The morning of Mr. Rogers’ discharge was filled with buzzing activity in Room 212. Nurses reviewed final medications, therapists gave their last bits of advice, and his daughter, Sara, stood by, gripping a neatly folded set of clothes for him to wear home. It should have felt like a victory—another patient successfully completing rehabilitation—but the weight of uncertainty hung in the air.
Mr. Rogers, 72, had fought hard. A stroke had left him with right-sided weakness, difficulty swallowing, and balance instabilities that put him at risk for falls. On top of that, his long history of diabetes and heart disease complicated every aspect of his recovery. Over the past eight weeks, he had learned how to transfer safely, navigate with a walker, and manage his medications—but was it enough? Was he truly ready to go home?
His physical therapist, Leena, had spent hours working with him, ensuring he could get in and out of his recliner without assistance and maneuver through his home safely. His speech therapist, Tony, had carefully guided him through swallowing exercises, emphasizing safe food textures and the importance of mindful eating. His occupational therapist, Luis, had provided patient and caregiver training on safe toileting and dressing techniques. His nurses had trained Sara relentlessly—how to monitor blood sugar fluctuations, watch for signs of heart failure, and what to do in case of another fall.
They had done everything. And yet, Leena still lost sleep over cases like this. She knew too well that rehab didn’t end when a patient walked out the door.
Now, as Mr. Rogers glanced around the room, Leena knelt beside him. “You’ve come a long way,” she said apprehensively. “You know what to do.”
He gave a small, knowing smile. “Thank you all for giving me a fighting chance,” he said.
Sara nodded, her eyes filled with worry. “You’ve given us the tools and training. It’s very overwhelming, but we will do our best.”
The transport team arrived, and as Mr. Rogers was wheeled toward the exit, Leena felt both pride and anxiety. They had done their best—provided skilled rehab, trained the family, ensured understanding. Still, she would worry. She always did.
Because the hardest part of physical rehabilitation wasn’t the treatment. It was letting go and hoping that all the lessons, all the care, and all the guidance would carry them safely forward.
As the doors closed behind them, Leena whispered, “Please, let him be okay.”
The Importance of Ongoing Support in Rehabilitation
Sound familiar? As rehab therapists, nurses, and doctors, we understand the challenges involved in discharging a patient, especially when they face significant health complexities like Mr. Rogers did. But what if there were a way to keep track of patients even after they’ve left the care facility? This is where Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) come into play.
These two tools allow healthcare professionals to keep tabs on their patients, improving outcomes and offering peace of mind to both patients and providers.
What is RTM and RPM?
Remote Therapeutic Monitoring (RTM) and Remote Patient Monitoring (RPM) share foundational similarities, as RTM codes were developed based on the success of RPM during the pandemic. However, the two differ in key aspects, including the type of data monitored, the method of data collection, and the healthcare providers eligible to bill for them.
- RTM tracks non-physiologic data related to therapeutic treatments, such as patient adherence to home exercise programs and responses to musculoskeletal and respiratory therapies.
- RPM, on the other hand, focuses on physiologic metrics like heart rate, blood pressure, and blood glucose levels. It’s sometimes called remote physiologic monitoring.
Another notable distinction is that RTM allows patients to self-report data in addition to using connected medical devices, whereas RPM requires automatic data transmission (typically in real-time) without manual input.
Why RTM and RPM Matter in Post-Acute and Rehabilitative Care
- Early Detection of Complications, Reducing Hospital Readmissions
One of the most significant advantages of remote monitoring is its ability to identify health concerns before they become serious complications. By continuously tracking vital signs, mobility levels, blood pressure, and other health indicators, healthcare providers can spot early warning signs of infections, cardiac issues, respiratory distress, or worsening chronic conditions.
For example, if a patient recovering from surgery develops an elevated heart rate or drops in oxygen levels, remote monitoring can alert healthcare providers, enabling them to intervene before a hospitalization is necessary. This proactive approach significantly reduces readmission rates and improves patient outcomes.
- Improved Continuity of Care Between Inpatient and Home Settings
The transition from a hospital or rehabilitation facility to home is a vulnerable period where patients are at risk for setbacks. Traditional care models rely on scheduled follow-up appointments, leaving gaps in communication and oversight. Remote monitoring eliminates these gaps, providing continuous oversight during a patient’s recovery.
With remote monitoring, healthcare providers can track a patient’s progress in real-time, ensuring their therapy plan is adapted as needed. This smooth transition between inpatient and home care ensures that patients receive the necessary support even after discharge, helping to prevent complications and ensuring better recovery.
- Increased Patient Engagement in Their Recovery
Patients who are actively involved in their own recovery tend to achieve better health outcomes. Remote monitoring helps foster this engagement by giving patients or caregivers access to dashboards, mobile apps, or wearable devices that track key health indicators.
For example, post-stroke patients in rehabilitation can monitor their gait, step count, and strength improvements over time. Seeing measurable progress motivates patients to stay committed to their recovery plans, reinforcing adherence to prescribed treatments. In turn, healthcare providers can monitor progress in real-time and provide feedback or support when necessary.
- Real-Time Data for Caregivers to Provide Better Support
Caregivers often face challenges when trying to provide adequate support to a loved one recovering at home. Remote monitoring offers caregivers real-time insights into a patient’s condition, enabling them to respond quickly to changes.
For example, if a caregiver is alerted that their loved one’s blood pressure is too high or that their physical activity levels have dropped, they can reach out to the healthcare provider for guidance. Real-time data not only improves patient safety but also reduces the emotional and physical burden on caregivers, who are no longer left to rely solely on their observations.
- Objective Data to Demonstrate Medical Necessity
Remote monitoring provides concrete, data-driven evidence of a patient’s condition, which can be crucial when justifying the need for ongoing care, treatments, or equipment. For instance, a patient with chronic conditions like COPD or heart disease can use real-time data to show that they still require continued support, such as in-home oxygen therapy or physical therapy.
Having access to objective data streamlines the process of securing insurance coverage and helps providers justify the need for specific medical interventions, making it easier for patients to receive the care they need.
- Customizable Care Plans Based on Patient Progress
Remote monitoring allows healthcare providers to adjust care plans dynamically based on real-time data from patients. This flexibility ensures that treatment plans remain personalized and tailored to the patient’s specific needs, making recovery more efficient and effective.
For example, if a patient recovering from knee surgery shows rapid improvement in walking or joint flexibility, the physical therapist can introduce more advanced exercises earlier than initially planned. Conversely, if progress is slower, the plan can be adjusted to provide additional support or alternative pain management strategies.
Implementation of Remote Monitoring
Remote monitoring has two primary pathways: Remote Therapeutic Monitoring (RTM) and Remote Patient/Physiologic Monitoring (RPM). These two tools differ in several aspects, including the data they track, how they collect it, and who is eligible to bill for each service.
- RTM is designed to track non-physiologic data such as patient adherence to home exercise programs and responses to therapies like musculoskeletal and respiratory treatments.
- RPM focuses on physiologic data such as heart rate, blood pressure, and blood glucose levels.
What are the CPT Codes for RTM and RPM?
For both RTM and RPM, there are specific CPT codes that healthcare providers use to bill for these services. For RPM, some of the most commonly used codes include CPT 99453 (device setup), CPT 99454 (monthly device supply and transmission), and CPT 99457 (20-minute initial treatment management).
RTM codes, introduced in 2022, are used by physical therapists, occupational therapists, and speech-language pathologists to bill for therapeutic services related to musculoskeletal and respiratory treatments, including home exercise program adherence and therapy response.
Conclusion
Remote monitoring offers immense value for post-acute and rehabilitative care by ensuring continuous patient oversight, improving patient outcomes, and providing caregivers with the support they need. With real-time data, healthcare providers can address complications before they escalate, personalize care plans, and increase patient engagement in their recovery. As the healthcare industry continues to embrace technology, remote monitoring will become an essential tool in ensuring better patient health and well-being, reducing hospital readmissions, and lowering healthcare costs.
