Comparing RPM vs. RTM is one of the first steps in planning a remote care program. Both services keep patients connected to their care team between visits. RTM monitoring and RPM monitoring still differ in the data they collect, the devices they use, and the clinicians who provide them.
Remote patient monitoring (RPM) tracks physiologic data, such as blood pressure, weight, and blood oxygen. Remote therapeutic monitoring (RTM) tracks non-physiologic data, such as therapy adherence, therapy response, and respiratory or musculoskeletal status. Medicare covers each under its own set of CPT codes, and the two cannot be reported for the same patient in the same period.
This article covers:
- What each service monitors
- The devices and data each one uses
- The 2026 RPM and RTM code sets
- Who can provide each service
- Changes CMS proposed for 2027
What Is Remote Patient Monitoring?
Remote patient monitoring collects physiologic data from patients outside a clinical setting. Patients take readings at home with connected devices. Those readings transmit automatically to the care team’s platform, where clinical staff review trends and respond to readings outside the ordered range.
Common RPM measurements include:
- Blood pressure and heart rate
- Weight
- Blood glucose
- Oxygen saturation and pulse rate
- Temperature
RPM is most often used for chronic conditions such as hypertension, heart failure, diabetes, and chronic obstructive pulmonary disease (COPD). A patient with heart failure who gains a few pounds over two days gives the care team a reason to call. That early contact can prevent an emergency visit.
The device must meet the Food and Drug Administration (FDA) definition of a medical device. Readings must be recorded and sent automatically. Patient-entered values do not qualify for RPM.
What Is Remote Therapeutic Monitoring?
Remote therapeutic monitoring tracks how a patient is responding to treatment, rather than vital signs. CMS created the RTM codes in 2022 so that therapy and treatment data collected at home could be covered.
RTM monitoring falls into three areas:
- Musculoskeletal system status, such as range of motion, exercise adherence, and pain during home exercise programs
- Respiratory system status, such as peak flow, spirometry, and inhaler use
- Cognitive behavioral therapy, such as adherence to a digital CBT program
Some RTM data comes from connected devices, like a digital peak flow meter for a patient with asthma. Other RTM data can be self-reported by the patient through a device or app. That flexibility is one of the clearest differences in RPM vs. RTM. As with RPM, the device used must meet the FDA definition of a medical device.
RTM fits patients in physical therapy, occupational therapy, pulmonary care, and behavioral health. A physical therapist can see whether a patient completed their home exercises and how much pain they reported. A pulmonologist can track peak flow trends alongside medication adherence.
RPM vs. RTM at a Glance
| Remote patient monitoring | Remote therapeutic monitoring | |
|---|---|---|
| Data type | Physiologic (vital signs) | Non-physiologic (therapy adherence and response) |
| Data entry | Automatic transmission only | Automatic or patient self-reported |
| Clinical areas | Any condition with physiologic parameters | Musculoskeletal, respiratory, and cognitive behavioral therapy |
| Common providers | Physicians and advanced practice clinicians | Physicians, advanced practice clinicians, and physical, occupational, and speech therapists |
| Setup code | 99453 | 98975 |
| Device codes | 99445 (2 to 15 days), 99454 (16 to 30 days) | 98984, 98985, 98986 (2 to 15 days); 98976, 98977, 98978 (16 to 30 days) |
| Management codes | 99470, 99457, 99458 | 98979, 98980, 98981 |
RPM Codes for 2026
The CY 2026 Physician Fee Schedule final rule added shorter monitoring and management codes to both code families, effective January 1, 2026. For rates and full descriptors, see our guide to RPM CPT codes.
- 99453: Initial device setup and patient education. Reported once per episode of care, after at least 2 days of data.
- 99445 (new for 2026): Device supply with daily recordings or programmed alert transmissions, 2 to 15 days in a 30-day period.
- 99454: Device supply with daily recordings or programmed alert transmissions, 16 to 30 days in a 30-day period.
- 99470 (new for 2026): First 10 minutes of treatment management time in a calendar month.
- 99457: First 20 minutes of treatment management time in a calendar month.
- 99458: Each additional 20 minutes, added on to 99457.
- 99091: Collection and interpretation of physiologic data by a physician or other qualified health care professional, at least 30 minutes each 30 days.
The management codes require at least one real-time interactive communication with the patient or caregiver during the month. That means a live phone or video conversation. Text messages, email, and portal messages do not meet the requirement on their own.
A few pairing rules apply. The 2 to 15 day and 16 to 30 day device codes cannot both be reported in the same 30-day period. CPT 99470 is reported instead of 99457 when management time falls between 10 and 19 minutes. CPT 99458 can only be added to 99457, not to 99470.
RTM Codes for 2026
RTM follows the same structure as RPM, with codes for setup, device supply, and management. Four RTM codes are new for 2026. Our guide to RTM CPT codes lists rates and descriptors for each.
- 98975: Initial setup and patient education on the device. Reported once per episode of care, after at least 2 days of data.
- 98984 (new for 2026): Respiratory system device supply, 2 to 15 days in a 30-day period.
- 98976: Respiratory system device supply, 16 to 30 days in a 30-day period.
- 98985 (new for 2026): Musculoskeletal system device supply, 2 to 15 days in a 30-day period.
- 98977: Musculoskeletal system device supply, 16 to 30 days in a 30-day period.
- 98986 (new for 2026): Cognitive behavioral therapy device supply, 2 to 15 days in a 30-day period.
- 98978: Cognitive behavioral therapy device supply, 16 to 30 days in a 30-day period.
- 98979 (new for 2026): First 10 minutes of treatment management time in a calendar month.
- 98980: First 20 minutes of treatment management time in a calendar month.
- 98981: Each additional 20 minutes, added on to 98980.
The pairing rules mirror RPM. A patient’s device code depends on days of data in the period. One musculoskeletal patient with 9 days of data would fall under 98985, and the same patient with 20 days would fall under 98977. The two are never reported together. CMS lists the RTM therapy codes in its 2026 therapy code list.
The CBT device codes, 98978 and 98986, have no national rate. Payment is set by each Medicare Administrative Contractor.
This material is provided for general informational and educational purposes only and does not constitute legal, compliance, billing, coding, or reimbursement advice. CPT® codes, descriptions, and Medicare payment rates referenced here are drawn from publicly available sources, are subject to change, and may vary by payer, locality, and patient circumstances. Tenovi makes no representation or guarantee regarding coverage, payment, or the appropriateness of any code for a particular patient or service, and any presented are illustrative only. Providers are solely responsible for independently determining medical necessity and applicable coding, coverage, documentation, and billing requirements and for submitting accurate claims. Consult applicable payer guidance and qualified billing, coding, compliance, or legal professionals before making billing decisions. CPT® is a registered trademark of the American Medical Association.
Why the 2026 Short-Period Codes Matter for Patients
Before 2026, a patient needed at least 16 days of data in a 30-day period for any device code. A patient who sent 12 days of readings had no device code, even when the care team reviewed the data and acted on it.
The new 2 to 15 day codes change that. Patients recovering from surgery, starting a new medication, or still building a daily routine can stay enrolled. A respiratory patient adjusting to a new inhaler might only need monitoring for a few weeks. A post-operative knee patient might log exercises for 10 days before their next in-person session.
The shorter management codes work the same way. A month with 12 minutes of clinical time now has a code that fits. That gives care teams room to match monitoring to what each patient needs.
Who Can Provide RPM and RTM Services
The clinicians who can furnish each service are one of the most practical differences in RPM vs. RTM.
RPM is ordered by a physician or other practitioner who can report evaluation and management services, such as a nurse practitioner or physician assistant. Clinical staff, including nurses and medical assistants, can perform much of the work under general supervision. Physical therapists cannot report the RPM codes.
RTM has a wider list. Physicians and advanced practice clinicians can report it. Physical therapists, occupational therapists, and speech-language pathologists can also report RTM directly, since CMS designates several RTM codes as sometimes therapy services. Therapy assistants can help deliver RTM under the supervision rules that apply to their setting.
Both services require an order, documented patient consent, and a medical need for monitoring. Both can be provided in the same month as chronic care management, principal care management, transitional care management, and behavioral health integration, as long as time is not counted twice.
Can a Patient Receive Both RPM and RTM?
A patient may benefit from both kinds of monitoring over time. A patient with COPD, for example, might need oxygen saturation data at one point and inhaler adherence data at another.
Medicare does not allow RPM and RTM to be reported for the same patient in the same period. The care team chooses the service that best fits the patient’s current needs. Only one practitioner can report the device codes for a patient in a 30-day period, so coordination across care teams matters.
What CMS Proposed for RPM and RTM in 2027
In the CY 2027 Physician Fee Schedule proposed rule, released July 14, 2026, CMS proposed several changes that would affect both services:
- Limiting RTM to established patients, matching the current RPM requirement
- Requiring a separately reportable initiating visit before RPM or RTM begins
- Paying for RPM and RTM only when furnished by clinical staff employed by the practice
- Seeking comment on replacing the current RPM and RTM CPT codes with four bundled HCPCS G-codes
None of these proposals are final. The final rule typically arrives in early November. Care teams should plan for closer attention to how monitoring starts, who provides it, and how it is documented.
Frequently Asked Questions About RPM vs. RTM
The questions below cover what care teams most often ask when comparing RPM vs. RTM. They address data types, self-reported data, who can provide RTM monitoring, and how the two services work together.
1) What is the main difference between RPM and RTM?
RPM tracks physiologic data, such as blood pressure, weight, and blood glucose. RTM tracks non-physiologic data, such as therapy adherence and therapy response for musculoskeletal, respiratory, and cognitive behavioral therapy care.
2) Can RTM use self-reported patient data?
Yes. RTM data can be transmitted by a device or reported by the patient through a device or app. RPM data must be recorded and transmitted automatically.
3) Can physical therapists provide RTM?
Yes. Physical therapists, occupational therapists, and speech-language pathologists can report the RTM codes. They cannot report the RPM codes.
4) Can RPM and RTM be provided to the same patient in the same month?
No. Medicare does not allow both services to be reported for the same patient in the same period. A patient can move from one to the other as their care needs change.
5) What counts as interactive communication for RPM and RTM?
The management codes require at least one real-time interactive communication with the patient or caregiver during the month. A live phone or video conversation meets that requirement. Text and email alone do not.
6) What changed for RPM and RTM in 2026?
CMS added codes for 2 to 15 days of data (99445, 98984, 98985, and 98986) and 10-minute management codes (99470 and 98979). These codes support patients with shorter-term or lighter monitoring needs.
Understanding RPM vs. RTM
RPM vs. RTM comes down to the type of data and the type of care. RPM tracks vital signs from devices that transmit automatically, and it is most often used for chronic conditions such as hypertension, heart failure, and diabetes. RTM tracks how patients respond to therapy, including musculoskeletal, respiratory, and cognitive behavioral therapy care, and it can include self-reported data. RTM can also be provided by physical, occupational, and speech therapists. Both code families gained short-period device codes and 10-minute management codes in 2026, which help care teams support patients with shorter-term needs. The CY 2027 proposed rule points to closer attention to how monitoring begins and who provides it. Choosing the right service for each patient starts with a clear view of these differences.
Tenovi provides cellular-connected remote patient monitoring and remote therapeutic monitoring devices, along with the data infrastructure that supports remote care programs. The Tenovi Cellular Gateway collects readings from FDA-cleared devices in the patient’s home, with no app, Wi-Fi setup, or Bluetooth pairing for the patient. If you are planning or growing a remote monitoring program, contact us for a free demo and consultation.
