Remote Therapeutic Monitoring for Pain Management Practices: A Practical Guide

Pain management is one of the most relationship-dependent specialties in medicine. Your patients aren't just coming in for a procedure and leaving - they're managing chronic conditions that affect every aspect of their daily lives. Pain levels fluctuate. Sleep deteriorates. Activity drops. Mood suffers. And most of the time, none of that is visible to you until the patient walks back through your door weeks later.

Remote Therapeutic Monitoring (RTM) was designed to close that gap.

This guide is written for pain management practice owners and physicians who want to understand what RTM actually looks like in practice - how it improves the care you deliver, what it means for your patients, and why a growing number of pain management groups across the country are adding it to their programs.

What RTM Does for Patient Care

The core promise of RTM is simple: it gives you a continuous window into how your patients are doing between visits.

In a traditional pain management model, you see a patient for fifteen or twenty minutes, review their chart, adjust their plan, and send them home. Then you wait - sometimes four weeks, sometimes eight - before you see them again. A lot can change in that time. Pain scores can spike. A patient might stop their home exercise program. Sleep problems can cascade into mood issues that affect their recovery.

RTM changes that by having patients complete short, structured check-ins from their phone or computer on a regular basis. At Pain Medicine Consultants in the Bay Area, for example, patients log five data points - pain, mood, activity, sleep, and overall improvement - in under a minute, as often as daily or at minimum once a week. That data flows directly into a clinical dashboard that providers can review any time, between visits and before appointments.

The result is that providers walk into every appointment with weeks of trend data rather than a single point-in-time report. They can see whether a patient's pain has been gradually worsening since their last injection, or whether their sleep improved after a medication adjustment. They can identify patients whose activity scores have dropped - a potential indicator of deconditioning or a flare - and reach out proactively rather than waiting for a crisis.

Dr. Richard Shinaman, MD at Pain Medicine Consultants describes it this way: "Patients check in weekly, we get the alerts that matter, and we've been able to intervene earlier when something changes. It's one of the easiest programs we've implemented."

The Problem RTM Solves for Pain Management Specifically

Every specialty could benefit from better between-visit data, but pain management has a particular need for it.

Chronic pain is dynamic. Unlike a post-surgical recovery that follows a relatively predictable trajectory, chronic pain fluctuates in ways that are hard to anticipate. A patient might be doing well at their appointment and in significant distress two weeks later. Without a monitoring mechanism, you simply don't know.

Patient-reported outcomes matter more here than almost anywhere else. Pain is inherently subjective. The most important data - how a patient feels, how well they're sleeping, how much they're moving - can only come from the patient. RTM creates a structured, consistent mechanism for collecting that data over time, which makes it far more actionable than a single intake form filled out in a waiting room.

Older patients are underserved by traditional models. Many pain management patients are Medicare-age adults managing multiple conditions. They may not have easy access to transportation. They may be reluctant to call the office between appointments even when something changes. A simple weekly check-in removes the barrier - patients don't need to feel like they're "bothering" anyone, and the care team gets the data without playing phone tag.

The window between visits is where outcomes are won or lost. Physical therapy adherence, medication compliance, activity levels, sleep quality - all of these between-visit behaviors have a significant impact on patient outcomes. RTM doesn't just monitor them; it creates accountability and connection that supports better adherence.

What the Patient Experience Actually Looks Like

One of the most common concerns practice owners raise when they first hear about RTM is whether their patients - many of whom are older or less tech-savvy - will actually use it.

The answer, in practice, is yes - if the enrollment process is simple enough.

At Pain Medicine Consultants, patients receive a personalized invite email from Pilothouse Health before their appointment. During the visit, a staff member hands them a one-page flyer and takes a moment to introduce the program - what it is, why the practice uses it, and how easy it is to get started. The patient clicks the link in their email, chooses a password, and their account is ready. The entire signup takes under a minute.

From there, the Pilothouse Health team takes over. We call each new patient directly to walk them through the program, answer any questions they have, make sure they are comfortable with the check-in process, and ensure they feel supported from day one. Your practice never has to field questions about how the platform works or troubleshoot anything on the patient side - that is all handled for you.

From there, patients complete a short log - five sliders covering pain, mood, activity, sleep, and overall improvement - that takes less than twenty seconds. The fifth slider, overall improvement, acts as a valuable feedback data point that gives providers a simple read on how the patient feels they are progressing overall, separate from any individual symptom. They can do it daily if they want, or as little as once a week. There's no app to download. It works on any phone or computer.

Patients consistently tell us they love the simplicity. Five sliders, under a minute, and they're done. But for patients who want to share more, there is an optional expanded section below the submit button where they can add granular detail - pain location, duration, type of pain, and other relevant context. It's there for those who want it, but it never gets in the way of the patients who just want to tap through quickly and move on.

The feedback from patients who use it is consistently positive. They feel more connected to their care team. They feel heard between visits. And for patients managing chronic conditions, that sense of continuity matters enormously.

What Your Team Actually Has to Do

This is usually the second concern: bandwidth. Pain management practices are busy. Providers are already stretched. Adding a new monitoring program sounds like more work.

In a well-run RTM program, the additional workload on your team is minimal.

The enrollment piece is handled outside your office - patients receive their invite automatically before their appointment. Your staff's role is to hand the patient the introduction flyer and introduce the program during the visit. From there, Pilothouse Health takes over - calling each new patient, walking them through the platform, answering their questions, and making sure they are fully set up and comfortable before their first log.

The monitoring itself is managed by the RTM platform. Pilothouse Health reviews patient data continuously and flags anything that warrants attention - a significant spike in pain scores, a sustained drop in activity, a patient who hasn't logged in several weeks. Your providers receive alerts for the things that matter, rather than having to review every patient's data manually.

Chart review - which is a billable event under RTM - happens naturally, before appointments. Providers who are already reviewing patient records before a visit can incorporate RTM trend data into that review with no additional time commitment.

Calls to patients - also billable - are the same outreach calls your team may already be making for follow-up. Under RTM, they're structured and documented in a way that generates reimbursement.

How RTM Billing Works for Pain Management Practices

CMS created the RTM billing codes specifically to reimburse practices for the work of monitoring patients between visits. For pain management, the relevant codes are:

98975 - Initial device setup and patient education (one-time, per patient)
98985 - Device supply with daily recordings, 2–15 days of data in a 30-day period
98977 - Device supply with daily recordings, 16 or more days in a 30-day period
98979 - Treatment management, first 10–19 minutes of provider time per month
98980 - Treatment management, first 20 minutes of provider time per month
98981 - Each additional 20 minutes beyond the first

The management codes are triggered by meaningful clinical activity - patient engagement with the monitoring program, documented provider review of that data, and direct communication between the care team and the patient. In other words, the billing follows the care. Practices that are genuinely using RTM to stay connected with their patients and act on what they learn will naturally satisfy the requirements.

At current Medicare reimbursement rates, a fully engaged RTM patient generates approximately $100–$155 in new monthly revenue. That figure reflects the real clinical work involved - reviewing trend data, identifying changes, and reaching out when something warrants attention. Across a meaningful patient panel, that adds up to significant recurring revenue that compounds as more patients become active in the program.

The reimbursement structure exists because CMS recognizes that between-visit monitoring has genuine clinical value. The codes were designed to incentivize exactly the kind of proactive, data-informed care that RTM enables - not to create a billing shortcut, but to make it financially viable for practices to invest in staying connected with their patients between appointments. That is the right framing for RTM, and it is the framing that will serve your practice best over the long term.

Common Concerns - Addressed Honestly

"Our patients are older. They won't use an app."

RTM doesn't require an app. It works in any web browser, on any device. The signup process is one click from an email link. And in practice, adoption rates among older Medicare patients are higher than most practices expect - especially when a staff member walks them through it briefly at the appointment.

"We don't have the staff bandwidth."

This is the concern we hear most often, and it's the one that disappears fastest once a practice gets started. Pilothouse Health handles the heavy lifting - patient onboarding calls, ongoing monitoring, and proactive outreach - so that your clinical team can access and act on patient data without it becoming extra work.

What that looks like in practice is a HIPAA-compliant dashboard that gives providers and staff instant visibility into how every patient is doing between visits. Trend data, alerts, engagement history - it's all there, organised and ready to review before an appointment or whenever a provider wants to check in. Rather than replacing clinical judgment, the platform supports it by surfacing the information that matters in a format that saves time rather than consuming it.

Staff can also call patients directly through the platform with a single click of the Call button - no need to pick up a separate phone or log the interaction manually. Every call is automatically tracked and timestamped, creating a full audit trail that feeds directly into the end of month billing report. It is one of those small workflow details that makes a real difference - the clinical interaction and the billing documentation happen in the same step, with nothing falling through the cracks.

The result is a sliding scale that works for every practice. Teams that want to be highly engaged with their patient data can be. Teams that are stretched thin can rely on Pilothouse Health to monitor, flag, and follow up - knowing that the moment they do open the dashboard, everything they need is already waiting for them. Either way, your patients are being monitored, your data is being collected, and your providers are walking into appointments better informed than before.

"What if patients report something concerning?"

The platform flags significant changes and routes alerts to the appropriate provider. This is a feature, not a liability - it means you're more likely to catch a deteriorating patient before they end up in the ED, not less. Your providers decide how to respond to alerts, just as they would with any clinical information.

"We're already busy. Is this worth the effort?"

The practices that find RTM most valuable are the ones who were already concerned about what was happening with their patients between visits. If you've ever had a patient show up to an appointment significantly worse than expected - and wondered whether an earlier intervention could have helped - RTM is designed specifically for that scenario.

Getting Started

RTM programs work best when they're implemented simply and consistently. The practices that see the strongest results are the ones that make enrollment part of the standard appointment workflow - not an optional add-on that depends on individual staff members remembering to mention it.

If you're a pain management practice considering RTM, the most important questions to answer upfront are:

Which patients are eligible? (Generally any patient with a musculoskeletal or pain-related diagnosis seen by your team)
Who will hand patients the flyer at appointments?
Who on the clinical team will review RTM data and handle flagged alerts?

From there, a good RTM partner handles everything else - the technology, the patient onboarding, the ongoing monitoring, and the billing documentation.

Pain Medicine Consultants in the Bay Area has been running their RTM program with Pilothouse Health since early 2026. As Dr. Shinaman puts it: "It's one of the easiest programs we've implemented" - and the patient data flowing in between visits has meaningfully changed how the team approaches appointments.

If you'd like to see how RTM could work for your practice, we'd be happy to walk you through it. Schedule a 15-minute call and we'll show you the platform, the expected reimbursement for your patient panel, and what implementation actually looks like.

Pilothouse Health is a fully managed Remote Therapeutic Monitoring platform built for pain management, orthopedic, and musculoskeletal practices. We handle enrollment, monitoring, and reporting - so your team can focus on patient care.