Run RTM for pain and MSK care without buying a device
CPT 98977's 16-day data-collection threshold counts patient-reported readings, not just device transmissions. Patients log pain, home-exercise adherence, range of motion, and Oswestry Disability Index scores from their phone — no hardware to ship, pair, or replace.
Built for commercial payers, not Medicare
Medicare does not recognize chiropractors as eligible RTM billers. That's a Medicare rule, not a clinical one — and it leaves the segment largely unaddressed by RPM/RTM platforms built around CMS.
VitalEdge's MSK program is configured against commercial-payer rules from the start: chiropractors are an eligible rendering provider, the diagnosis requirement accepts acute post-injury and post-surgical MSK conditions (not just chronic pain), and the payer list is broad rather than a single named contract — refined per your actual payer mix.
What the criteria actually check
- Rendering provider: DC, MD/DO, NP, PA, PT, or OT — not gated to Medicare's eligible-biller list
- Diagnosis: musculoskeletal, acute or chronic — no 12-month chronicity requirement
- Insurance: commercial payer, matched and refined per your contracts
What the patient does, from their phone
Four short logging actions replace a device. Each one feeds the same 16-day threshold and the same clinical picture your care team reviews.
Pain intensity
A 0–10 scale, logged daily. Feeds the trend chart on the patient's own program home, with mild/moderate/severe zones.
Home-exercise adherence
One tap — Done, Partial, or Skipped — against the prescribed HEP. One entry per day; correcting today's entry replaces it, it doesn't stack.
Range of motion
A percentage-of-target reading the patient or a caregiver logs, tracked against the prior reading to catch decline early.
Oswestry Disability Index
A functional-disability score the patient logs directly, banded from minimal to bedbound severity.
One dashboard, four functional signals
Pain intensity is only half the picture. The pain dashboard pairs it with the functional data the patient logged, so "plateaued but adherent" reads differently from "plateaued because doses were missed."
- Pain categorization
Intensity band, interference across sleep/activity/mood/work, pain-quality pattern (neuropathic vs. nociceptive), breakthrough episodes, and treatment response vs. baseline.
- Functional status
Range-of-motion trend, HEP adherence band, and Oswestry severity — the three signals a pain-only view misses.
- Disengagement alerts
Fire on low HEP adherence over three consecutive days, range of motion below target or declining over two weeks, or a severe Oswestry score — before the next visit, not after.
Why this catches what pain-alone misses
A patient reporting stable pain can still be disengaging from therapy. Pairing pain with home-exercise adherence and range of motion is what separates "adherent but plateaued — consider changing the plan" from "not doing the exercises — address that first."
The four codes, and what unlocks each one
CMS 2026 rates. Treatment-management minutes only count toward 98980/98981 once a live phone or video touchpoint is logged for the month — the platform prompts for it and flags a month at risk before it closes, so a missed call doesn't surface as a surprise at billing time.
| CPT | What it covers | Unlocked by | 2026 rate |
|---|---|---|---|
| 98975 | Initial setup & patient education | One-time | $22 |
| 98977 | Device supply, 16+ days of data | Patient-reported data counts — no device required | $51 |
| 98980 | Treatment management, first 20 min | Requires a logged interactive touchpoint | $54 |
| 98981 | Treatment management, each additional 20 min | Requires 98980 first | $41 |
National, non-facility rates before any regional adjustment. Confirm current-year rates and your specific payer contracts before submitting claims.
See it against your own patient list
Upload a CSV in Billing Pulse to see which of your MSK patients are already billable this month, or book a demo to walk through the full RTM workflow.