Remote Therapeutic Monitoring (RTM) allows eligible providers to bill Medicare for monitoring and managing patients remotely during their rehabilitation.
With Vertigenius™, clinicians can remotely track exercise performance, adherence, and patient-reported symptoms between visits—providing the clinical data needed to support ongoing therapeutic management.
2026 CMS changes create greater flexibility for shorter periods of patient engagement, opening new reimbursement opportunities for eligible vestibular rehabilitation providers.
A quick reference for billing teams: 2026 Medicare national averages alongside estimated commercial payer ranges for the core RTM code set.
Initial Setup
Patient setup, onboarding, and platform / head-sensor education.
Once per episode
NEW
DEVICE SUPPLY
Short-duration MSK monitoring (2–15 days of active automated data transmission).
Every 30 days
DEVICE SUPPLY
Standard MSK monitoring (16 or more days of automated data transmission).
Every 30 days
NEW
management
Low-intensity treatment management (10–19 minutes of clinical data review).
Calendar month
management
Standard treatment management (first 20 minutes of clinical review).
Calendar month
management
Extended management (each additional 20 minutes of clinical management).
Calendar month
Immediate validation on which patients qualify and why the Vertigenius™ ecosystem satisfies CMS device requirements out of the box.
Unlike traditional RPM that tracks physiological metrics, RTM focuses on data like treatment adherence, symptom scores, and therapeutic response, aligning perfectly with Vestibular Rehabilitation Therapy (VRT). To utilize MSK codes (98977 and 98985), patients must present an approved diagnosis affecting balance and movement, such as:
CMS strictly mandates that RTM data must be collected via software or hardware that meets the FDA definition of a medical device.
The Vertigenius™ Advantage
Our entire Platform, clinician web portal, patient mobile application, and integrated head sensor is fully registered with the FDA as a medical device.
Automated Tracking
The system automatically captures and securely transmits the mandatory non-physiological data required to back your clinical claims.
A three-step path from provider verification to audit-ready documentation, engineered to prevent the denials that quietly erode RTM revenue.
Who Can Bill
Physical Therapists (PTs), Occupational Therapists (OTs), Speech-Language Pathologists (SLPs), Physicians (MD/DO), Nurse Practitioners (NPs) & Physician Assistants (PAs).
Supervised setup
PTAs and OTAs cannot bill independently but may perform setup and monitoring under direct supervision.
Who Cannot Bill
Chiropractors and independent assistants.
Missing modifiers results in immediate automated denials. Ensure your billing team applies:
GP Modifier
Always required for every RTM code submitted under a Physical Therapy plan of care.
GO Modifier
Required for all codes under an Occupational Therapy plan of care.
CQ / CO Modifiers
Required if a PTA (CQ) or OTA (CO) handles setup/monitoring, triggers a statutory 15% payment reduction for time-based management.
KX Modifier
Required once combined annual therapy spend exceeds the 2026 cap of $2,480, certifying medical necessity.
To legally substantiate claims for treatment management (98979 and 98980), clinician notes must explicitly feature:
The Synchronous Threshold
Proof of at least one live, interactive communication (phone, secure video, or face-to-face) that month. Texts, automated alerts, and unreturned voicemails do not count.
System Log Validation
Device transmission summaries proving the exact tracking days, validating short-duration (2–15d) vs. standard (16d+) supply codes.
Clinical Audit Trail
A detailed log of clinical time analyzing vestibular data, customizing protocols, and modifying care directives.
The questions billing teams ask most about the 2026 tiered RTM updates.
Prior to 2026, short-term vestibular rehab plans that didn't hit the strict 16-day monitoring mark went completely uncompensated. With the new short-duration code (98985), clinics can confidently deploy Vertigenius™ sensors for acute vertigo or post-maneuver tracking lasting 2 to 15 days, ensuring complete revenue capture across all care cycles.
Yes. Medicare covers 80% of the allowed fee schedule, and the remaining 20% residual is the patient's responsibility or is forwarded to their secondary/supplemental insurance.
Standard compliant billing practice mandates that the patient is billed later, after the claim successfully adjudicates and an official Explanation of Benefits (EOB) is issued. Collecting estimated flat fees up front is discouraged due to monthly monitoring variations (e.g., transitioning between 98985 and 98977).
No. If you intend to submit claims for the RTM device supply codes (98977 or 98985), you cannot charge the patient an upfront retail fee for hardware. Doing so represents unallowable double-billing, as insurance supply reimbursement is structured to cover the costs of provisioning tracking technology.
Insurance companies do not verify coverage based on commercial brand names. When performing eligibility checks, clinical teams must verify coverage using specific CPT codes.
Staff Script Requirement: Instruct your staff to ask: "Does the plan cover CPT codes 98975, 98977, 98985, 98979, and 98980 for Remote Therapeutic Monitoring of musculoskeletal status?"
Get the full 2026 RTM playbook, or book a call to integrate Vertigenius™ reimbursement workflows into your billing stack.
