How Much Can a Therapist Earn from RTM? Revenue Scenarios for Mental Health Practices

We get asked this question more than any other about RTM: what are the actual numbers? Not theoretical maximums. Not best-case projections. What does a real mental health practice actually earn from Remote Therapeutic Monitoring after accounting for data compliance rates, partial months, and the time required?

Here are the 2026 numbers, built from actual CMS reimbursement rates and realistic compliance assumptions.

The Building Blocks: What Each Code Pays

There are three codes that make up the monthly RTM billing stack for mental health monitoring. Here is what each one pays at 2026 national average rates for non-facility (private practice) settings.

CPT 98978 (CBT device supply, 16-30 days of data): $41.42/month

CPT 98986 (CBT device supply, 2-15 days of data, new for 2026): $41.42/month

CPT 98980 (treatment management, 20+ minutes): $40.08/month

CPT 98979 (treatment management, 10-19 minutes, new for 2026): $26.39/month

CPT 98975 (initial setup and education): $21.71, billed once per episode of care

CPT 98981 (additional 20 minutes of treatment management): $33.57/month, billed when management time exceeds 40 minutes

The two codes you will bill most months for most clients are the device supply code (98978 or 98986) and the treatment management code (98980 or 98979). Combined, these produce either $81.50 per client per month (full billing) or $67.81 per client per month (lower time threshold).

Revenue Scenarios at Different Client Counts

These projections use the following assumptions:

80% of monitored clients meet the 16-day data threshold (bill 98978 at $41.42). The remaining 20% fall in the 2-15 day range (bill 98986 at $41.42). Net device supply revenue per client: $41.42 regardless, because both codes pay the same rate.

70% of clients receive 20+ minutes of treatment management per month (bill 98980 at $40.08). The remaining 30% receive 10-19 minutes (bill 98979 at $26.39). Weighted average treatment management per client: approximately $35.97.

Combined weighted average per client per month: approximately $77.39.

Solo Practice: 5 Monitored Clients

Monthly RTM revenue: approximately $387 Annual RTM revenue: approximately $4,644 First month bonus (5 x 98975 setup): additional $109

This is a conservative starting point. Five clients is enough to learn the workflow and establish documentation practices. The revenue alone is modest, but the clinical value (better informed sessions, earlier crisis detection) is immediate.

Solo Practice: 10 Monitored Clients

Monthly RTM revenue: approximately $774 Annual RTM revenue: approximately $9,288 First month bonus (10 x 98975 setup): additional $217

At 10 clients, RTM revenue covers the cost of most monitoring platforms and begins generating net income. If your platform subscription is $500 per month, you are netting approximately $274 per month in RTM revenue after the platform cost. The platform's clinical features (session prep briefs, risk alerts, biometric dashboards) come effectively free.

Solo Practice: 15 Monitored Clients

Monthly RTM revenue: approximately $1,161 Annual RTM revenue: approximately $13,932 Net after $500/month platform cost: approximately $661/month or $7,932/year

This is the point where RTM becomes a meaningful revenue line. $661 per month in net revenue for reviewing data you would want to review anyway.

Solo Practice: 20 Monitored Clients

Monthly RTM revenue: approximately $1,548 Annual RTM revenue: approximately $18,576 Net after $500/month platform cost: approximately $1,048/month or $12,576/year

At 20 clients, RTM is adding over $1,000 per month to your practice income, net of platform costs.

Small Group Practice: 3 Clinicians, 15 Clients Each (45 total)

Monthly RTM revenue: approximately $3,483 Annual RTM revenue: approximately $41,796 Net after $1,000/month platform cost (Practice tier): approximately $2,483/month or $29,796/year

Group Practice: 5 Clinicians, 20 Clients Each (100 total)

Monthly RTM revenue: approximately $7,739 Annual RTM revenue: approximately $92,868 Net after $2,000/month platform cost (Group tier): approximately $5,739/month or $68,868/year

What These Numbers Do Not Include

The projections above are conservative in several ways.

No CPT 98981 billing. If treatment management time exceeds 40 minutes for any client in a month (20 minutes base plus an additional 20 minutes), you can bill an additional $33.57. This is common for clients in crisis, during medication changes, or during intensive treatment phases. We did not include this in the projections.

No commercial insurance premium. Some commercial payers reimburse RTM codes at higher rates than Medicare. If your payer mix includes commercial insurance that covers RTM, your actual revenue may be higher.

No value assigned to the clinical benefits. Fewer crisis calls, fewer no-shows (because you catch deterioration early), better session outcomes (because you walk in already knowing how the week went), higher client retention (because clients feel monitored and supported). These have real financial value to a practice but are difficult to quantify in a billing projection.

The Time Investment

RTM is not free money. It requires clinical time. Here is a realistic estimate of the time involved per client per month.

Reviewing monitoring data before sessions: 5-10 minutes per client per session. If you see the client weekly, that is 20-40 minutes per month. However, this time directly improves your session quality, so it is not purely administrative.

Interactive communication (required for treatment management codes): 5-10 minutes per client per month. One phone call to discuss the week's data or check in on a flagged trend.

Documentation and billing: 5-10 minutes per client per month if your platform automates data logs and compliance tracking. More if you are documenting manually.

Total: approximately 30-60 minutes per client per month. At $77.39 per client, that is an effective hourly rate of approximately $77-155 per hour for the clinical time involved, depending on efficiency. For context, average therapy session reimbursement for a 60-minute session ranges from $80-150 depending on location and payer.

The time investment is real. But the hourly rate is comparable to or better than session billing, and the clinical value (better data, better outcomes, fewer crises) multiplies the benefit beyond the direct revenue.

When RTM Does Not Make Financial Sense

Honesty matters here. RTM is not a good fit for every practice.

If your caseload is primarily short-term (under 8 weeks). The setup code is billed once, and it takes 1-2 months to establish a monitoring baseline that generates clinically useful trends. Clients who are in and out in 6 sessions may not generate enough billing months to justify the onboarding effort.

If your payer mix is entirely commercial insurance that does not cover RTM. Check with your payers first. If none of them reimburse RTM codes, the revenue case disappears. The clinical value remains, but you cannot bill for it.

If you are not willing to make the monthly phone call. The interactive communication requirement is non-negotiable for treatment management codes. If you cannot commit to one brief call per client per month, you can only bill the device supply codes (98978 or 98986), which cuts your revenue roughly in half.

If you have fewer than 5 clients who would clinically benefit from monitoring. At very low volumes, the workflow overhead may not justify the return. Start with 5 and scale from there.

How to Start

Begin with your highest-need clients. Clients in active medication changes, clients with recurring mood episodes, clients with poor insight into their own patterns, and clients at elevated crisis risk are the strongest candidates for between-session monitoring and the easiest to justify clinically for RTM documentation.

Confirm your provider eligibility. Read the documentation requirements so your claims are clean from the first month. Review our complete RTM billing guide for the full code-by-code breakdown.

Then start monitoring, start documenting, and start billing. The codes exist. The reimbursement is real. The clinical value is immediate. The only variable is whether your practice captures the opportunity.