# RTM vs RPM: The Difference for Therapy Clinics

By Sulo Health Team (Pediatric home programs) · Published 2026-07-09
Canonical: https://sulohealth.com/blog/rtm-vs-rpm/

**The bottom line:** RTM (Remote Therapeutic Monitoring) reimburses for monitoring non-physiological data (exercise adherence, pain, function), and PTs, OTs, and SLPs can bill it directly. RPM (Remote Patient Monitoring) covers physiological vitals like heart rate and blood pressure and is billed by physicians and other providers with E/M billing rights. For a therapy clinic, RTM is almost always the right program.

- RTM monitors therapy adherence and response; RPM monitors vital signs.
- Therapists bill RTM in their own right, but RPM requires E/M billing privileges they don't have.
- RTM data can be self-reported by the patient; RPM data must be automatically transmitted by a device.
- The same practitioner cannot bill RTM and RPM for the same patient in the same period.
- RTM is not telehealth and does not count as a visit, but it does count toward the annual therapy dollar threshold.

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## What is Remote Therapeutic Monitoring (RTM)?

**RTM is a set of CPT codes (98975–98986) that reimburse clinicians for monitoring how therapy is going between visits.** The data is *non-physiological*: whether the patient did their home exercises, how much pain they felt, how the program is affecting function. It was added to the Medicare Physician Fee Schedule in January 2022, and it's the program built for the way PT, OT, and SLP care actually works: prescribe a home program, then manage it remotely. Our [complete RTM guide](/what-is-remote-therapeutic-monitoring) covers the full picture.

## What is Remote Patient Monitoring (RPM)?

**RPM is the older sibling (CPT 99453–99458, plus 2026 additions 99445 and 99470): codes that reimburse for monitoring *physiological* data** (blood pressure, glucose, weight, oxygen saturation) captured and transmitted automatically by a medical device. RPM is classified as an evaluation-and-management (E/M) service, which means it's billed by physicians, nurse practitioners, and physician assistants managing medical conditions like hypertension, diabetes, or heart failure. (The 2026 fee schedule gave both programs partial-month flexibility: RPM's new 99445 and 99470 mirror RTM's 98985 and 98979.)

## RTM vs RPM: the comparison

| | RTM | RPM |
|---|---|---|
| Data monitored | Non-physiological: adherence, pain, function, therapy response | Physiological: heart rate, BP, weight, SpO₂, glucose |
| Who bills | Physicians **and** PTs, OTs, SLPs directly | Physicians, NPs, PAs (E/M billing rights required) |
| How data is captured | Device-based **or patient self-reported** | Must be automatically captured and transmitted |
| Equipment | Software on the patient's own phone qualifies | Typically dedicated connected hardware |
| CPT family | 98975–98986 | 99453–99458, plus 99445 & 99470 (2026) |
| Typical use | Home exercise programs, therapy adherence | Chronic disease management |
| Counts as a visit? | No, and MPPR doesn't apply | Not applicable to therapy visit limits |

## Why does RTM fit therapy clinics better?

Three structural reasons, all baked into how the codes were written:

1. **Billing rights.** RPM's E/M classification locks therapists out. RTM codes are general-medicine codes, so **[PTs, OTs, and SLPs bill them in their own right](/blog/can-pts-ots-slps-bill-rtm/)**, with no supervising physician required, just a therapy plan of care and the usual GP, GO, or GN modifier on each claim.
2. **The data matches the care.** Therapy outcomes live in adherence, effort, pain, and function, exactly the categories RTM defines. There's no vital sign that tells you whether a child did their torticollis stretches.
3. **Self-reported data is allowed.** RPM requires automatic device transmission; RTM explicitly permits patient- or caregiver-reported data. In pediatrics, where a parent logs the session from a text-message link, this single rule is what makes remote monitoring practical at all.

## Can a patient be on both RTM and RPM?

**Possibly, but don't assume it.** The firm rule is that **the same provider can't bill both programs for the same patient in the same period**, and AMA guidance directs that 98980 not be reported alongside RPM's 99457. The scenario clinics ask about most (a child with a cardiac condition getting RPM through cardiology while receiving RTM from their physical therapist) isn't squarely addressed in published CMS guidance, and some readings treat the RTM/RPM exclusion as applying to the patient rather than the practitioner. Verify with the payer before billing that pattern.

Within RTM itself, two coordination rules apply. Only one practitioner bills the device-supply code per patient per 30-day period. And more restrictively, **Medicare will not pay RTM to both PT and OT for the same beneficiary**, not even across separate episodes of care with different diagnoses. When multiple therapy disciplines share a patient, one of them has to own the RTM billing outright. APTA and AOTA are both lobbying CMS to relax this.

## Which should your clinic use?

If you're a therapy practice, the decision is nearly made for you: **RTM is the program you can actually bill.** The real question isn't RTM vs RPM. It's whether your clinic captures the RTM revenue for follow-up work it already does informally. At 2026 national rates the recurring pair of codes is worth **$105.55 per active patient per month**; the [RTM guide's estimator](/what-is-remote-therapeutic-monitoring#estimate) shows what that means at your volume, and [RTM CPT codes explained](/blog/rtm-cpt-codes-explained/) breaks down each code's requirements.

One more reason the choice is easy: **RTM isn't a visit.** It isn't telehealth, it doesn't consume an authorized visit, it doesn't count toward the 10-visit progress report requirement, and MPPR doesn't apply to it. It does count toward the annual therapy dollar threshold. So RTM runs alongside the in-person plan of care rather than competing with it for the patient's visit budget.

## Frequently asked questions

### Can a physical therapist bill RPM?

Generally no. RPM codes are evaluation-and-management (E/M) services, which PTs, OTs, and SLPs cannot bill under Medicare. RTM codes were created as general-medicine codes precisely so therapists could bill remote monitoring directly.

### Can a patient be enrolled in both RTM and RPM?

A single practitioner cannot bill both programs for the same patient concurrently. That much is settled, and AMA guidance is that 98980 should not be reported in conjunction with the RPM management code 99457. The split-practitioner case (say, RPM from a cardiologist and RTM from a physical therapist) is not clearly addressed in published CMS guidance, so treat it as payer-specific and confirm before billing rather than assuming it's allowed.

### Which pays more, RTM or RPM?

Per-patient monthly economics are broadly similar: both pair a device-supply code with time-based management codes. The choice should be driven by what's being monitored and who's billing, not by rate differences.

### Does RTM require special hardware like RPM does?

No. RPM requires a device that automatically transmits physiological data. RTM explicitly allows patient self-reported data through software that meets the FDA's definition of a medical device under section 201(h) of the Food, Drug, and Cosmetic Act, so an app on the family's own phone is enough. The software needs to meet the definition, not to be FDA-approved, cleared, or registered.


## Sources

1. [CMS: 2026 Physician Fee Schedule Relative Value Files (RVU26A/RVU26C; source for all rates quoted here)](https://www.cms.gov/medicare/payment/fee-schedules/physician/pfs-relative-value-files)
2. [CMS: Therapy Code List: 2026 Annual Update (MM14250)](https://www.cms.gov/files/document/mm14250-therapy-code-list-2026-annual-update.pdf)
3. [CMS: Physician Fee Schedule Search (RTM and RPM rates by locality)](https://www.cms.gov/medicare/physician-fee-schedule/search)
4. [AMA: CPT overview and code maintenance](https://www.ama-assn.org/practice-management/cpt)

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