Remote therapeutic monitoring billing for physical therapy clinics

Physical therapists, occupational therapists, and speech-language pathologists can bill Medicare for remote therapeutic monitoring. The service pays for two separate things: supplying a patient with a device or software that collects data about their therapy, and the time a clinician spends managing their care using what comes back.

Most of the confusion around it is not conceptual. It is that whether a given month is billable comes down to counting, and the things being counted are different for each code. This is what has to be true.

Remote therapeutic monitoring

The collection and review of non-physiologic patient data related to therapy, including musculoskeletal status, respiratory status, therapy adherence, and therapy response. It differs from remote physiologic monitoring, which covers physiologic data such as blood pressure or weight, and which therapists cannot bill.

Who can bill

Remote therapeutic monitoring codes are billable by physicians and qualified healthcare professionals, and that category includes physical therapists, occupational therapists, and speech-language pathologists. This is the distinction that makes the code family matter for outpatient therapy: remote physiologic monitoring is not billable by therapists, and remote therapeutic monitoring is.

The codes can also be billable under commercial plans, but coverage is not uniform. Medicare policy is the floor, not the whole picture, and a clinic that assumes a commercial payer follows Medicare here will sometimes be wrong.

The code set

The family splits cleanly in two. The device supply codes pay for giving the patient the thing that collects the data, and they are counted in days. The treatment management codes pay for clinician time spent on that data, and they are counted in minutes per calendar month.

Codes 98976 and 98978 cover device supply for respiratory system monitoring and for cognitive behavioral therapy monitoring. They follow the same shape as 98977 and are the relevant ones outside musculoskeletal care.

What changed in 2026

Until this year the thresholds were unforgiving. A patient had to transmit data on at least 16 days in a 30-day period before the device supply code could be billed, and a clinician had to spend at least 20 minutes in the month before any management time could be. A patient who engaged for ten days, or a month where a clinician spent twelve minutes, produced nothing billable at all.

Two codes effective January 1, 2026 fill those gaps. 98985 covers device supply for 2 to 15 days, and 98979 covers the first 10 minutes of treatment management. Both pair with the existing codes rather than replacing them.

• 98985 and 98977 are mutually exclusive. A 30-day period falls into one bracket or the other, never both.
• 98979 and 98980 are mutually exclusive for the same reason, applied to minutes.
• 98979 and 98985 are designated sometimes therapy services, which affects how they are billed when furnished under a therapy plan of care.

The thresholds that decide a billable month

Two counters run independently, and confusing them is the most common source of a denied claim. Days of transmitted data decide which device supply code applies. Minutes of clinician time decide which treatment management code applies. A patient can clear one and miss the other.

The treatment management codes carry a second condition that is easy to overlook: the month must include at least one interactive communication with the patient or caregiver. Reviewing data alone does not satisfy it. For 98979 that communication is specified as real-time.

What has to be documented

The claim rests on being able to show three things after the fact: that the patient was set up and educated on the device, how many days data was actually transmitted, and how much clinician time was spent along with the interactive communication that took place. A record that captures the first and last of those but not the day count will not survive a review.

Patient consent must be obtained and documented before the service begins. Treat it as a precondition rather than a formality.

Where physical therapist assistants fit

This is the part most summaries get wrong, and it is worth reading carefully if you are a private practice.

Supervision requirements for physical therapist assistants furnishing remote therapeutic monitoring differ by setting. In response to an inquiry from APTA, CMS indicated that private practices should continue direct supervision of PTAs providing these services, while general supervision is permitted in rehab agencies, comprehensive outpatient rehabilitation facilities, and other institutional providers. Guidance that states general supervision without naming the setting is describing only half of the rule, and the half that does not apply to most outpatient clinics.

APTA has treated the private practice requirement as an active advocacy target, so this is a rule worth rechecking rather than learning once. The APTA practice advisory linked below is the place to confirm the current position.

What it pays

Payment amounts are set by the Medicare Physician Fee Schedule and vary by locality, so a single national figure is a starting point rather than an answer. Published summaries of the same codes circulate with materially different values, usually because a work relative value unit has been quoted where a total relative value unit was meant.

Rather than restate a number here that we cannot tie to a primary source, the honest version is a calculation you run against your own volumes. That is a separate piece of work and is not published yet. In the meantime, the fee schedule lookup published by CMS is the authoritative place to check a specific code against a specific locality.