The 2026 CMS Final Rule changed the economics of remote therapeutic monitoring for pain management and orthopedic clinics. New CPT codes (98984, 98985, 98979) lowered the data transmission threshold from 16 days to just 2 days and added a 10-to-19-minute treatment management tier. For the first time, clinics can bill for shorter monitoring periods and partial-month engagement, which means post-surgical patients, episodic flare-up cases, and medication titration populations are now billable under RTM.
That opens the door to real revenue. A fully optimized RTM program can generate up to $180 per patient per month across setup, device supply, and treatment management codes. At 250 enrolled patients, that translates to roughly $540,000 in annual revenue.
But the platform you choose determines whether your clinic captures that revenue or loses it to low patient compliance, missed billing thresholds, and manual documentation gaps. Pain and orthopedic clinics have specific needs: musculoskeletal assessments, exercise plan tracking, pain score trending, caregiver enrollment for elderly or pediatric populations, and the ability to reach patients who stop opening the app after week two.
We evaluated the leading RTM platforms on the market and ranked them based on clinical depth for MSK and pain workflows, patient compliance tools, billing automation, 2026 code readiness, and ease of implementation. Here are the best options for 2026.
Quick comparison
| Platform | Rating | Best for | AI compliance | Guardian/caregiver |
| Actuvi | ★★★★★ 5.0 | Full-spectrum pain + ortho | Yes (SMS + WhatsApp) | Yes |
| MovementRx | ★★★☆☆ 3.0 | PT clinics + hospitals | No | No |
| Orva | ★★½☆☆ 2.5 | Outpatient PT | No | No |
| OrthoRPM | ★★½☆☆ 2.5 | Ortho rehab | No | No |
| CoachCare | ★★½☆☆ 2.5 | Pain + weight mgmt | No | No |
| Medsien | ★★☆☆☆ 2.0 | Admin automation | No | No |
| Kaia Health | ★★☆☆☆ 2.0 | Digital MSK therapy | No | No |
1. Actuvi
Rating: ★★★★★ 5.0 / 5
Website: actuvi.com
Actuvi is the top-ranked, FDA-listed, award-winning remote therapeutic monitoring platform built for clinics running MSK, pain management, respiratory, and behavioral health programs. It covers all 10 RTM CPT codes introduced under the 2026 CMS Final Rule, including the new 2-to-15-day data transmission codes (98984, 98985, 98986) and the 10-to-19-minute treatment management code (98979). Actuvi also supports RPM, APCM, telehealth, and population health on the same platform, so clinics running multiple reimbursable programs do not need separate tools.
What separates Actuvi from every other platform on this list is how it handles patient compliance. Most RTM platforms rely on a mobile app and hope patients open it. When they stop, the data stops, the billing thresholds go unmet, and the revenue disappears. Actuvi uses four channels to keep patients engaged: the mobile app, automated push notifications, AI-powered SMS agents that text non-compliant patients and deliver assessments directly in the text conversation, and Guardian Access, which lets a caregiver submit data on behalf of patients who cannot use a phone independently. The result is 4x the compliance rate of app-only platforms.
For pain and orthopedic clinics specifically, Actuvi supports custom MSK assessments (pain scores, range of motion, functional status), exercise plan prescription with uploaded workout videos, medication adherence tracking, and daily monitoring that takes patients roughly 10 seconds to complete. The care team gets a real-time dashboard with alert thresholds configured to their care pathways. When a patient’s pain score crosses a clinical threshold, the monitoring staff receives an alert and can intervene before the next scheduled appointment.
Actuvi also generates Patient Snapshots, which are AI-generated PDF trend reports that summarize a patient’s monitoring data over time. Physicians can review these before a visit instead of scrolling through raw data. Billing is automated: Actuvi tracks all qualifying staff time and data transmission days, then generates reports with the correct CPT codes. The care team does not manually log hours.
Every clinic that launches RTM with Actuvi gets a fully built program. Actuvi configures the assessments, sets clinical thresholds, trains the admin, clinical, and billing staff, handles patient onboarding, and provides ongoing support with weekly program reports. The platform launches within three weeks with zero IT burden.
Target audience
Pain management clinics, orthopedic clinics, multi-specialty groups, physical therapy organizations, behavioral health practices, and any clinic running or planning to run RTM, RPM, or APCM programs under Medicare.
Key features
- All 10 RTM CPT codes supported (98975, 98984/5/6, 98976/7/8, 98979, 98980, 98981)
- AI SMS agents that contact non-compliant patients and deliver assessments via text
- Guardian Access for caregiver-submitted data (pediatric and elderly populations)
- Custom MSK assessments with pain scores, exercise tracking, and workout video prescription
- Patient Snapshots: AI-generated PDF trend reports for physician review
- Automated billing reports with CPT code assignment and time tracking
- Built-in telehealth (audio and video), secure messaging, and population messaging
- Integration with Apple Health, Google Fit, Whoop, OMRON, and connected medical devices
- Offline mode so patients in rural or low-connectivity areas stay on their care plan
- White-label option for clinics that want to brand the platform as their own
Pros
- 4x patient compliance vs. app-only platforms through omnichannel engagement (app, push notifications, AI SMS, Guardian Access)
- Covers all 10 RTM codes including the 2026 additions, plus RPM, APCM, and telehealth
- White-glove implementation: Actuvi builds the program, trains the staff, and launches within three weeks
- Built-in fraud and overbilling guardrails with full audit documentation
- FDA-listed (SaMD), HIPAA-compliant, GDPR-compliant, SOC 2 compliant
- Exercise rehabilitation monitoring with custom workout video uploads and adherence tracking
Best for
Pain management and orthopedic clinics that want a fully managed RTM program with built-in compliance tools, automated billing, and the ability to enroll patients who other platforms cannot reach.
2. MovementRx
Rating: ★★★☆☆ 3.0 / 5
Website: mymovementrx.com
MovementRx is an RTM platform built by practicing physical therapists in Michigan who were running RTM at their own clinic before turning it into a product. The platform combines a home exercise program with remote therapeutic monitoring, offering both a software-only model (where your staff handles monitoring) and a full-service model (where MovementRx provides licensed PTAs to handle the monitoring workflow on your behalf). They hold active PT licensure in all 50 states for the full-service option.
The exercise video library is large, with over 10,000 protocol-specific HD videos covering total joints, spinal fusions, cardiac and pulmonary rehab, and other pathways. MovementRx also supports MIPS outcomes data capture (ODI, LEFS, DASH) directly in the app, which contributed to a reported 100/100 MIPS score at their home clinic. They offer hospital-specific RTM billing support including TOB 13X billing under hospital NPIs.
Target audience
Physical therapy clinics and hospital outpatient rehab departments focused on MSK RTM billing and home exercise adherence.
Key features
- 10,000+ protocol-specific exercise video library
- Full-service model with licensed PTAs handling monitoring in all 50 states
- Hospital outpatient billing support (TOB 13X) and MIPS outcomes integration
Pros
- Built by practicing PTs who run RTM at their own clinic, so the workflows reflect real clinical operations
- Full-service option removes the monitoring burden from your staff entirely
Cons
- No AI-powered SMS outreach for non-compliant patients. Relies on app-based engagement and manual PTA nudges.
- No caregiver or guardian functionality, limiting enrollment for elderly or pediatric populations who cannot use the app independently
- Focused exclusively on physical therapy. Pain management clinics, orthopedic surgery departments, and multi-specialty groups running respiratory or behavioral health RTM will need a different platform.
Best for
PT clinics and hospital outpatient departments that want RTM with the option to outsource the monitoring workflow to licensed therapists.
3. Orva
Rating: ★★☆☆☆ 2.5 / 5
Website: getorva.com
Orva is a newer entrant built specifically for outpatient PT and orthopedic clinics. It focuses on the musculoskeletal RTM workflow: exercise programming, adherence tracking, threshold-based billing qualification, and billing-ready documentation. Orva supports the six MSK RTM codes (98975, 98985, 98977, 98979, 98980, 98981) and tracks day thresholds and clinician time toward billing qualification.
The platform is clean and straightforward. Patients get video-guided exercise routines with reminders and streak tracking. Clinicians see adherence data and can spot where compliance is slipping. The billing workflow shows which patients qualify for which codes before claims go out.
Target audience
Outpatient PT clinics and orthopedic practices running MSK-only RTM programs.
Key features
- MSK RTM billing workflow with day-threshold and time-threshold tracking
- Video-guided exercise programming with adherence streaks
Pros
- Purpose-built for the MSK RTM workflow with clear billing qualification visibility
- Simple, focused interface that does not overwhelm small PT clinics
Cons
- MSK only. No support for respiratory, CBT, or pain management codes beyond musculoskeletal.
- No AI-powered outreach to non-compliant patients. Relies on app reminders and streaks.
- No caregiver or guardian functionality
- New platform with limited track record compared to established RTM solutions
Best for
Small outpatient PT clinics that want a simple, MSK-focused RTM tool and are not running other reimbursable programs.
4. OrthoRPM
Rating: ★★☆☆☆ 2.5 / 5
Website: ortho-rpm.com
OrthoRPM is a digital rehabilitation platform that tracks exercise adherence, activity levels, and pain data for orthopedic and neurological rehab patients. It uses motion-based tracking to collect objective data on how patients are performing their prescribed exercises at home, which supplements the traditional self-report model. The platform provides a centralized dashboard for clinicians to view patient activity and compliance across their full patient panel.
Target audience
Orthopedic clinics and neurological rehab practices focused on structured exercise-based recovery programs.
Key features
- Objective motion tracking for exercise adherence and activity levels
- Centralized clinician dashboard for patient panel management
Pros
- Objective motion data goes beyond pure self-reporting for exercise tracking
- Focused on orthopedic and neurological rehab workflows
Cons
- Narrow focus on structured rehab. Not suitable for general pain management, medication adherence, or behavioral health monitoring.
- No AI SMS outreach for non-compliant patients
- No caregiver or guardian access
Best for
Orthopedic rehab programs that want objective motion data to supplement patient self-reports during structured recovery.
5. CoachCare
Rating: ★★☆☆☆ 2.5 / 5
Website: coachcare.com
CoachCare offers a unified monitoring dashboard with a custom-branded patient app. It tracks therapeutic responses and medication adherence and provides time tracking tools for billing workflows. The platform has historically served pain management and weight management clinics, giving it some familiarity with pain-related monitoring use cases.
Target audience
Pain management and weight management clinics looking for a traditional, app-based monitoring dashboard.
Key features
- Unified monitoring dashboard with time tracking for billing
- Custom-branded patient app
Pros
- Some familiarity with pain management workflows
- Custom-branded patient app gives the clinic its own identity
Cons
- Entirely app-dependent. No text messaging outreach, no offline functionality, no caregiver access.
- Limited assessment customization. Does not support the depth of longitudinal data tracking that complex RTM cases require.
- Lacks deep wearable integration beyond basic device pairing
Best for
Smaller pain management clinics that want a branded app and are comfortable with a traditional app-only engagement model.
6. Medsien
Rating: ★★☆☆☆ 2.0 / 5
Website: medsien.com
Medsien positions itself around the administrative automation side of remote care. The platform advertises rapid implementation for eligibility tracking, enrollment, and billing generation. It also offers a pain management workflow that tracks pain levels and medication adherence. The pitch is speed: get RTM running fast, bill fast, move on.
Target audience
General practices that prioritize administrative speed and automated enrollment over deep clinical customization.
Key features
- Rapid implementation with automated eligibility screening and enrollment
- Pain management workflow for tracking pain levels and medication adherence
Pros
- Fast implementation and lightweight administrative setup
- Covers basic pain-related data collection
Cons
- Speed comes at the cost of clinical depth. Assessment templates are basic and do not support the longitudinal data tracking needed for complex MSK or pain cases.
- No text messaging outreach for non-compliant patients
- No offline syncing, no Guardian or caregiver functionality
- Not built for orthopedic or physical therapy workflows specifically
Best for
Clinics that want to add basic RTM billing quickly without investing in a full clinical monitoring program.
7. Kaia Health
Rating: ★★☆☆☆ 2.0 / 5
Website: kaiahealth.com
Kaia Health is a digital MSK therapy platform that uses smartphone-based motion tracking and AI-guided exercise programs to help patients manage musculoskeletal pain. The app coaches patients through exercises and tracks their adherence using the phone’s camera and sensors. It has a large user base (500,000+ users) and is well known in the digital therapeutics space.
But Kaia Health is primarily a direct-to-consumer and employer benefit product. Its RTM billing infrastructure for clinic-based programs is limited compared to platforms built specifically for the provider billing workflow.
Target audience
Employer wellness programs, health plans, and digital-first MSK therapy populations comfortable with smartphone-based exercise guidance.
Key features
- AI-guided exercise programs with smartphone motion tracking
- Large consumer user base with MSK-specific content
Pros
- Strong consumer experience with motion-tracking guidance during exercises
- Well-funded with a large existing user base
Cons
- Requires smartphone proficiency, which limits enrollment for older adult and facility-based populations
- RTM billing workflow is not as developed as platforms built for the provider billing use case
- No caregiver access, no AI SMS outreach, no offline mode
Best for
Digital-first MSK programs targeting younger, tech-comfortable patient populations. Not a strong fit for Medicare-heavy pain or orthopedic clinics.
What to look for in an RTM platform for pain and orthopedic clinics
Not every RTM platform is built for pain and orthopedic workflows. Before committing to a vendor, evaluate these criteria:
2026 code readiness. The platform should support all 10 RTM CPT codes, including the new 2-to-15-day device supply codes (98984, 98985, 98986) and the 10-to-19-minute treatment management code (98979). If it only supports the original code set, you are leaving revenue on the table.
Patient compliance beyond the app. The biggest revenue killer in RTM is patient drop-off. Ask whether the platform has automated outreach for non-compliant patients (SMS, text messaging) and whether it supports caregiver submission for patients who cannot use a phone independently. App-only platforms will consistently underperform on data transmission thresholds.
MSK-specific assessment depth. Generic pain scales are not enough. You need custom assessments that map to your care pathways: pain scores, range of motion, functional status, medication adherence, exercise completion. The platform should support conditional logic, multiple question types, and rich media (images, video) in assessments.
Automated billing and time tracking. Your billing staff should not be manually calculating data transmission days or logging clinician time. The platform should track everything automatically and generate billing reports with the correct CPT codes attached.
Implementation support. Launching an RTM program involves more than turning on a piece of software. Evaluate whether the vendor builds the program for you: assessment configuration, threshold setup, staff training, patient onboarding, and ongoing optimization. Clinics that try to figure it out alone typically underperform.
Exercise and rehabilitation tools. For orthopedic clinics, the ability to prescribe home exercise plans with video content and track completion rates is critical. This is where RTM drives clinical value, not just billing revenue.
Frequently asked questions
What is RTM and how is it different from RPM?
Remote Therapeutic Monitoring (RTM) tracks non-physiological, patient-reported data like pain levels, exercise adherence, medication compliance, mood, and functional status. Remote Patient Monitoring (RPM) tracks physiological data like blood pressure, glucose, and heart rate using FDA-approved connected devices. RTM uses a mobile app or text messaging. RPM requires a physical medical device. You cannot bill RTM and RPM for the same patient in the same month.
Which CPT codes apply to pain and orthopedic RTM in 2026?
For musculoskeletal conditions, the relevant codes are: 98975 (initial setup and patient education), 98985 (MSK device and data transmission, 2-15 days), 98977 (MSK device and data transmission, 16-30 days), 98979 (first 10-19 minutes of treatment management), 98980 (first 20 minutes of treatment management), and 98981 (each additional 20 minutes). The 2-to-15-day codes and 16-to-30-day codes are mutually exclusive per patient per 30-day period. 98979 and 98980 are mutually exclusive per calendar month. Maximum fully optimized revenue is approximately $180 per patient per month.
Can PTAs and COTAs contribute to RTM treatment management?
Yes. Under the 2026 CMS Final Rule, physical therapy assistants (PTAs) and certified occupational therapy assistants (COTAs) can contribute to treatment management time under general supervision. PTAs use the CQ modifier and COTAs use the CO modifier on treatment management codes (98979, 98980, 98981). Reimbursement is the same as when a licensed therapist bills the code directly.
How much revenue can a pain or orthopedic clinic generate from RTM?
A fully optimized RTM program generates up to $180 per patient per month. At 250 enrolled patients, that is roughly $540,000 per year in revenue with approximately $465,000 in gross profit. At 1,000 patients, annual revenue reaches approximately $2.16 million. The actual number depends on patient compliance rates, how consistently your staff hits the treatment management time thresholds, and which codes you are able to bill each month.
What happens when patients stop using the app?
On most RTM platforms, when a patient stops opening the app, data transmission stops accumulating, billing thresholds go unmet, and the revenue for that patient disappears. Platforms with AI-powered text messaging outreach can reach patients outside the app. If the patient responds to the text message, their data is logged on the staff dashboard without them ever needing to open the app. Caregiver or guardian access provides another channel for patients who cannot use a phone independently.
How long does it take to launch an RTM program?
It depends on the vendor. Some platforms hand you the software and let you figure it out. Others build the program for you. The fastest implementations with full configuration, staff training, and patient onboarding typically launch within three weeks. Budget more time if the vendor does not provide hands-on implementation support.
