Physical therapy's expansion into telehealth and remote therapeutic monitoring (RTM) represents one of the most significant revenue opportunities in the profession since the introduction of functional limitation reporting codes—but it comes with administrative complexity that many practices have struggled to operationalize. The RTM code set (CPT 98975, 98976, 98977), introduced by CMS effective January 2022, allows PTs to bill for the setup, device supply, and monthly monitoring of patient-reported musculoskeletal and respiratory status data collected between in-clinic visits. However, these codes require specific documentation, minimum data collection thresholds, and patient onboarding workflows that differ entirely from standard outpatient PT billing.
According to the American Physical Therapy Association, fewer than 15 percent of outpatient PT practices that are eligible to bill RTM codes were actively doing so as of 2024—largely because the administrative setup required to support RTM billing was not in place.
Understanding the RTM Code Requirements
CPT 98975 is billed once per episode of care for initial setup and patient education on the RTM device or application. CPT 98976 covers supply of a device with scheduled alert transmissions for musculoskeletal conditions (billed monthly when the patient provides 16 or more days of monitoring data within the 30-day period). CPT 98977 covers the same for respiratory conditions. A separate monitoring and treatment management code (CPT 98980/98981) covers the clinical staff time for reviewing the data and communicating with the patient.
For a PT practice to bill these codes compliantly, it must: enroll eligible patients in the RTM platform, document patient education at setup, track data transmission days for each patient, trigger billing when the 16-day threshold is met, and ensure that clinical staff review and document a response to patient-reported data each billing period.
Patient App Onboarding: The VA's Critical Entry Point
The RTM revenue cycle begins with patient enrollment. A VA managing the RTM onboarding workflow contacts newly eligible patients, explains the program, assists them in downloading and setting up the designated app or device, and confirms that data transmission is functioning before the 30-day billing window begins. For practices using platforms such as Reflexion Health, MedBridge, or Keet Health, the VA handles the platform enrollment process end-to-end.
Patients who fail to complete onboarding within the first week of their episode are unlikely to generate the 16 days of data needed for monthly billing. A VA tracking onboarding completion rates can identify patients who need a follow-up call to troubleshoot app setup and ensure that the billing window starts correctly.
16-Day Data Collection Tracking: The Billing Threshold Trigger
The single most common reason RTM practices lose RTM revenue is failing to track which patients have accumulated 16 or more days of data within the 30-day billing window. A VA maintaining a daily RTM data log—pulling each patient's data day count from the platform and flagging patients approaching the 16-day threshold—ensures that billing is triggered at the right time and that patients who are falling behind on data submission receive a prompt to log in before the window closes.
For a practice with 50 active RTM patients, this tracking function involves daily platform checks and a small number of outreach calls or texts—manageable by a VA but impractical for a therapist managing a full clinical schedule.
Live Video Session Scheduling and Technical Support
Telehealth PT sessions require scheduling infrastructure that accounts for video platform access, patient technology readiness, and documentation requirements specific to telehealth visits. A VA can manage the telehealth scheduling workflow: booking live video sessions in the practice's EHR or telehealth platform, sending patients the video link and connection instructions in advance, troubleshooting basic connection issues before the session begins, and ensuring that the post-session documentation flags the visit as telehealth for billing purposes.
Payers have specific modifier requirements for telehealth PT visits (modifier 95 for synchronous telehealth via interactive audio-video), and a VA familiar with these requirements can ensure that claims are coded correctly to avoid telehealth billing denials.
Outcomes Dashboard Reporting: Connecting RTM Data to Clinical Value
The outcomes data collected through RTM platforms—pain scores, functional status reports, adherence to home exercise programs—is only clinically and commercially valuable if it is synthesized and presented in a format that supports clinical decision-making and payer communication. A VA can generate weekly outcomes dashboard reports for the treating therapist, summarizing the patient's self-reported status trends, exercise completion rates, and any alert conditions flagged by the RTM platform.
This outcomes synthesis function also supports the medical necessity documentation required to continue RTM services beyond the initial period and provides compelling data for payer contract negotiations that include value-based components.
For PT practices ready to build a compliant, revenue-generating RTM and telehealth administrative workflow, Stealth Agents provides virtual assistants trained in RTM billing and telehealth operations.
Sources
- American Physical Therapy Association. "Remote Therapeutic Monitoring Resources." APTA.org.
- Centers for Medicare & Medicaid Services. "RTM Final Rule and CPT Code Guidance." CMS.gov.
- American Medical Association. "CPT Code Changes 2022: Remote Monitoring Codes." AMA-ASSN.org.
- KLAS Research. "Remote Therapeutic Monitoring Platform Adoption Report." KLASresearch.com.