How Remote Therapeutic Monitoring Is Helping Us Keep Our Doors Open for Medicare Patients

At Ascent Total Performance, we are a locally owned physical therapy practice. We’ve built our reputation on a core belief: every patient deserves one-on-one time with a Doctor of Physical Therapy for the full length of their appointment, every single visit.

Maintaining that standard has always been our mission. But the reality is that it has become a significant challenge with each passing year, particularly when it comes to serving our Medicare patients. 

For independent practices like ours, the shifting regulatory landscape has moved from a paperwork hurdle to an existential threat. Without finding new ways to provide care, we faced the very real possibility of no longer being able to accept Medicare patients.

The reality of Medicare reimbursement 

The Medicare conversion factor dropped to $32.35 in 2025, down from $33.29 in 2024—a 2.83 percent reduction and the fifth consecutive year of payment cuts to physical therapy reimbursement rates.¹ Looking at the bigger picture, the trend reflects nearly a 30 percent decrease in Medicare payments over the past two decades.²

For a practice like ours, where every visit is delivered by a DPT, these cuts are not just numbers on a spreadsheet, but a direct hit to patient access. Each reduction affects our ability to keep serving the seniors who depend on us. We weren’t willing to change our one-on-one care delivery model, so we had to find a way to make the math work.

Remote therapeutic monitoring (RTM) became our strategic path forward.

Enter remote therapeutic monitoring

RTM is a program that allows clinicians to digitally track and support patients’ progress, pain levels, and home exercise adherence between visits. RTM launched in 2022 when CMS approved a new set of CPT codes, making it possible for patient-generated data to be reviewed by clinical staff between visits so patients can receive support as needed.³ 

While many practices still view RTM as an extra tech feature, we see it as the differentiator that allows smaller agencies to stay afloat. For us, RTM has been a transformative addition to our practice, and not just for financial reasons, though we won't pretend those don't factor in. 

On the business side, RTM billing helps offset the persistent reimbursement reductions we absorb for in-person services such as manual therapy and therapeutic activities. It doesn't solve everything, but it provides the essential breathing room necessary to keep saying yes to Medicare patients.

But beyond financial viability, RTM provides a massive access opportunity. By extending our reach into patients' homes, we ensure that high-quality care isn't limited to the minutes spent within our clinic walls.

What genuinely excites us is how this access translates to outcomes. In the first quarter of the year, we saw an activation rate of 80 percent, and 85 percent of those patients met the billing threshold for the first interval. This demonstrates high patient compliance, proving that our patients are actually doing their exercises outside of the clinic. 

We know that two to three days a week of strength training is necessary for meaningful muscle adaptation and strength gains.⁴ By hitting these compliance numbers, our patients are building the consistent habits and momentum necessary to reach their functional goals and stay healthy long after they graduate from our care.

What the research says

One of the most persistent challenges in physical therapy is home exercise compliance. Research shows that fewer than 35 percent of patients consistently follow through with their home exercise programs, often citing barriers like limited access to care, time constraints, and cost.⁴

Closing this gap has always been a priority for us because what happens between sessions is just as important as the work done in the clinic. Our in-person time is reserved for skilled interventions—the hands-on work and complex progressions that require a trained professional. RTM steps in to bridge the gap by providing the daily movement and consistency required for recovery.

Research backs this up. RTM helps patients overcome common barriers to adherence, and higher levels of engagement are associated with improved functional outcomes.⁵ Medbridge has also found that patients using RTM engage with their care programs 2.8 times more often on average than those using standard home exercise programs alone.⁶ Over the course of a full plan of care, that additional engagement can have a meaningful impact on a patient’s recovery and overall progress.

Beyond the numbers, RTM also strengthens the patient-therapist relationship. Because our therapists have access to real-time data on how patients are doing, they can identify issues earlier and adjust exercise plans based on each patient’s needs.⁴ This kind of ongoing, personalized connection helps patients feel supported throughout their recovery, even when they are at home.

Our hybrid model 

We knew that for RTM to be successful, it had to work for every patient—not just those who are already comfortable with technology or happen to have a home gym. To ensure no one was left behind, we built a model centered on maximum accessibility.

For our Medicare patients, this evolved into what we call a hybrid physical therapy model. Through the Medbridge GO app, patients can access their personalized exercise programs with clear video guidance, whether they’re at home or using our open gym space. We offer daily open gym hours where patients can come in, use our equipment, and work through their home program in a comfortable, supported setting.

Our front-desk staff is always available to assist with the app or exercise tracking, removing the technology barrier that sometimes prevents seniors from engaging with digital health. Additionally, we offer wellness exercise classes for this population as a cash-pay service. This allows patients who have graduated from their formal plan of care to maintain their results while staying connected to the community and the accountability they’ve built here.

This model wasn’t something we found in a guidebook. We developed it out of necessity to protect patient access, and we are incredibly proud of the results.

Let’s talk numbers

The financial impact of this shift became clear almost immediately. We implemented Medbridge GO in December 2025 and closely tracked our reimbursement data throughout the first quarter of 2026.

In just 90 days, we billed 235 RTM units, resulting in a total reimbursement of $8,349.50.

For a locally owned practice, that is a critical revenue stream that helps stabilize the care of our Medicare patients. But the numbers also tell a story of better clinical management.

One of our unique challenges has actually been getting patients to “graduate.” Many of our patients value the one-on-one connection so much that they want to extend their plan of care indefinitely. RTM gives us a visual, data-driven way to have honest conversations about compliance and progress. By showing patients their own data, we can move from clinical dependence to patient empowerment. It reinforces our hybrid model and aligns with our ultimate goal of ensuring patients feel confident and capable of continuing their movement journey on their own once they’ve reached their functional milestones.

Why we’re sharing this 

The yearly Medicare cuts aren’t just a paperwork problem. For small, independent practices committed to high-quality, one-on-one care, these reductions create a direct threat to our ability to serve our communities. We believe everyone deserves excellent physical therapy—skilled, personalized treatment delivered by someone who knows you and your goals.

Remote therapeutic monitoring has helped us find a path forward where others might see a dead end. It supports our revenue, improves patient outcomes, and deepens the partnership we have with every person who walks through our doors.

We’re sharing our experience because we know we aren’t the only practice navigating these challenges. RTM is the tool that is allowing us to stay afloat in a changing regulatory landscape, and we hope that by being open about what’s worked for us, we can help lead a larger conversation about the future of outpatient physical therapy and what it looks like to keep putting patients first without compromising our viability.

References 

1. PatientStudio. (2025). 2025 physical therapy reimbursement rates. https://www.patientstudio.com/2025-physical-therapy-reimbursement-rates

2. Tuffun, S. (2025, December 2). Medicare physician fee schedule updates for physical therapy 2025. SpryPT. https://www.sprypt.com/blog/medicare-physical-therapy-reimbursement

3. Nowell, W. B., & Curtis, J. R. (2023). Remote therapeutic monitoring in rheumatic and musculoskeletal diseases: Opportunities and implementation. Medical Research Archives, 11(7.2), 3957. https://pmc.ncbi.nlm.nih.gov/articles/PMC10972608/

4. Mayo Clinic Staff. (2023, April 29). Strength training: Get stronger, leaner, healthier. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/strength-training/art-20046670

5. Marshall, T., Goldman, A., Lyles, R., Grundstein, M. J., Ahmadian, N., Koc, T. A., Jr., & Gruner, M. (2025). Retrospective case-control study on the effect of in-person physical therapy with remote therapeutic monitoring on functional outcomes and plan of care adherence amongst individuals with musculoskeletal conditions. Archives of Rehabilitation Research and Clinical Translation, 7(3), 100466. https://pmc.ncbi.nlm.nih.gov/articles/PMC12447196/

6. Internal Medbridge data.