoversInitial set-up and patient education
ThresholdOnce per episode
Why it mattersThis is the start of the workflow. The patient is enrolled, oriented, and actually taught how to use the monitoring experience.
98985
CoversMusculoskeletal device supply
Threshold2 to 15 days in a 30-day period
Why it mattersThis lower-threshold path matters for shorter episodes and partially engaged patients who still generate legitimate billable monitoring activity.
98977
CoversMusculoskeletal device supply
Threshold16 to 30 days in a 30-day period
Why it mattersThis is the higher device-supply threshold and remains the target for strongly engaged full-month patients.
98979
CoversRTM treatment management
ThresholdFirst 10 minutes in a calendar month, with at least one real-time interactive communication
Why it mattersThis creates a cleaner path for months that involve real management work but do not reach the older 20-minute threshold.
98980
CoversRTM treatment management
ThresholdFirst 20 minutes in a calendar month, with at least one real-time interactive communication
Why it mattersThis remains the core full-threshold management code when the clinic is materially managing the patient between visits.
98981
CoversAdditional RTM treatment management
ThresholdEach additional 20 minutes after 98980
Why it mattersThis is the add-on path for higher-touch cases. It does not exist by itself. It follows the full 98980 base path.

How clinics actually operationalize RTM

Successful RTM programs are usually not built on a single trick. They are built on a repeatable sequence. Enroll the right patient, keep the patient engaged between visits, make the clinician’s management work visible, and close the month without a scavenger hunt.

Step 1

Start with the right patients

RTM works best when the patient has a real home plan, a real reason to stay accountable, and a clinical pathway where between-visit work changes outcomes.

Step 2

Make adherence visible

The clinic needs to know who is engaging, who is slipping, and which episodes are trending toward the lower device threshold or the higher one before the period ends.

Step 3

Close the month cleanly

Most RTM pain shows up at month-end. The better the workflow, the less the team relies on side spreadsheets, memory, and manual interpretation to know what qualifies.


Documentation that actually matters

Good RTM documentation is less about volume and more about traceability. A payer should be able to see what happened, when it happened, and how the clinician responded.

For most clinics, that means documenting set-up and education for 98975, qualifying device-supply activity for 98985 or 98977, and real treatment-management work plus interactive communication for 98979, 98980, or 98981 when applicable.

The operational mistake is leaving those pieces scattered across messages, notes, and staff memory. The stronger the workflow, the less assembly is required at the end of the month.


Modifiers and place of service are a separate layer

The code path is only one part of the billing picture. Therapists furnishing RTM under a therapy plan of care need the appropriate therapy modifier, and only part of the RTM family falls under the de minimis assistant-modifier rule. Place of service can matter too, especially when clinics over-assume telehealth logic.

That is why we break the overview page apart from the billing mechanics. You can see the full breakdown on our RTM modifiers and place of service guide.

Compliance

What usually causes RTM denials

Threshold miss

The patient was active, but not active enough for the billed path

This is exactly why the 2026 lower-threshold codes matter. Clinics need to know whether the patient belongs in the 2 to 15 day path, the 16 to 30 day path, or neither.

Management miss

The work happened, but the month was not closed correctly

Time-based codes often fail because the clinician activity, the interactive communication, and the billing logic are tracked in different places and never pulled together cleanly.

Workflow miss

The clinic relied on effort instead of a system

RTM becomes fragile when the program depends on one staff member remembering who qualifies, what was done, and what still needs action before claims go out.


Why clinics use Orva for RTM

Orva is built for outpatient rehab and orthopedic workflows, not retrofitted from a different remote-monitoring category. The goal is not just to support the codes. It is to make the whole process easier to run, from patient adoption through month-end billing review.

  • A patient experience that feels like a recovery routine, not just a reminder stream
  • Visibility into day thresholds, management thresholds, and who needs attention now
  • Cleaner documentation outputs for billers and clinic leadership
  • A workflow that reduces manual tracking instead of creating another layer of it

Related RTM pages

98975, 98985, 98977, 98979, 98980, and 98981 for code-specific detail.

RTM billing modifiers and place of service for the billing mechanics clinics get wrong most often.


See Orva in action

We’ll show you how Orva handles patient engagement, threshold tracking, and billing-ready RTM workflow across all six musculoskeletal codes.