Remote Therapeutic Monitoring (RTM) for Chiropractors: Billing, Codes, and ROI

TL;DR

Chiropractors can bill Remote Therapeutic Monitoring, but reimbursement is less consistent than it is for physical and occupational therapists, so adoption should turn on realistic ROI rather than assumed parity with rehab billing.

• The applicable CPT codes are 98975 for setup, 98977 for device supply and monthly musculoskeletal data, and 98980 and 98981 for treatment management time.
• Some commercial payers and state Medicaid programs restrict RTM billing by provider type, so DC eligibility varies more than PT or OT eligibility does.
• Practical use cases include tracking home exercise adherence after spinal manipulation, watching pain and range-of-motion trends between visits, and flagging patients who fall behind on home care.
• Physitrack works as the software that bridges patient monitoring to your existing EMR, not as the sign-up step itself.

What RTM means for a chiropractic practice

Remote therapeutic monitoring lets you track a patient's home care between adjustments and bill for the clinical time you spend reviewing it. For a chiropractor, that means watching whether a patient actually completes their prescribed home exercises after spinal manipulation, and following their self-reported pain and function while they are away from your table. You collect structured data between visits, review it, and act on it before the patient returns.

Most RTM content assumes a physical therapy or occupational therapy rehab plan, where a course of care runs for weeks and the home program is the treatment. Chiropractic care works differently. The adjustment happens in the clinic, and the home exercises support recovery and reduce recurrence between visits. RTM fits that gap. It gives you visibility into the days you don't see the patient, so you know whether home care is holding the gains from the last adjustment or whether a patient is drifting off plan.

RTM complements your manual care rather than replacing or documenting it. It does not chart the adjustment itself, and it is not a substitute for your visit notes. It sits alongside the visit, capturing adherence and outcome trends that your in-clinic exam alone cannot show. A patient who reports rising pain and skipped exercises on day four tells you something you would otherwise learn only at the next appointment, if at all.

Chiropractors need their own read on RTM because the clinical rhythm and the reimbursement picture both differ from PT and OT. The codes are the same, but the workflow around them, and the payer treatment of a chiropractor billing them, are not. The rest of this guide works through those specifics for a chiropractic practice.

The CPT codes chiropractors need to know

Four CPT codes carry RTM billing, and each maps to a distinct point in a chiropractic care plan. Two cover setup and device costs, two cover the monitoring time you spend each month. Learning where each one fires in your workflow matters more than memorizing the code descriptions.

98975: the setup code

You bill 98975 once when you first enroll a patient in monitoring. After you finish an adjustment series and prescribe a home exercise program, you set the patient up on a monitoring method and record the initial data. The code covers that onboarding step, and you use it a single time per episode of care, not every month.

98977: the device supply code

You bill 98977 for the software or device that collects the musculoskeletal data over a full calendar month. The related code, 98976, applies to respiratory system monitoring, so a chiropractic practice tracking movement, pain, and function uses 98977 instead. Both device codes require the monitoring tool to gather data across a full calendar month, not a rolling 30-day window. If a patient enrolls on the 20th, you cannot bill the device code until the next complete calendar month produces the required data.

98980 and 98981: the management time codes

You bill 98980 and 98981 for the time you spend reviewing monitoring data and communicating with the patient. These are time-based codes, and 98980 covers the first 20 minutes of management in a calendar month. When a patient's adherence data shows they have stopped their home exercises, you call them, adjust the plan, and log the minutes. That interactive communication with the patient is a requirement, not an optional step. You cannot bill management time for passively watching a dashboard.

The second code, 98981, is an add-on for each additional 20 minutes in the same month. If you spend 45 minutes across a month reviewing a patient's pain trends and coaching them through a stalled program, you bill 98980 for the first 20 minutes and 98981 once for the next 20. You bill 98981 only after you meet the full 98980 threshold first.

Calendar month versus time thresholds

The distinction that trips up new billers is which codes depend on a full calendar month and which depend on accumulated minutes. The device code, 98977, requires 16 days of data within a calendar month before you can bill it. The management codes, 98980 and 98981, depend on time you log, and you can bill them once you cross the 20-minute and 40-minute marks in that month. Tracking both the day count and the minute count per patient keeps your claims defensible when a payer asks for documentation.

Where reimbursement gets complicated for DCs

Reimbursement for chiropractor-billed RTM is less predictable than it is for physical therapists, occupational therapists, and speech-language pathologists, and the reason is provider-type eligibility rather than the codes themselves. The CPT codes stay the same across professions, but payers decide which provider types they will actually pay for those codes. Some payers recognize RTM only when a physical therapist or physician bills it, and they apply that policy to chiropractors regardless of what the code descriptor allows.

Medicare set the initial pattern by adding RTM codes to the Physician Fee Schedule, which created a baseline that many practices assume extends everywhere. It does not. Commercial payers write their own coverage policies, and a plan that reimburses RTM for a physical therapy clinic may exclude chiropractic providers or fold RTM into a broader scope-of-practice limit. Two clinics in the same city can see different results from the same billed code because their patients carry different plans.

State Medicaid programs add another layer of variation. Medicaid coverage is set state by state, and several programs either exclude RTM entirely or restrict it by rendering-provider type. A chiropractor in one state may bill RTM to Medicaid without issue, while a colleague across a state line finds the same claim denied on eligibility grounds. That inconsistency makes it risky to model RTM revenue on a national reimbursement figure.

Verify coverage before you bill, and verify it per payer rather than per code. Call the payer or pull the written policy, confirm that chiropractors are an eligible rendering provider type for RTM, and check whether the plan requires the monitored condition to fall within a covered scope. Do the same check for each Medicaid program you participate in, since state rules will not follow Medicare's lead automatically. A short verification call before your first RTM claim prevents a batch of denials three months later.

None of this argues against adopting RTM in a chiropractic practice. It argues for confirming eligibility first, so your revenue projections rest on payers you know will pay rather than on an assumed parity that may not hold. Practices that do this groundwork can still build a workable RTM program. They simply enter it knowing which patient populations and payers actually support it.

Chiropractic use cases that justify RTM

Three chiropractic scenarios make the case for monitoring patients between visits, and each one gives you a reason to act on the data before the patient walks back through the door.

Home exercise adherence after spinal manipulation

Patients rarely tell you the truth about their home stretches. After a spinal adjustment, you prescribe corrective exercises to hold the change, and RTM shows you whether the patient actually did them. When adherence data drops off in week two, you know before the next visit that the follow-up appointment needs to cover technique or motivation rather than progression. That saves you from advancing a plan the patient never completed, which is the most common reason home care stalls.

Pain and range-of-motion trends between visits

A single visit gives you one data point. Patient-reported pain scores and range-of-motion measurements collected over two or three weeks give you a trend line, and the trend tells you far more than any bedside test. If cervical rotation improves steadily but forward flexion flattens out, you can adjust your next treatment toward the segment that stopped responding. A patient reporting rising pain mid-week, despite a good adjustment, signals that the home load is too aggressive and needs to come down before they aggravate the joint further.

Early flagging of patients falling behind

The patients who quietly disengage are the ones who drop out of care and never rebook. RTM surfaces them early. When a monitoring dashboard flags someone who has logged nothing for five days, you or a staff member can send a short message or bring them in sooner rather than waiting for a missed appointment to reveal the problem. Catching disengagement at day five instead of day twenty changes the outcome, because a patient who feels seen between visits is far more likely to finish the plan.

Each of these scenarios shares one practice-management logic. The value of RTM is not the data itself but the intervention it lets you make earlier. A DC who reviews adherence and pain trends before a scheduled visit walks in already knowing what to change, and that turns a routine follow-up into a targeted one. Reserve monitoring for patients on active home programs where the data will actually change your decision, rather than enrolling every walk-in, and the clinical payoff stays real.

Setting up RTM in your practice

Adopting RTM works best when you treat it as a four-step sequence rather than a switch you flip during a busy clinic day. Start with patient consent. Explain to the patient that you will monitor their home care between adjustments, document how they respond, and confirm they agree, since consent is a billing requirement, not a formality.

Next, choose how you will collect the data. Chiropractic RTM usually tracks home exercise adherence and patient-reported pain and range of motion, so your monitoring method needs to capture both consistently. A patient app that logs completed exercises and prompts short symptom check-ins gives you cleaner data than asking patients to remember details at the next visit.

Set a documentation and billing cadence before you enroll anyone. Decide which staff member reviews incoming data each week, and block time near month-end to confirm which patients cleared the 16-day device code threshold and to log your management minutes. A predictable weekly review keeps the time-based codes accurate and stops billing from piling up.

Then connect the monitoring to your existing records. Physitrack acts as the software bridge between patient monitoring and your chiropractic EMR. We capture adherence, pain, and range-of-motion data through the patient app, then feed it back to your clinical workflow so the numbers land where you already document care. Physitrack is not a chiropractic EMR and does not replace your documentation system. The point is to give you structured remote therapeutic monitoring data that supports your notes and your billing without forcing you to run two parallel record systems.

One practical note on sequencing. Verify payer eligibility for your provider type before you enroll patients, not after you have a month of data to bill. Confirming coverage first protects the time you invest in setup and keeps the ROI you modeled realistic. Once eligibility and cadence are settled, enrolling additional patients becomes routine, and the monitoring data starts informing how you adjust home care between visits rather than sitting unused until the patient returns.

Modeling RTM's revenue impact per patient

A single active RTM patient generates recurring revenue by stacking one setup code, one monthly device code, and one or two management codes each month. Working through the math with conservative reimbursement figures gives a defensible range rather than the inflated per-patient numbers that some RTM pitches quote.

Start with the first month, since it carries the most codes. You bill 98975 once when you set up monitoring and establish the treatment plan, then 98977 for the device supply once the patient submits sixteen days of data in the calendar month. Add 98980 for your first twenty minutes of management time. Using 2026 Medicare national average payment amounts, the first management increment (98980) pays roughly $54 and each additional increment (98981) pays roughly $42. The setup and device codes pay smaller amounts on top of that, so first-month revenue for one patient lands in a comparable range, before accounting for any patient who does not clear the 16-day device threshold.

Ongoing months drop the one-time setup code. You continue billing 98977 for the monthly device supply and 98980 for management time, with 98981 added when your review and communication crosses the second twenty-minute block. A patient who needs a single management increment (98980 plus the device code) brings in roughly $100 to $110 each month at Medicare rates. A more involved patient who also justifies the add-on code (98981) reaches roughly $140 to $155. Across a panel of active RTM patients, those figures compound into a meaningful monthly line, but only for patients who actually meet the data and time thresholds.

Two variables move the model more than the code count. Provider-type eligibility decides whether a given payer pays you at all, as covered earlier, so a DC panel with a high share of restricted payers will see the effective per-patient number fall well below the Medicare figures above. Patient adherence decides whether 98977 clears its sixteen-day requirement each month, and patients who lapse simply do not generate that code.

Run your own panel through the RTM calculator with your local reimbursement rates and your realistic adherence rate. Plugging in the payers you actually bill, rather than a national average, keeps the projection honest and tells you whether RTM clears the effort of setting it up in your practice.

Getting started with RTM

Two steps decide whether RTM fits your practice. First, confirm that your major payers and state Medicaid program reimburse chiropractor-billed RTM, since provider-type eligibility varies more for DCs than for physical therapists. Second, evaluate a monitoring tool that connects to your existing EMR rather than replacing it.

Physitrack sits between patient monitoring and your practice's clinical records, so home exercise adherence and patient-reported outcomes flow back to you without a second documentation system. If your payer checks come back clean, the tooling decision is the shorter conversation.

See how Physitrack supports RTM for your practice.

Perguntas frequentes

Do Medicare and commercial payers reimburse DC-billed RTM the same way? No. Medicare covers RTM under specific CPT codes, but chiropractic billing eligibility varies by contractor and by commercial payer. Confirm provider-type eligibility with each payer before you bill, since some plans and state Medicaid programs restrict RTM to physical therapists, occupational therapists, or physicians.

Does RTM require a separate device? Not necessarily. RTM under codes 98975 and 98977 uses a monitoring method that captures musculoskeletal data, and a patient-facing app that records home exercise adherence and reported pain qualifies. Physitrack collects that data through PhysiApp, so most chiropractic practices monitor without adding hardware.

How does RTM differ from CCM and RPM? RTM monitors non-physiologic data such as home exercise adherence, pain, and function, which fits chiropractic care between adjustments. Remote physiologic monitoring (RPM) tracks vitals like blood pressure or glucose, and chronic care management (CCM) covers care coordination for chronic conditions. For a DC tracking musculoskeletal recovery, RTM is the relevant category, and Physitrack is built to capture that data rather than physiologic readings.

Does Physitrack replace my chiropractic EMR? No. Physitrack is not an EMR and does not store your clinical documentation. It handles the monitoring side, collecting adherence and patient-reported outcomes, and connects that data back to your existing EMR so your records and billing stay in one place.