Telehealth vs. Remote Therapeutic Monitoring (RTM): What's the Difference for PT Clinics?
Telehealth is live care; RTM is asynchronous monitoring between visits. How each works, how each bills, and when to use which.
Telehealth and remote therapeutic monitoring (RTM) both extend care beyond the clinic, but they are different services. Telehealth is live, real-time interaction, such as a video visit. RTM is asynchronous: patients log data on adherence, pain, and function between visits, and the clinic reviews it on its own schedule. They use separate billing codes and solve different problems.
For an independent physical therapy practice, confusing the two leads to missed revenue and workflow gaps. This guide breaks down what each one is, how they bill, and when to use which.
What Is Telehealth?
Telehealth is the delivery of care through a live, synchronous connection between a provider and a patient. In physical therapy, that usually means a video evaluation, a virtual follow-up, or a real-time consultation. The provider and patient are present at the same time, and the session functions like an in-person visit conducted remotely.
The American Physical Therapy Association recognizes telehealth as a way to widen access to PT, particularly for patients in rural areas or those with mobility or transportation barriers. Its defining trait is timing: care happens during a scheduled appointment, in real time.
What Is Remote Therapeutic Monitoring (RTM)?
RTM is the use of technology to collect and review non-physiologic patient data between visits, including therapy adherence, pain levels, and functional progress. Unlike telehealth, no live session is required. Patients report through an app or connected tool, and the therapist reviews the data asynchronously, then adjusts the plan of care as needed.
The Centers for Medicare and Medicaid Services (CMS) established RTM as a distinct, separately billable service. If you want the full primer on how RTM works day to day, the RTM 101 guide covers it in depth. The short version: RTM is built for continuity, not for the live encounter.
Telehealth vs. RTM: Key Differences
Both use digital tools, but they differ in how and when care is delivered.
| Feature | Telehealth | RTM |
|---|---|---|
| Interaction | Live, synchronous | Asynchronous |
| Timing | During a scheduled appointment | Between visits, on the patient's schedule |
| What it captures | Real-time clinical assessment during the session | Ongoing non-physiologic data: adherence, pain, function |
| Primary purpose | Deliver care remotely | Monitor progress and engagement between visits |
| Billing | Standard evaluation/treatment codes, delivered virtually | Dedicated RTM codes (98975–98981, plus 98985 and 98979 as of 2026) |
| Best fit | Virtual visits, follow-ups, access for remote patients | Long-term monitoring, HEP adherence, post-op and orthopedic rehab tracking |
The simplest way to hold the two apart: telehealth replaces the visit, RTM fills the gap between visits.
How RTM Bills, in Brief
RTM became separately billable when the AMA introduced Category I codes 98975–98981, effective January 1, 2022. They cover three functions: initial setup and patient education (98975), device or app supply for musculoskeletal monitoring (98977, billed per 30-day episode), and treatment management time (98980 for the first 20 minutes per calendar month, 98981 for each additional 20).
The CY2026 Physician Fee Schedule Final Rule expanded the set. CMS added 98985 for shorter device-supply episodes (2 to 15 days of data) and 98979 for the first 10 minutes of treatment management, removing the previous all-or-nothing thresholds that left short-stay and partial-adherence patients unbillable. RTM reimbursement varies by locality and payer. PhyxUp internal data puts a fully enrolled RTM patient at roughly $165 per month, above the commonly cited CMS national average near $135. Telehealth, by contrast, does not have its own code family: virtual visits bill under the same evaluation and treatment codes used in person, subject to payer-specific telehealth rules.
Why RTM Matters for Independent PT Practices
RTM addresses the space where progress is usually lost: the weeks between appointments. A home exercise program only works if the patient does it, and RTM gives the clinic visibility into whether that is happening, plus a channel to intervene before a patient stalls or drops off.
For a practice that runs lean, the operational question is who does the monitoring each month. RTM's treatment-management codes require documented review time and at least one interactive communication, which is real work on top of a full patient schedule. This is where a fully managed, done-for-you model matters: PhyxUp Health runs enrollment, monitoring, and billing so an independent practice, including orthopedic and surgical practices, can add the service without adding headcount. The alternative, bolting RTM onto an already stretched front desk, is where most in-house RTM programs quietly die.
Sangwon Lim
When to Use Each, and How They Work Together
These are not competing choices. Most clinics benefit from using both, in different roles.
Telehealth is the right tool when a patient needs a live clinical touchpoint but cannot come in: a virtual re-evaluation, a follow-up, a face-to-face answer to a question. RTM is the right tool for everything that happens in between, when what you need is continuity and data rather than a scheduled encounter.
Being honest about the limits helps: RTM is not a substitute for hands-on assessment, and telehealth is not built for continuous, day-to-day tracking. A common hybrid is an initial in-person evaluation, telehealth follow-ups when a live check-in is warranted, and RTM running underneath the whole episode. The catch is that this only works if the RTM side actually runs every month. The billing codes reward documented review time and patient contact, which means the value of RTM is real but conditional: it depends on someone consistently doing the monitoring work that a full patient schedule leaves no room for.
In Practice
- A patient completes an in-person evaluation, then logs HEP data and pain scores through an RTM app between visits.
- The therapist reviews the trend, spots a drop in adherence early, and adjusts the plan without scheduling an extra visit.
- A short telehealth check-in handles a question that needs face-to-face time, while RTM keeps monitoring in the background.
Frequently Asked Questions
Is RTM the same as telehealth?
No. Telehealth is live, real-time care delivered during a scheduled session. RTM is asynchronous monitoring of patient data between visits. They serve different purposes and bill under different codes.
Can a PT clinic bill for both telehealth and RTM?
Yes, when each service is separately documented and medically necessary. Telehealth bills under standard evaluation and treatment codes delivered virtually, while RTM bills under its own code family. Payer rules vary, so confirm coverage with each plan.
What CPT codes are used for RTM?
The core RTM codes are 98975 (setup and education), 98977 (musculoskeletal device supply), and 98980 and 98981 (treatment management). As of 2026, CMS added 98985 and 98979 for shorter episodes and shorter management windows.
Does RTM replace in-person physical therapy?
No. RTM supplements in-person care by maintaining continuity between visits. Hands-on assessment and treatment still happen in the clinic or over telehealth.
Who can bill RTM codes?
Physical therapists, occupational therapists, and speech-language pathologists can furnish RTM under a therapy plan of care, along with certain physicians and qualified staff. Specific supervision and modifier rules apply, and payer policy determines coverage.
Which One Does Your Clinic Need?
For most PT clinics, the answer is both, used deliberately: telehealth for the live moments, RTM for the continuity in between. The harder question is not which service to offer, but who keeps the RTM side running once patients are enrolled. That is a workflow and billing decision more than a technology one.
If you are weighing how to run RTM without overloading your team, the guide on how to choose RTM software for a small PT clinic compares the models side by side, including who performs the monitoring under each. Subscribe to the blog for new RTM and billing breakdowns as the 2026 rules roll out.