98976 is respiratory. 98977 is musculoskeletal. Mixing those two up is the most common way a therapy practice’s RTM program loses money, and it happens on every patient every month until someone catches it.
Remote therapeutic monitoring pays for tracking how patients respond to treatment between visits, such as home exercise adherence, pain levels, or inhaler use. Unlike remote patient monitoring, it covers non-physiologic data, and physical therapists, occupational therapists, and speech-language pathologists can bill it under their own NPI.
Key Takeaways
- RTM bills as setup (98975), monthly device supply by system (98976 respiratory, 98977 musculoskeletal, 98978 cognitive behavioral therapy), and monthly treatment management (98980 and 98981).
- The device supply codes require at least 16 days of data in a 30-day period.
- Treatment management requires at least 20 minutes in the calendar month, including at least one real-time interactive communication with the patient.
- Only one practitioner can bill RTM for a patient in a given period, and RTM and RPM can’t both be billed for the same patient in the same period.
- RTM billed by therapists carries the GP, GO, or GN modifier and counts toward the Medicare therapy threshold.
RTM CPT Codes
RTM codes fall into three groups. The setup code is billed once per episode of care, the device supply code is billed once per 30 days, and the treatment management codes are billed once per calendar month.
98975 (initial setup and patient education on the device, once per episode of care)- 98976 (device supply for monitoring respiratory system status, each 30 days)
- 98977 (device supply for monitoring musculoskeletal system status, each 30 days)
- 98978 (device supply for monitoring cognitive behavioral therapy, each 30 days)
- 98980 (treatment management, first 20 minutes in a calendar month, with at least one interactive communication)
- 98981 (treatment management, each additional 20 minutes in the calendar month)
98975 (initial setup and patient education on the device, once per episode of care)The device has to meet the FDA definition of a medical device, which can include software or an app. The data can be self-reported by the patient through the device or transmitted automatically. Our guide to which CPT codes are used in RTM billing goes deeper on each code.
Data and Time Requirements
The setup and device supply codes require at least 16 days of data in a 30-day period. A patient who uses the app for 12 days that month doesn’t support the device code, and billing it anyway is the most frequent RTM audit finding. The 16-day count has to come from the device data itself, not from an estimate.
Treatment management (98980) requires at least 20 minutes of time in the calendar month spent reviewing the data and managing the patient’s treatment, and at least one real-time interactive communication with the patient or caregiver by phone or video. Additional 20-minute increments bill as 98981. Time spent setting up the device or on routine messaging that doesn’t involve treatment decisions doesn’t count.
CPT has added codes for shorter monitoring periods and shorter management time, so practices billing in 2026 should confirm which payers accept them before using them.
Who Can Bill RTM
Physical therapists, occupational therapists, and speech-language pathologists in private practice can bill RTM under their own NPI. For Medicare, therapist-billed RTM carries the GP, GO, or GN modifier, counts toward the annual therapy threshold, and needs to fit within the patient’s plan of care. Therapy assistants can furnish RTM services under general supervision of the therapist in private practice, with the CQ or CO modifier where it applies.
Physicians and NPPs can also bill RTM, usually for musculoskeletal or respiratory conditions, and clinical staff can furnish the services incident-to under general supervision. Respiratory therapists can’t bill Medicare on their own, so respiratory RTM in a pulmonology practice is billed under the physician or NPP.
Only one practitioner can bill RTM for a patient during a given period, even when the patient is seeing more than one provider. A patient can’t be billed for both RTM and remote physiologic monitoring in the same period. Our remote patient monitoring page covers RPM.
Documentation and Consent
Every RTM claim depends on a few records being in place before the first device code is billed. These include the patient’s consent to RTM and any cost-sharing, the order or plan of care showing why monitoring is medically necessary, the device and condition being monitored, and the monthly data showing at least 16 days of readings. For treatment management, the record needs the minutes spent, the date and format of the interactive communication, and any changes made to the treatment plan.
Patients usually owe coinsurance on RTM each month. Patients who weren’t told about that up front are the most common source of RTM complaints and write-offs, so consent should include the cost.
Commercial and Medicaid Coverage
Commercial coverage for RTM varies widely. Some plans pay all six codes, some cover only the treatment management codes, and some consider RTM investigational. Medicaid coverage depends on the state. Checking coverage before enrolling a patient avoids months of unpaid device codes, and our physical therapy and occupational therapy pages cover the rest of each discipline’s billing.
RTM Credentialing
RTM doesn’t need its own enrollment, but every therapist and physician who bills it has to be enrolled with each payer under their own NPI. Therapists in private practice enroll with Medicare individually through PECOS and reassign benefits to the group. Commercial plans that route therapy through a network manager may also need the RTM codes added to the contract before they’ll pay. Until each provider is approved, their RTM claims can’t be billed, which is why you can’t bill what you can’t credential.
RTM Billing FAQs
What is the difference between 98976 and 98977?
98976 covers device supply for monitoring respiratory system status, and 98977 covers musculoskeletal system status. Both are billed once per 30 days with at least 16 days of data.
How many days of data are required to bill RTM?
At least 16 days in a 30-day period for the setup and device supply codes. Treatment management codes are based on time, not days of data.
What does 98980 require?
At least 20 minutes in the calendar month spent managing the patient’s treatment using the monitoring data, with at least one real-time interactive communication with the patient or caregiver.
Can physical therapists bill RTM?
Yes. PTs, OTs, and SLPs in private practice can bill RTM under their own NPI, with the GP, GO, or GN modifier for Medicare. It counts toward the therapy threshold.
Can RTM and RPM be billed for the same patient?
Not in the same period. A patient can be enrolled in RTM or remote physiologic monitoring, but not both at once, and only one practitioner can bill RTM for a patient at a time.
Can respiratory therapists bill RTM?
Not to Medicare under their own number. Respiratory RTM is billed by the physician or NPP, with respiratory therapists furnishing services as clinical staff.
Setting Up RTM Billing with Medwave
RTM claims depend on device days and treatment management minutes, like RPM, but with different codes and a different set of providers allowed to bill. Medwave counts device days and management time for each RTM code, including the shorter-period codes added for 2026, and keeps RTM and RPM off the same patient in the same period. Our billing team keeps RTM at a 98% clean claim rate.
PTs, OTs, and other therapists can bill RTM, so our credentialing team enrolls them along with physicians, averaging 85 days. Our payer contracting work checks which commercial plans cover RTM at all.
If you already bill RPM, ask us below about adding RTM.