TL;DR
Tracking patient progress without in-person visits relies on a set of technologies, billing codes, and behavioral strategies that most rehab providers are still learning. Remote Therapeutic Monitoring (RTM) is the central framework, made billable by CMS in 2022 and significantly expanded in 2026. This glossary defines every term you need, from CPT codes to behavior change nudges, and explains how they connect into a single workflow that improves adherence, outcomes, and revenue.
Why This Glossary Exists
A significant portion of patient recovery happens at home, not in the clinic. The problem is that most providers have zero visibility into what patients actually do between appointments. Research shows that non-adherence to home exercise programs runs as high as 70%, and a systematic review found that only about 21% of patients are fully adherent to their prescribed exercises.
Those numbers explain a lot of stalled outcomes.
Tracking patient progress without in-person visits has gone from a nice-to-have concept to a reimbursable, evidence-backed standard of care. But the terminology can be confusing. RTM, RPM, SaMD, PROMs, CPT 98979… the abbreviations pile up fast.
This glossary is built for physical therapists, occupational therapists, speech-language pathologists, chiropractors, and athletic trainers who want a single reference for every term that matters in remote progress tracking. The entries are grouped by theme (not alphabetically) so they mirror how you’ll actually encounter these concepts in practice.
Explore AC Health’s platform features to see how these concepts come together in a working tool.
Group 1: The Big-Picture Concepts
Between-Visit Engagement
Between-visit engagement refers to any structured interaction between a provider and patient that happens outside of scheduled clinic appointments. This includes exercise reminders, secure messages, educational content delivery, progress check-ins, and outcome surveys.
The concept matters because clinical contact time represents a fraction of a patient’s recovery timeline. A typical PT patient might spend 2-3 hours per week in the clinic and 165+ hours outside it. Between-visit engagement fills that gap with accountability and clinical oversight.
Providers who build strong patient engagement strategies report fewer no-shows, better adherence, and higher satisfaction scores. When done through a HIPAA-compliant platform, this engagement also generates data that supports RTM billing.
Telerehabilitation
Telerehabilitation is the delivery of rehabilitation services through telecommunications technology. It encompasses live video sessions (synchronous), app-based exercise delivery (asynchronous), and remote monitoring of patient-reported data.
The global telerehabilitation market was valued at $6.09 billion in 2025 and is projected to reach $20.60 billion by 2034, reflecting a compound annual growth rate of 14.5%. The U.S. segment alone is expected to grow from $2.45 billion to $7.10 billion over a similar timeline.
Telerehabilitation is the broadest category in this glossary. RTM, HEP apps, and asynchronous care all fall under its umbrella.
Asynchronous Care
Asynchronous care is clinical communication and treatment delivery that does not require both parties to be present at the same time. In rehab, this typically means a provider assigns an exercise program or educational content through an app, and the patient completes it on their own schedule. The provider reviews the patient’s activity data and responses later.
This is the opposite of a live telehealth video call. Asynchronous care scales better because it doesn’t require appointment slots, and it matches how most patients actually do their home exercises: on their own time, often at odd hours.
For providers tracking patient progress without in-person visits, asynchronous care is the default mode. The patient exercises at home, logs their activity or pain levels, and the provider reviews that data during normal working hours.
Group 2: Monitoring Methods and Technology
Remote Therapeutic Monitoring (RTM)
Remote therapeutic monitoring is the most important term in this glossary. RTM is a CMS-recognized program that allows rehabilitation providers to track patient progress without in-person visits using software-based tools. Patients self-report data like pain levels, exercise completion, and functional status through an app, and clinical staff review that data between visits to adjust treatment as needed.
RTM became billable under Medicare effective January 1, 2022. Physical therapists, occupational therapists, and their assistants can provide and be reimbursed for these services by CMS, Medicare Advantage plans, and potentially commercial insurers.
A 2025 retrospective study of 1,224 patients across 95 clinics found that 72% of patients receiving PT plus RTM achieved their functional status benchmark, compared to 63% for PT alone. That 9-percentage-point difference is clinically meaningful and statistically significant.
Practitioners on Reddit and in rehab forums frequently cite patient compliance as the number one barrier to RTM adoption. As one DPT writing at Wibbi put it: “When your reimbursement depends on patients remembering to sync their devices for 16 out of 30 days, you’re fighting an uphill battle.” The 2026 code expansion (covered below) directly addresses this problem.
For a step-by-step implementation guide, see how to enroll patients in remote monitoring programs.
Remote Patient Monitoring (RPM)
Remote patient monitoring is RTM’s older cousin, and the two are frequently confused. The distinction is straightforward:
RPM tracks physiological data (heart rate, blood pressure, blood oxygen, body temperature) using connected medical devices. It is billed by physicians and clinical staff under physician supervision. The data uploads automatically from the device.
RTM tracks non-physiological data (pain levels, exercise adherence, medication compliance, functional status) using software tools. It can be billed by PTs, OTs, and SLPs, which opens a reimbursement channel that rehabilitation practices couldn’t access before.
A patient cannot be enrolled in both RPM and RTM during the same calendar month. For rehab providers, RTM is almost always the relevant program.
Software as a Medical Device (SaMD)
Software as a medical device is a regulatory classification for software that performs a medical function without being part of a physical hardware device. In the RTM context, the app a patient uses to report pain, log exercises, and receive care instructions qualifies as SaMD.
This matters because RTM billing requires the use of a qualified device or software tool. Unlike RPM, which requires automatic data upload from a physical medical device, RTM permits patient self-reporting through SaMD platforms. This lower barrier to entry is part of what makes RTM accessible to rehab practices of all sizes, including solo practitioners and small clinics.
Patient-Reported Outcomes (PROs / PROMs)
Patient-reported outcome measures are standardized questionnaires that capture a patient’s perception of their health status, function, or symptoms. Common PROMs in rehab include the DASH (upper extremity), LEFS (lower extremity), Oswestry Disability Index (low back), and NPRS (pain).
In the context of tracking patient progress without in-person visits, PROMs serve as the data layer. When a patient completes a PROM through an app between visits, it generates an electronic patient-reported outcome (ePRO) that the clinical team can review without scheduling an appointment.
RTM was specifically designed to capture this type of data. As described in a 2023 PMC review, RTM is a program allowing ePRO and other patient-generated data to be reviewed by clinical staff between visits so patients can receive clinical attention as needed.
HIPAA-Compliant Messaging
HIPAA-compliant messaging refers to secure communication channels that meet the privacy and security requirements of the Health Insurance Portability and Accountability Act. In practice, this means encrypted messaging platforms purpose-built for healthcare, not standard SMS, WhatsApp, or email.
When providers track patient progress without in-person visits, they inevitably exchange protected health information (PHI): exercise videos showing a patient’s form, pain reports, photos of surgical sites, or clinical instructions. Sending this through personal text messages violates HIPAA and exposes the practice to significant liability.
Secure in-app messaging keeps PHI in a protected environment. For clinics still relying on personal channels, there are HIPAA-secure alternatives to text messaging that maintain the convenience patients expect.
Group 3: What Gets Tracked
Home Exercise Program (HEP)
A home exercise program is a set of therapeutic exercises prescribed by a clinician for a patient to perform independently outside the clinic. HEPs are the primary intervention that providers monitor when tracking patient progress without in-person visits.
Traditionally, HEPs were delivered as paper handouts or generic printouts from exercise libraries. The problem with this approach is well documented: patients lose the papers, misunderstand the instructions, and have no way to confirm they’re doing exercises correctly. Many providers now create custom video exercise instructions that show exactly what the clinician demonstrated during the visit.
The shift from paper to digital HEP delivery is foundational to every other concept in this glossary. Without a digital HEP platform, there is nothing to monitor remotely.
HEP Adherence
HEP adherence (also called exercise compliance) measures how consistently a patient performs their prescribed home exercises. It is the single biggest variable in determining whether remote progress tracking actually works.
The numbers are not encouraging. Studies consistently report non-adherence rates between 50% and 70%. Physical therapists cite pain, forgetfulness, time constraints, and low self-efficacy as the most frequent barriers patients face.
This is not just a patient problem. It is an infrastructure problem. When clinics rely on paper handouts and hope, they have no mechanism to detect non-adherence until the next visit, at which point weeks of potential progress have been lost. Digital tracking surfaces adherence data in real time, giving clinicians the chance to intervene early.
Plan of Care Adherence
Plan of care adherence is broader than HEP adherence. It encompasses attendance at scheduled visits, completion of home exercises, follow-through on activity modifications, and compliance with precautions or lifestyle changes.
For providers tracking patient progress without in-person visits, plan of care adherence is the outcome metric that ties everything together. A patient might be doing their exercises consistently but skipping appointments, or attending every visit but ignoring their home program. Both patterns lead to suboptimal outcomes.
Platforms that track both visit attendance and between-visit activity give providers a complete picture of where breakdowns occur.
Behavior Change Prompts and Nudges
Behavior change prompts are automated, context-sensitive notifications designed to encourage specific patient actions, like completing an exercise set, logging a pain score, or watching an instructional video. The term “nudge” comes from behavioral economics and refers to subtle environmental cues that make a desired behavior easier or more likely.
In rehab, nudges take the form of push notifications (“Time for your exercises”), streak-based motivation (“You’ve completed 5 days in a row”), and visual progress indicators. These are not random reminders. Effective nudge design considers timing, frequency, tone, and patient preferences.
This is one of the least discussed but most impactful components of remote progress tracking. A passive tracking app that simply records data is useful. A platform with built-in behavior triggers that actively drive adherence is transformative.
Measurement-Based Care
Measurement-based care is the systematic use of standardized outcome measures to assess progress, identify problems, and adapt clinical interventions in real time. According to the Donabedian model of healthcare quality, outcomes and their tracking measures represent the third essential element after structure and process.
In practice, measurement-based care means a clinician doesn’t just ask “How are you feeling?” at the next visit. Instead, they review PROM scores, adherence percentages, and pain trends collected between visits to make data-driven decisions about the plan of care. It turns subjective impressions into objective clinical intelligence.
Group 4: Billing and Reimbursement
CPT Codes for RTM
CPT (Current Procedural Terminology) codes are the standardized billing codes used to report medical services to insurers. For remote therapeutic monitoring, CMS established a dedicated code family that has expanded significantly since its 2022 launch.
Here is the full RTM code set as of 2026:
| CPT Code | Description | Key Threshold |
|---|---|---|
| 98975 | Initial setup and patient education for RTM | One-time per episode |
| 98977 | Device supply (MSK system), 16-30 days of data | 16+ days of patient data |
| 98985 (NEW 2026) | Device supply (MSK system), 2-15 days of data | 2+ days of patient data |
| 98980 | Treatment management services, first 20 minutes | 20+ min clinical time |
| 98981 | Treatment management, each additional 20 minutes | Add-on to 98980 |
| 98979 (NEW 2026) | Treatment management services, 10-19 minutes | 10-19 min clinical time |
The 2026 Physician Fee Schedule delivered the most significant RTM expansion since the program launched, adding three new codes that lower billing thresholds dramatically. The minimum dropped from 16 days and 20 minutes to just 2 days and 10 minutes.
For a quick-reference breakdown with reimbursement rates, see the RTM cheat sheet for CPT codes and billing rules.
The “All-or-Nothing” Problem and the 2026 Fix
Before 2026, RTM billing had a structural flaw that practitioners in webinars and industry forums described as the “all-or-nothing revenue cliff.” If a patient only transmitted data for 15 days instead of 16, or if clinical staff spent 18 minutes reviewing data instead of 20, the practice could bill nothing for that month’s monitoring work.
Practitioners on LinkedIn and in industry webinars from companies like Raintree and Limber Health pointed out that this payment structure didn’t reflect how patients or clinics actually operate. Patients have inconsistent weeks. Clinicians sometimes need only 12 minutes to review data and make adjustments. The rigid thresholds punished partial engagement rather than rewarding it.
The new 2026 codes (98985 for 2-15 days of data, 98979 for 10-19 minutes of management time) fill these gaps. One DPT estimated that this expanded billing capability could realistically increase billable RTM services by 30-40% for practices already offering monitoring. The change essentially rewards practices for doing what they are already doing: tracking patient progress without in-person visits and staying engaged between appointments.
CMS-1500 in the RTM Context
The CMS-1500 is the standard paper or electronic claim form used to bill Medicare and most commercial insurers for professional services. In RTM workflows, the CMS-1500 is where CPT codes 98975, 98977, 98985, 98979, 98980, and 98981 are submitted.
The practical challenge is documentation. Each RTM claim must be supported by records showing the dates of patient data transmission, the time spent on clinical review, and the interventions or adjustments made. Platforms that automate RTM report generation and produce attachable documentation significantly reduce the administrative burden of preparing CMS-1500 submissions.
Provider Eligibility for RTM Billing
Not every provider type can bill RTM codes. Under current CMS rules, eligible billing providers include:
- Physical therapists (PTs)
- Physical therapist assistants (PTAs, under PT supervision)
- Occupational therapists (OTs)
- Occupational therapy assistants (OTAs, under OT supervision)
- Speech-language pathologists (SLPs)
- Physicians and qualified healthcare professionals
This eligibility list is what makes RTM uniquely valuable to rehabilitation practices. RPM codes are billed by physicians and clinical staff under physician supervision, which historically excluded most rehab providers from remote monitoring revenue. RTM changed that equation in 2022.
Physical therapists and speech-language pathologists now have a direct path to billing for the between-visit work they were often doing anyway, just without compensation.
How These Terms Connect in Practice
Understanding each term individually is useful. Understanding how they fit together is what actually changes clinical workflows.
Here is the sequence most rehab practices follow when tracking patient progress without in-person visits:
- The clinician creates a personalized HEP during the visit, ideally using custom video rather than generic library content.
- The HEP is delivered through a HIPAA-compliant SaMD platform, making it accessible on the patient’s phone or tablet.
- Behavior change prompts and nudges encourage the patient to complete exercises, log pain scores, and report functional status (PROMs) between visits.
- The platform captures this data as ePROs, creating a record of adherence and outcomes.
- Clinical staff review the data asynchronously, adjusting the plan of care as needed without requiring a visit.
- The practice bills the appropriate RTM CPT codes and attaches generated reports to the CMS-1500 claim.
Every term in this glossary maps to a specific step in that workflow. The technology enables the tracking. The behavioral design drives the adherence. The billing codes make it sustainable.
See how clinics implement this workflow with real-world examples and results.
Frequently Asked Questions
What is the difference between tracking patient progress remotely and telehealth?
Telehealth typically refers to live, synchronous video visits that replace in-person appointments. Tracking patient progress without in-person visits is broader and usually asynchronous. It includes monitoring exercise adherence, collecting patient-reported outcomes, and reviewing data between scheduled sessions. RTM billing codes specifically cover this asynchronous monitoring work, which is distinct from telehealth evaluation codes.
Can physical therapists bill for tracking patient progress without in-person visits?
Yes. Since January 2022, PTs, OTs, SLPs, and their assistants have been eligible to bill RTM codes under Medicare. The 2026 expansion added lower-threshold codes that make billing practical for a wider range of patient scenarios. Commercial insurance coverage varies by carrier and plan.
What technology do I need to start tracking patient progress remotely?
At minimum, you need a HIPAA-compliant app that qualifies as software as a medical device (SaMD) and allows patients to self-report outcomes and exercise completion. The app should support custom HEP delivery, secure messaging, and automated documentation for RTM billing. Explore pricing for platforms that combine these features.
How do the new 2026 RTM codes change things for small practices?
The new codes (98985 and 98979) lower the minimum billing thresholds from 16 days of data and 20 minutes of clinical time to just 2 days and 10 minutes. This eliminates the all-or-nothing problem that prevented many smaller practices from launching RTM programs. If a patient only engages for a week before discharge, the practice can still bill for that monitoring work.
What patient data is collected during remote therapeutic monitoring?
RTM collects non-physiological data, including pain levels, exercise completion rates, functional status questionnaire responses, medication adherence, and therapy response. This is distinct from RPM, which collects physiological data like heart rate and blood pressure. Patients self-report this data through the monitoring app.
Is tracking patient progress without in-person visits actually effective?
The evidence supports it. A 2025 study across 95 clinics found that patients receiving PT plus RTM achieved functional benchmarks at a significantly higher rate (72%) than those receiving PT alone (63%). Beyond outcomes, remote monitoring gives clinicians earlier visibility into problems like declining adherence or worsening pain, allowing intervention before the next scheduled visit.
Do patients need special equipment for remote progress tracking?
No. Unlike RPM, which requires connected medical devices (blood pressure cuffs, pulse oximeters), RTM works through smartphone apps. The patient’s phone or tablet is the only hardware needed. This is one reason RTM adoption has been faster in rehab settings than RPM.
How do I keep patient data secure when tracking progress remotely?
Use a HIPAA-compliant platform that encrypts data in transit and at rest. Avoid sending exercise videos, progress photos, or clinical instructions through personal text messages or consumer email. The platform should provide secure in-app messaging and store all patient health information within a protected environment that meets both HIPAA and standard data privacy requirements.
Ready to start tracking patient progress without in-person visits? Request a free demo and see how the workflow comes together in your practice.
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