RTM uses two clocks: 30 days and calendar months

That distinction comes from the Centers for Medicare & Medicaid Services (CMS) 2026 therapy-code update and its final physician payment rule.

This guide explains the reporting periods, not whether a particular patient or service qualifies for payment.

A month-end question with two different answers

Consider this hypothetical clinic example.

A physical therapist and biller review a patient's records on October 31. For illustration, the clinic has already established a device reporting period of October 15 through November 13. That is 30 days, counting both endpoints.

The therapist also has dated treatment-management entries from October. The biller asks whether to wait until November 13 before closing the October management record.

These records answer different questions. The device record concerns its established 30-day period. The management record concerns work performed during October.

This example assumes the device period was already established correctly. It does not say that enrollment, an exercise session, or the first transmission always starts day one. Confirm that starting point through current coding instructions and the applicable payer's guidance.

What each record measures

The CMS annual update distinguishes these musculoskeletal device-supply codes:

These are alternative duration categories. CMS's final rule says the shorter-duration and longer-duration codes are not additive. They are not a base code and an extra code for the same period.

Neither listed category describes zero or one day. That does not make every other RTM service ineligible. It means those days do not fit either device-supply category shown here.

The management record uses a different unit: clinician time within a calendar month. CMS's final rule says practitioners choose the appropriate management code for time spent that calendar month. Its 2026 update describes code 98979 as the first 10 minutes. It requires at least one real-time interactive communication that month: a live, back-and-forth conversation.

This is not an exercise timer. A patient's time exercising and a clinician's treatment-management time are different records.

The calendar distinction also does not remove the live-communication requirement. Nor does reaching a day count or time amount establish a payable claim by itself.

Put the two clocks beside each other

Here is the hypothetical October example as a period ledger.

The first row includes 17 days in October and 13 in November. Those are calendar dates in the example, not a claim that data was recorded every day.

An October management entry stays in October's record. A November entry stays in November's record. The device period crossing November 1 does not combine those calendar-month totals.

For example, eight minutes dated October 30 and six minutes dated November 2 do not become 14 minutes in one calendar month.

That arithmetic illustrates the reporting boundary. It does not decide whether either activity is qualifying treatment-management work.

Likewise, do not reset this example's device record on November 1 merely because the management month changed. November 1 is still inside the assumed October 15 through November 13 device period.

These are recordkeeping dates, not instructions for the date of service placed on a claim. The reporting period, claim submission date, and claim date of service are separate questions.

Give the therapist and biller a shared handoff

HepBuddy recommends a two-part handoff rather than one field labeled "RTM month." This is a practical recordkeeping suggestion, not a CMS form or a complete billing checklist.

For the device record, show:

• The established period's start and end dates.
• The dates with qualifying device data, supported by the underlying record.
• The duration category being considered.
• Any unresolved question about the period or data.

For the management record, show:

• The calendar month.
• The clinician's dated activities and time.
• The record of required real-time interactive communication during that month.
• Any unresolved question about which activities qualify.

Keep those questions visible when the records reach the biller. Do not hide an uncertain activity inside a monthly total.

The clinic still needs to check the other requirements that apply to its services. The CMS final rule explicitly retains the requirement that remote-monitoring services be reasonable and necessary.

This two-part handoff does not replace current coding instructions, payer rules, or the clinic's full documentation process.

Avoid two tempting shortcuts

"Monthly" is not precise enough. A software report labeled "monthly RTM" may leave you unsure which dates it includes. Before using it, ask whether it groups device periods, calendar-month management, or both.

Check the underlying dates rather than assuming the label matches your task.

Sixteen days is not the only device-duration category in 2026. The CMS update includes 98985 for 2 to 15 days and 98977 for 16 to 30 days. A checklist that mentions only 98977 leaves out the shorter-duration category.

That is a code-description distinction, not advice to prescribe more exercises or seek more recorded days. The patient's treatment plan is a separate clinical decision.

Also keep device records separate from conclusions about exercise adherence. A recorded day and a fully completed home routine answer different questions. Our guide to measuring home-exercise adherence explains that distinction without treating the record as a billing rule.

What this guide does not decide

This guide uses CMS's 2026 Medicare materials, effective January 1, 2026. Do not assume another payer follows every Medicare rule.

It does not determine the correct device-period start event, claim date of service, qualifying device, qualifying caregiver, or eligible clinician activity. It does not establish payment eligibility or promise reimbursement.

It also does not establish that HepBuddy or any particular software meets a device requirement. Verify those separate questions before using these records for a claim.

The useful change is smaller: stop making one "monthly" field carry two different reporting periods. Write the device dates explicitly. Label management by calendar month. Then the therapist and biller can see which record is ready for review and which is still open.