What Is Remote Therapeutic Monitoring — and Why Pain Management Practices Should Care

The Gap Between Visits Is Where Patients Struggle Most

Pain is unpredictable. A patient who presents well on a Tuesday may be in significant distress by Friday — a flare from overexertion, a medication side effect that crept in overnight, a week of poor sleep compounding everything else. By the time they see you again, the window to intervene has often passed.

Traditional care models weren't built to address this. Appointments are scheduled weeks apart. Phone calls go unreturned. Patients manage in isolation until something becomes severe enough to warrant action.

Remote Therapeutic Monitoring changes this. It creates a structured, reimbursable bridge between visits — one that surfaces issues earlier, supports better adherence, and generates consistent monthly revenue for your practice.

What Remote Therapeutic Monitoring Actually Is

Remote Therapeutic Monitoring (RTM) is a set of CMS-recognized billing codes that allow practices to be reimbursed for monitoring patient-reported therapeutic data between in-person visits.

The key word is therapeutic, not physiological. Unlike Remote Patient Monitoring (RPM) — which tracks vital signs from wearable devices — RTM covers musculoskeletal and respiratory therapy data reported by patients directly. This makes it a natural fit for pain management, where the clinically relevant signals are pain intensity, medication adherence, activity levels, sleep quality, and mood.

CMS introduced RTM codes in 2022 and has expanded reimbursement rates each year since. The program is designed to be accessible to any eligible provider — you do not need specialized equipment or a dedicated care management team.

The RTM CPT Codes Pain Management Practices Should Know

The RTM billing framework consists of five primary codes:

CPT 98975 — Initial setup and patient education (billed once per patient, ever). Reimburses approximately $19–$21.
CPT 98976 — Device supply for musculoskeletal monitoring; 16-day minimum supply period. Reimburses approximately $55–$65/month.
CPT 98977 — Device supply for respiratory monitoring (less common in pain management).
CPT 98980 — First 20 minutes of monthly treatment management services by a qualified healthcare professional. Reimburses approximately $50–$60/month.
CPT 98981 — Each additional 20 minutes of treatment management beyond the first. Reimburses approximately $40–$45/month.

In practice, a patient who is actively engaged in RTM — completing regular check-ins and requiring at least 20 minutes of monthly clinical review — generates $100–$155+ per month in net new revenue for the practice.

Who Qualifies for RTM

RTM eligibility is broad by design. Any patient with a musculoskeletal condition who has a treatment plan and can provide self-reported data is a potential candidate. For pain management practices, this includes:

Chronic low back and neck pain
Post-surgical recovery and rehabilitation
Neuropathic and radicular pain
Fibromyalgia and widespread pain conditions
Patients on long-term opioid therapy requiring adherence monitoring
Post-procedure follow-up (e.g., spinal cord stimulation, injections)

The core requirement is that a qualified healthcare professional — a physician, PA, or NP — reviews and acts on the data monthly. RTM is a clinical service, not a passive data collection exercise.

Why Pain Management Is the Ideal Specialty for RTM

Pain management has a unique combination of factors that make RTM particularly effective and particularly lucrative:

Long-term treatment relationships. Pain management patients aren't seen once and discharged. They maintain active relationships with their practice for months or years. RTM revenue compounds the longer a patient remains enrolled.

High proportion of Medicare patients. CMS reimbursement is the foundation of RTM economics. Pain management practices typically see a high percentage of Medicare and Medicare Advantage beneficiaries — exactly the patient population for whom these codes were designed.

Clinically relevant between-visit data. Pain and functional status fluctuate. Daily or weekly check-ins capture this variability in a way that scheduled appointments cannot. Practices using RTM consistently report catching medication side effects, early-onset flares, and adherence issues earlier — before they escalate.

No additional staff required. When RTM is properly implemented, the monitoring infrastructure handles alert generation automatically. Clinical staff engage only when a patient's data flags a concern or when meeting the monthly review requirement. This is not an add-on to the clinical workload — it's a structured use of time that was previously uncompensated.

The Revenue Math

Consider a practice with 200 patients enrolled in RTM:

Metric	Value
Enrolled patients	200
Average revenue per patient/month	$120
Monthly RTM revenue	$24,000
Annual RTM revenue	$288,000

This is revenue that requires no additional patient visits, no additional procedures, and no expansion of clinical capacity. It captures value that practices are already delivering — the ongoing relationship, the monitoring, the availability — but were not previously billing for.

For a practice with 500 eligible patients, the annual number exceeds $700,000.

The Common Objection: "We Don't Have Time for This"

This is the most frequent concern practices raise when RTM is introduced, and it's a legitimate one. Practices are stretched. Adding any new program that creates administrative burden is a real risk.

The answer depends entirely on implementation. RTM programs managed in-house — where existing staff are expected to handle patient onboarding, monitoring, and billing — do add workload. Programs that are fully managed externally, with a dedicated partner handling every operational aspect except the monthly clinical review, do not.

At Pilothouse Health, we identify eligible patients, handle onboarding and consent, monitor check-ins, generate alerts, and manage billing end to end. The only thing your practice does is review a summarized report of flagged patients each month — a task that typically takes less than 30 minutes.

What to Expect From Patient Adoption

The second concern practices raise is patient compliance. Will patients actually complete their check-ins?

The honest answer: some won't, and that's fine. RTM revenue is proportional to enrolled patients — a patient who doesn't engage is simply not billed for that month. There's no cost or administrative burden from low responders.

In our experience, engagement rates are significantly higher when:

The invitation is personalized and pre-filled (patients don't create accounts or enter data already in your system)
The check-in is genuinely simple — five sliders, under 60 seconds
Patients understand why they're being monitored and feel it's connected to their care

Practices that implement RTM well consistently achieve engagement rates above 60%. At that level, the revenue is substantial and the clinical benefit is real.

Getting Started: What the First 90 Days Look Like

A well-implemented RTM program follows a predictable ramp:

Month 1: Identify eligible patients, configure monitoring thresholds, send initial invitations. Expect 40–60% of invited patients to complete setup.

Month 2: First billing cycle closes. Revenue from enrolled patients begins flowing. Refine outreach for patients who haven't engaged.

Month 3: Program is at steady state. Revenue is consistent and predictable. Clinical team is reviewing alerts and monthly summaries as part of normal workflow.

The learning curve is real, but it's short. Most practices are at full operating capacity within 60–90 days.

The Window of Advantage Is Still Open

RTM adoption across pain management practices remains lower than it should be, given the revenue opportunity. Practices that implement now have a genuine first-mover advantage — in terms of revenue capture, patient experience differentiation, and organizational readiness when payers increase scrutiny or requirements change.

CMS has signaled continued commitment to RTM reimbursement. Commercial payers are following. The question for practice administrators and physician owners isn't whether RTM will become standard in pain management — it's whether your practice will be ahead of that curve or catching up.

Pilothouse Health is a fully managed RTM program built specifically for pain management practices. We handle every operational aspect of the program, from patient identification through billing, so your team doesn't need to. Schedule a 15-minute call to see how much RTM could add to your practice.