As digital tools become more integrated into rehabilitation care, many physical therapists are navigating new service models like remote monitoring. But when it comes to billing, compliance, and clinical applications, it’s important to understand the differences Remote Therapeutic Monitoring (RTM) vs Remote Patient Monitoring (RPM).
While the two models may sound similar, they serve different purposes, track different types of data, and follow separate billing rules. For physical therapists, understanding how these services apply and who is allowed to bill for them is critical for both compliance and reimbursement.
This article breaks down the key differences between RTM and RPM, highlights real-world examples, and clears up common misconceptions so you can make informed decisions for your practice.
What Is Remote Therapeutic Monitoring?
Remote Therapeutic Monitoring is a service designed to track non-physiological data related to a patient’s therapeutic progress. This includes things like:
- Home exercise program (HEP) adherence
- Pain levels
- Functional mobility scores
- Patient-reported outcomes
- Respiratory status in some cases
For physical therapists, RTM creates a structured way to monitor patients between visits, adjust care plans in real time, and bill for the clinical time spent managing that data. It is particularly useful for patients recovering from surgery, managing chronic conditions, or transitioning from frequent in-person visits to a maintenance program.
What Is Remote Patient Monitoring?
Remote Patient Monitoring is typically used in primary care, cardiology, endocrinology, and similar settings to track physiological data. This includes:
- Blood pressure
- Glucose levels
- Weight
- Pulse oximetry
- Heart rate
These services require FDA-cleared medical devices that collect biometric data, often on a daily basis. RPM is highly valuable for managing chronic medical conditions and is often used in coordination with a patient’s care team.
Comparison: Remote Therapeutic Monitoring vs Remote Patient Monitoring
Here’s a side-by-side breakdown of the key differences between Remote Therapeutic Monitoring and Remote Patient Monitoring:
| Feature | Remote Therapeutic Monitoring (RTM) | Remote Patient Monitoring (RPM) |
|---|---|---|
| Type of data | Non-physiological (pain, adherence, mobility) | Physiological (heart rate, glucose, blood pressure) |
| Who can bill | PTs, OTs, SLPs, physicians | Physicians, nurse practitioners, PAs (PTs cannot bill) |
| Device requirement | Software or device classified as a medical device | FDA-cleared physiological device required |
| Codes used | 98975, 98976, 98977, 98980, 98981 | 99453, 99454, 99457, 99458 |
| Communication requirement | At least one interactive communication per month | Same, plus device data must be collected at least 16 days per month |
| Common use cases | Post-surgical rehab, chronic pain, HEP management | Hypertension, diabetes, congestive heart failure, COPD |
Clinical Examples That Clarify the Difference
Example 1: Post-Op Rehab with RTM
A patient recovering from ACL reconstruction uses a mobile app to log daily exercises, rate pain, and answer mobility check-ins. Their physical therapist reviews the data weekly, adjusts the HEP, and calls the patient once to check progress. This qualifies for RTM billing codes, including 98980.
Example 2: Hypertension Management with RPM
A patient with high blood pressure uses a Bluetooth-enabled monitor to send daily blood pressure readings to their primary care provider. The provider reviews the data, makes medication changes, and communicates with the patient. This is billed under RPM using code 99457.
Example 3: When PTs Need to Know Their Role
A physical therapist cannot bill RPM codes, even if the data looks similar or the technology overlaps. For example, if a PT uses a wearable to track heart rate during rehab, that data does not fall under RTM or RPM billing. It must be tied to therapeutic activity and non-physiological progress to qualify under RTM.
Who Can Bill for RTM vs. RPM?
This is one of the most important distinctions. Physical therapists can bill for RTM under the designated CPT codes. They cannot bill for RPM, as those codes are restricted to physicians and certain advanced practice providers.
Here’s a breakdown of billing eligibility:
| Provider Type | Eligible for RTM | Eligible for RPM |
|---|---|---|
| Physical Therapist | ✅ Yes | ❌ No |
| Occupational Therapist | ✅ Yes | ❌ No |
| Speech-Language Pathologist | ✅ Yes | ❌ No |
| Physician (MD/DO) | ✅ Yes | ✅ Yes |
| Nurse Practitioner / PA | ✅ Yes | ✅ Yes |
If you’re a physical therapist using software to track patient engagement and function, you’re working within the scope of RTM, not RPM.
Common Misconceptions
1. “They’re basically the same thing.”
Not quite. They differ in the type of data collected, the devices required, and who can bill for the service.
2. “If I track vitals, I can bill RPM.”
Physical therapists cannot bill RPM codes, even if the device collects RPM-eligible data. Those codes are limited to medical providers.
3. “Only hardware devices qualify.”
For RTM, CMS allows the use of software-based devices as long as they meet the definition of a medical device under the FDA. This is not the case for RPM, which requires FDA-cleared physiological monitors.
4. “Any app will do.”
RTM platforms must meet specific criteria to support billing. Using a non-compliant tool, even if it tracks exercises, will not qualify.
Final Takeaway
Remote Therapeutic Monitoring and Remote Patient Monitoring may share similar goals—keeping patients on track between visits—but they are distinct in both scope and billing.
For physical therapists, Remote Therapeutic Monitoring is the model to focus on. It allows you to stay connected with your patients, document progress, and receive reimbursement for the time and expertise you’re already providing outside the clinic.
If you’re implementing remote monitoring in your practice, make sure your platform supports RTM-specific codes and workflows and that your documentation clearly reflects your clinical involvement.