Step-by-step guide to implementing Remote Therapeutic Monitoring (RTM) in your pain practice.
Learn patient selection, workflow integration, billing compliance, and practice economics with RTM codes 98975-98981.
Step 1: Patient Selection
Ideal RTM Candidates
Examples of typical clinical scenarios where providers may choose to apply RTM under CMS guidance. These examples illustrate RTM use in general and do not define the intended use or indications of PD Care system or any specific software
Pain conditions with measurable functional outcomes.
Chronic low back pain
Post-surgical rehabilitation (orthopedic and spine)
Complex regional pain syndrome (CRPS)
Fibromyalgia and widespread pain syndromes
Patients on long-term opioid therapy requiring functional monitoringMusculoskeletal injuries with prolonged recovery
Patient Technology Requirements
Before enrolling patients, verify they have:
Smartphone (iOS or Android)
Internet access
Basic comfort with technology
Assessment Questions for Patient Selection
During evaluation, ask:
"Do you have a smartphone?"
"Are you comfortable using apps for health tracking?"
"Would you be willing to check in daily about your activities and symptoms?"
Pro Tip: Patients who already use digital self-monitoring tools often adapt well to RTM workflows.
When RTM May Not Be Appropriate
Consider alternatives for:
- Patients without reliable technology access
- Acute pain episodes resolving in <4 weeks
- Patients with cognitive impairments affecting app use
- Those preferring entirely in-person care
- Severe depression
Step 2: Workflow Integration
Clinical Workflow Overview
Week 1: Initial Setup
- Provider identifies appropriate RTM candidate during visit
- Staff conducts setup appointment (CPT 98975)
- Patient downloads app and completes onboarding
- Baseline self-reported assessments recorded
- Patient-defined monitoring goals established
Ongoing: Monthly Monitoring Cycle
- Patient engages with app ≥16 days per month
- Data flows to clinical dashboard
- Care team may review self-reported data as part of their standard workflow
- Monthly comprehensive review (CPT 98980/98981)
- Care plan adjustments should be based on the clinician’s independent clinical judgment, with RTM data serving as supplemental information only
Staffing and Role Assignment
Designate clear responsibilities:
Medical Assistant / Care Coordinator:
- Initial patient setup and CPT 98975 education
- Technology troubleshooting
- Weekly review for engagement or changes in reported patterns
- Patient engagement follow-up
Physician / Clinical Lead:
- Patient selection and enrolment decisions
- Monthly comprehensive review
- Clinical decision-making, with any adjustments based on standard clinical evaluation
- Documentation for CPT 98980/98981
Billing Specialist:
- RTM code submission
- CMS documentation verification
- Compliance tracking
Integration with Existing Visits
RTM doesn't replace in-person care - it serves as complement.
During routine follow-ups:- Review functional trend graphs on dashboard
- Discuss specific patterns (e.g., sleep disruption, activity changes)
- Consider patient-reported trends alongside standard clinical evaluation when discussing care plans
Between visits:
- Monitor for reduced engagement or notable changes in patient-reported entries
- Reach out proactively when patient-reported information indicates the need for follow-up
- Provide encouragement based on patient engagement and self-reported trends
- Document time spent reviewing and communicating
Step 3: Patient Onboarding Process
The Setup Appointment (CPT 98975)
The RTM onboarding in four easy steps
1
Explain the "Why"
"RTM allows us to stay informed between visits by giving us additional insight into your self-reported daily activities and functioning. This information supplements, but does not replace, your in-person evaluations or clinical care."
2
Technology Walkthrough
- Download app together
- Complete registration
- Review notification settings
- When to expect check-ins from care team
- Emergency protocols (RTM doesn't replace urgent care
3
Establish
Baseline
- Complete initial self-reported questionnaires
- Set realistic goals together
- Identify activities the patient wishes to track as part of their self-monitoring (e.g., daily walking, stretching routines)
4
Set
Expectations
"We need you to check in to the app at least 16 days each month. This takes about 2-3 minutes per day. If you can't check in, just let us know-we're here to help."
Step 4: Documentation and Compliance
A high-quality RTM system ensures compliance is built into every step of the workflow.
Document Engagement
- Meets 16-day engagement requirement
- Full audit trail via system logs
- Verified patient-reported outcomes & activity tracking
RTM Product Compliance
- Visualize functional trends using validated, patient-specific real-world data.
- Support clinical decisions while final treatment decisions remain with licensed providers
- Enable secure patient communication and structured follow-up with documented interactions
Time Tracking
- Verified monthly clinician review time. (minimum 20 minutes for CPT 98980)
- Documented interactive patient communication
- Logged time for data-driven clinical decisions
Required elements for CPT 98975 billing
- Patient consent for remote monitoring documented
- Education on device/app use provided
- Initial treatment goals established
- Time spent on setup recorded
Training and Team Preparation
Core Team Training (2 hours)
- Platform navigation
- Patient enrolment process
Billing Training (1 hours)
- CMS documentation requirements
- Code selection and time tracking
- Compliance review
Ongoing: Monthly Check-ins
- Troubleshooting common issues
- Workflow optimization
- New feature training
The training outline above is based on our experience with our own system and implementation processes. Actual workflows, experiences, and training needs may vary depending on the specific product, clinical environment, and team structure.
Common Implementation Challenges
Challenge
Patients forget to engage daily
Staff overwhelmed by new workflow
Low engagement from certain patients
Identify potential barriers early and support patients in navigating the tools as needed.
Start with a small pilot group of patients, refine processes, then scale gradually
Solution
Automated reminders and periodic follow-up can help maintain engagement when appropriate
Frequently asked questions
Initial setup (CPT 98975) typically takes 20-30 minutes per patient, combining education, technology walkthrough, and baseline assessment.
That month cannot be billed for RTM services. Monitoring continues into the next month. Providers may follow up to understand barriers and offer support as appropriate.
RTM can complement Chronic Care Management (CCM) and Principal Care Management (PCM). Time spent on RTM review counts separately if properly documented.
Yes. Physical therapists, occupational therapists, physicians, and other qualified providers can bill RTM services according to Medicare guidelines.
Providers review patient-reported trend data, discuss observations with the patient, and make care decisions based on their independent clinical judgment. Document required time and communication according to CMS guidelines.
Ready for the Next Step?
1
Pilot
Identify 10-15 pilot patients
2
Define roles
Assign staff roles and responsibilities
3
Training
Schedule team training
4
Start
Plan first setup appointments
Read Part 1: Why Functional Monitoring Matters More Than Pain Scores
- See Paindrainer CARE system in action—watch our video now.
- Book a demo of PD Care system
Important Notice: The information provided here is for educational purposes. Healthcare providers should use their professional judgment when implementing RTM programs and selecting patients. All billing and reimbursement information should be verified with payers.
202512-EN032