Library/Reimbursement

RTM billing & the 90-day global period

~$115.60 per cycle under 2026 CMS codes — billed by the care team, not the operating surgeon.

$21.71
98975 setup
$40.08
98977 device supply
$53.81
98980 management

The codes

Per the 2026 CMS Physician Fee Schedule, home monitoring of a SofPulse patient bills under Remote Therapeutic Monitoring: 98975 (setup, $21.71, once), 98977 (musculoskeletal device supply, $40.08, per 30 days), and 98980 (treatment management, $53.81, first 20 minutes/month) — about $115.60 per protocol cycle.

The global-period rule (important)

A provider who received the global surgical payment cannot separately bill RTM within the 90-day global period. So for a Medicare patient recovering from surgery, RTM is billed by a co-managing provider who is not receiving the global payment — a physical therapist or physiatrist — or by the prescriber directly for chronic-pain and wound patients, who have no global period at all.

The math at 30 patients

A practice with 30 patients on active SofPulse RTM protocol at any given time bills approximately $3,468 per month in RTM revenue (30 × $115.60). At steady state with a reasonable surgical volume, 30 concurrent patients is achievable for a mid-size orthopedic or plastic-surgery practice. At 50 patients the monthly figure reaches $5,780. That revenue flows to the practice NPI — not to SofPulse, not to a billing company — and does not require the operating surgeon to be the billing provider during the 90-day global window. Annual RTM revenue at 30 patients: approximately $41,600.

Common objections

"We don't have bandwidth to document RTM." The documentation requirement is 16 days of device-generated data per 30-day billing period — data the device and SMS outcome system generate automatically. The provider reviews a structured summary and signs. Clinical time is 5–10 minutes per patient per month. "Our global payments cover everything." The global payment covers the operating surgeon during the 90-day window. It does not preclude a co-managing provider (PT, physiatrist) from billing RTM for the same patient during that period. "Patients won't comply with the monitoring." SMS-based daily pain scoring achieves open rates above 90% — higher than any app-based system — because patients respond to a text without downloading anything.

Sources

  • 2026 CMS Physician Fee Schedule
  • CMS RTM billing guidance (global-period interaction)

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For education only — not medical advice, and not a substitute for a clinician's judgment. SofPulse is available by prescription only. Reimbursement figures reflect the 2026 CMS Physician Fee Schedule and vary by locality, payer, and documentation.