Help Assisted Living Residents Stay Engaged While Creating New Revenue Opportunities Through RTM
Physical therapists working in assisted living communities face a unique challenge. Residents often need continued exercise, mobility training, and functional strengthening between therapy visits, but therapists may only see each patient a limited number of times per week.
Remote Therapeutic Monitoring (RTM) provides a solution by allowing physical therapists to monitor patient engagement, track exercise performance, and provide ongoing support between visits while creating additional Medicare reimbursement opportunities.
Exercise Pro Live helps physical therapists implement RTM programs efficiently by combining a comprehensive home exercise program platform, patient engagement tracking, compliance monitoring, and an easy-to-use therapist dashboard.
For therapy providers serving assisted living, independent living, and senior living communities, RTM creates a practical way to extend care beyond the clinic or scheduled therapy visits.
What Is Remote Therapeutic Monitoring (RTM)?
Remote Therapeutic Monitoring is a Medicare-approved service that allows healthcare providers to monitor patients remotely using digital health technology.
Unlike traditional therapy visits that occur only when the therapist is physically present, RTM allows therapists to collect information between visits, including:
- Patient exercise participation
- Exercise difficulty levels
- Patient feedback
- Program adherence
- Symptoms and progress updates
For physical therapists, RTM creates a structured way to stay connected with patients while helping improve outcomes.
RTM is especially valuable in assisted living communities because residents frequently require ongoing mobility, balance, strengthening, and functional exercise programs.
Why RTM Is a Strong Fit for Assisted Living Communities
Assisted living residents often participate in exercise programs designed to maintain independence, reduce fall risk, improve mobility, and support daily activities.
However, many residents struggle with consistency when they are not actively supervised by a therapist.
A typical assisted living therapy workflow may involve:
- Initial evaluation
- Development of a personalized exercise program
- Scheduled therapy visits
- Independent exercise between visits
- Periodic reassessment
The challenge is knowing what happens between visits.
Are residents completing their exercises?
Are exercises too difficult?
Are they experiencing pain?
Are they losing motivation?
RTM helps answer these questions by providing therapists with visibility between appointments.
How Physical Therapists Can Use RTM in Assisted Living
A successful RTM workflow can be simple and require minimal additional administrative work.
Step 1: Verify Insurance Coverage Before Starting
Before enrolling any resident in RTM, verify coverage.
Medicare generally covers RTM services when all requirements are met. Many Blue Cross Blue Shield plans also reimburse for RTM. Some commercial insurance companies provide coverage, while others do not.
A quick verification at the start of care prevents billing surprises later and helps your team decide whether RTM should be part of the resident's plan of care.
Step 2: Introduce RTM at the Initial Visit, With the Caregiver Present
The initial evaluation is the best time to set expectations, ideally with a family member or facility caregiver in the room.
After building the resident's home exercise program in Exercise Pro Live, explain something similar to the following.
"We're sending your exercise program today. You, or whoever helps you day to day, can log completed exercises using our patient website or the free phone app. We'll be checking in on your progress between visits to help keep things on track."
Residents and caregivers who understand that the care team is actively reviewing progress are far more likely to stay engaged.
Step 3: Identify a Caregiver or Family Contact for Reporting Support
Cognitive or dexterity limitations do not automatically disqualify a resident from RTM.
At enrollment, identify a facility aide, nurse, or family member who can help the resident report exercise completion, pain levels, or difficulty ratings if needed. Exercise Pro Live supports caregiver-assisted reporting for exactly this reason, so a resident's participation isn't dependent on managing an app entirely on their own.
Step 4: Schedule the Monthly Interactive Communication Call
Before leaving the community after the initial visit, have someone on your team schedule a convenient time for a follow up call or video visit with the resident or their designated caregiver.
During this call, a PTA or OTA can:
- Review exercise compliance
- Answer questions from the resident or caregiver
- Address barriers to completing the program
- Reinforce proper exercise technique
- Coordinate with facility staff on mobility status
This call also satisfies the interactive communication requirement needed to bill monthly management time, so scheduling it consistently protects your billing as well as your patient's outcomes.
Step 5: Build Daily Monitoring Into Your Team's Routine
Each day, have a PTA or OTA spend a few minutes reviewing resident activity within Exercise Pro Live.
The RTM dashboard quickly identifies:
- Residents completing their exercise programs
- Missed exercise sessions
- Pain reports
- Difficulty ratings
- Overall compliance trends across the community
As your team reviews each resident, record the monitoring time directly in Exercise Pro Live. Over the course of the month, these small daily check-ins add up to billable RTM time while keeping your team aware of any resident who is falling behind.
Step 6: Address Noncompliant Residents Early
If a resident has stopped completing exercises, do not wait until the next scheduled visit.
Instead:
- Have a team member follow up with a friendly reminder call
- Loop in the facility caregiver or family contact if needed
- Send a secure message through Exercise Pro Live
A simple, early reminder often gets a resident back on track and prevents a small gap from turning into a larger setback.
Step 7: Document Your Time as You Go
Trying to reconstruct RTM time at the end of the month almost always results in missed billable time.
Instead, document activities immediately. Exercise Pro Live allows your team to record initial setup, daily monitoring time, patient and caregiver communications, PTA or OTA calls, and secure messages, all in one place, ready for monthly billing review.
Billing RTM in Assisted Living: What Changed for 2026
CMS's CY 2026 Physician Fee Schedule Final Rule restructured RTM billing to better reflect how residents actually engage with monitoring, replacing the old all-or-nothing 16-day threshold with a tiered structure. Here is how it applies to an assisted living workflow.
Initial Visit: Setup and Enrollment
When the exercise program is first issued and the resident is enrolled in RTM, bill CPT 98975.
This code is billed once per episode of care. If the resident returns later for a new diagnosis or episode of care, CPT 98975 may generally be billed again, subject to payer guidelines.
Monthly Billing: Treatment Management Time
Next, review the accumulated RTM management time your team logged for the resident that month in Exercise Pro Live.
- Bill CPT 98980 for the first monthly occurrence of at least 20 cumulative minutes of management time, along with at least one interactive communication with the resident or caregiver.
- Bill CPT 98981 for each additional 20 minute occurrence in the same month.
- If only 10 to 19 cumulative minutes were documented, bill CPT 98979 instead.
CPT 98979 cannot be billed alongside 98980 or 98981 in the same period, and it has no add-on code of its own. In most cases, aim to reach the 20 minute threshold so you can bill 98980 and 98981.
Place of Service: Use POS 13
Assisted living communities use place of service code 13, distinct from a resident's own home (POS 12) or a skilled nursing facility. Both POS 12 and POS 13 are treated as non-facility settings, so Medicare reimburses RTM claims for assisted living residents at the same non-facility rate as a patient monitored at home.
Confirm the correct POS is set on every claim. This is one of the more common clerical errors that trigger denials or underpayment in facility-adjacent settings.
At Discharge
When a resident completes therapy, review any accumulated but unbilled RTM management time and bill it before closing the episode of care. This ensures your practice is reimbursed for all documented services.
Common Pitfalls in This Setting
- Assuming a resident can’t participate. A caregiver or family member can report on the resident’s behalf, so cognitive or dexterity limitations should rarely be a reason to skip RTM entirely.
- Skipping the interactive communication call. Automated compliance data alone is not enough. The real time interaction requirement still applies regardless of setting.
- Billing 98977 and 98985 in the same month, or stacking 98979 with 98980 or 98981. Both are hard mutual exclusions under the current code structure.
- Losing track of time across a shared caseload. When a supervising therapist and a PTA or OTA are both touching a resident’s RTM data, keep time logged in one place rather than estimated after the fact.
- Using the wrong place of service code. Confirm POS 13 is applied to assisted living claims rather than a code intended for a skilled nursing facility.
Why Exercise Pro Live Makes RTM Easy in Assisted Living
Many practices hesitate to bring RTM into assisted living because they assume the documentation and coordination will be too complex. Exercise Pro Live is built to simplify exactly this kind of workflow by allowing your team to:
- Deliver exercise programs through the patient website, mobile app, email, text link, or printed handout with QR codes
- Support caregiver-assisted reporting for residents who need help logging progress
- Monitor exercise completion, pain, and difficulty ratings across an entire community from one dashboard
- Record monitoring time and communication time as it happens
- Generate RTM reports that support billing and compliance
Rather than juggling multiple systems for each community you serve, your team completes the entire RTM workflow inside the same platform you already use to prescribe home exercise programs.
Benefits of RTM for Senior Living Physical Therapy Providers
Improve Patient Compliance
One of the biggest challenges with any home exercise program is adherence.
Many patients understand what exercises they should perform but do not complete them consistently.
RTM provides accountability by allowing therapists to monitor participation and encourage continued engagement.
Reduce Falls and Improve Mobility
Falls are one of the most common concerns among older adults.
Consistent exercise programs focused on strength, balance, and mobility can help residents maintain independence and reduce functional decline.
RTM helps therapists support these programs between visits.
Extend the Therapist's Reach
Physical therapists serving senior living communities often manage many patients with different needs.
RTM provides a scalable way to monitor patients without requiring additional in-person visits for every interaction.
Create Additional Medicare Reimbursement Opportunities
RTM may provide eligible providers with additional reimbursement opportunities when Medicare requirements are met.
Therapists should follow current Medicare guidelines and documentation requirements when implementing RTM programs.
Exercise Pro Live helps simplify the technology side of RTM by providing the tools needed for exercise delivery, patient engagement monitoring, and documentation support.
How Exercise Pro Live Supports RTM in Assisted Living
Exercise Pro Live was designed specifically for rehabilitation professionals who need a simple and effective way to deliver home exercise programs and improve patient engagement.
Key RTM features include:
Large Exercise Library
Access over 7,000 exercises with videos and instructions to quickly create customized programs for a wide variety of patients.
AI-Powered Exercise Search
Exercise Pro Live uses AI technology to help therapists quickly find appropriate exercises based on patient needs.
The AI assists therapists in finding relevant exercises instead of simply providing a searchable database.
Patient Engagement Tracking
Monitor patient participation and identify when additional support may be needed.
Flexible Exercise Delivery
Programs can be delivered through:
- Mobile app
- Online patient portal
- Printed instructions
RTM Use Cases in Assisted Living and Senior Living
RTM can support many common conditions treated in senior living communities.
Examples include:
Fall Prevention Programs
Monitor balance, strengthening, and mobility exercises designed to reduce fall risk.
Post-Hospital Rehabilitation
Support residents returning from hospitalization who need continued exercise after discharge from skilled therapy.
Joint Replacement Recovery
Help patients maintain progress after hip or knee replacement.
Chronic Condition Management
Support residents with:
- Arthritis
- Parkinson’s disease
- Stroke recovery
- General weakness
- Balance impairments
RTM for Independent Living Communities
RTM is not limited to assisted living.
Independent living residents can also benefit from remote monitoring because many older adults want to maintain independence while managing mobility challenges.
RTM can support wellness and rehabilitation programs focused on:
- Strength maintenance
- Balance training
- Fall prevention
- Functional mobility
For therapy companies operating across multiple senior living settings, RTM creates a consistent approach to extending care.
Final Thoughts
Practices that succeed with RTM in assisted living do not build a separate program for it. They fold it into the visits and relationships they already have with each resident and community. RTM results in better patient exercise program compliance leading to better outcomes.
A reliable workflow looks like this:
- Verify insurance coverage.
- Issue the exercise program through Exercise Pro Live at the initial visit.
- Explain how the resident or caregiver should log completed exercises.
- Identify a caregiver or family contact who can support reporting.
- Schedule a monthly interactive communication call before leaving the community.
- Monitor resident compliance daily.
- Contact noncompliant residents promptly.
- Record monitoring and communication time as it occurs.
- Review RTM billing each month, using the correct device supply and management time codes.
- Bill any remaining eligible RTM time at discharge.
Following this workflow helps your team improve resident compliance, strengthen continuity of care across every community you serve, and build a reliable source of additional reimbursement with very little added administrative effort.
Frequently Asked Questions
Can Remote Therapeutic Monitoring be billed for residents in assisted living?
Yes. RTM can be billed for residents in assisted living communities the same way it is billed for patients living independently at home. The key difference is the place of service code used on the claim. Assisted living uses POS 13, while a resident's own home uses POS 12. Both are treated as non-facility settings, so Medicare reimburses RTM at the same non-facility rate in either setting.
Does a resident need to use the app themselves to qualify for RTM in assisted living?
No. A caregiver, facility aide, or family member can report exercise compliance, pain levels, and difficulty ratings on the resident's behalf if the resident has cognitive or dexterity limitations that make it hard to use an app independently. Cognitive impairment alone should not be treated as a reason to exclude a resident from RTM.
Which CPT codes changed for RTM billing in 2026?
CMS introduced two new codes for 2026: CPT 98985, which covers device data transmission for 2 to 15 days in a 30-day period, and CPT 98979, which covers 10 to 19 minutes of monthly treatment management time. These lower-threshold codes replaced the previous all-or-nothing structure, where a resident who transmitted data for fewer than 16 days generated no reimbursement at all. This is especially relevant in assisted living, where a resident's engagement can dip during an illness or hospital stay.
Can a Physical Therapist Assistant (PTA) perform RTM monitoring and follow-up calls?
Yes. PTAs and OTAs can contribute monitoring time toward CPT 98980 and 98981 under general supervision, subject to the de minimis standard and appropriate modifiers. A common workflow in assisted living has a PTA or OTA make a brief monthly interactive communication call with the resident or their caregiver, then handle daily review of compliance data between visits.
Is there a free trial of Exercise Pro Live?
Yes, we provide a free 2 week full working trial of Exercise Pro Live.
Can a PTA or OTA handle RTM monitoring and follow-up calls for assisted living residents?
Yes. PTAs and OTAs can contribute monitoring time toward CPT 98980 and 98981 under general supervision, subject to the de minimis standard and appropriate modifiers. A common workflow in assisted living has a PTA or OTA make a brief monthly interactive communication call with the resident or their caregiver, then handle daily review of compliance data between visits.
Is RTM billing in assisted living covered by Medicare and commercial insurance?
Medicare generally covers RTM services when documentation and interactive communication requirements are met. Many Blue Cross Blue Shield plans also reimburse for RTM, while other commercial payers vary in their coverage. Because coverage differs by plan, it's best practice to verify RTM eligibility for each resident before enrolling them in a monitoring program.
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This article is intended as general educational information, not billing, legal, or compliance advice. RTM billing rules are set by CMS and may vary by payer. Confirm current requirements with your Medicare Administrative Contractor or a qualified billing compliance professional before submitting claims.