New revenue for your practice, without adding sessions.
Remote therapeutic monitoring (RTM) is a Medicare service for the support your clients get between sessions. Nudge delivers short daily exercises and check-ins, tracks what Medicare needs, and shows your clinicians who needs them this week.
Your growth is capped by your clinicians' calendars
Most practices only earn when a clinician is in a session. A full caseload or a waitlist means you've hit the ceiling.
Meanwhile, some clients drop out early, some never make it to the first appointment, and some only need a lighter touch than weekly therapy. RTM pays for structured support between sessions, billed separately from psychotherapy.
Therapy dropout after first visits
Over 70% of all mental health treatment dropout occurs after the first or second visit, before therapeutic gains can take hold.
World Mental Health Surveys / PMC, 2021Adults with mental illness receive no treatment
Among 61.5 million U.S. adults with any mental illness, 48% did not receive any mental health treatment in the past year.
SAMHSA NSDUH, 2024Estimate your RTM revenue
Medicare pays for RTM per client, per month. Move the sliders to see a range for your practice.
Estimated new revenue with Nudge
+$320 to $870 a month
From 16 enrolled clients and about 5.3 hours of review a month. An hour of review can pay about as much as a therapy session, without using a session slot.
Estimate based on 2026 Medicare national rates (CMS Medicare Physician Fee Schedule, 2026). Actual payment depends on your location, payer, clinician licenses and documentation. Plus a monthly monitoring payment set by your Medicare contractor, not included. Master's-level ranges start at 75% of the full rate, which applies to some licenses. Before your costs. Medicare pays 80% of these amounts; the client or a secondary plan covers the rest. Not billing advice.
RTM works best when most of these are true
Not sure? Bring your payer mix to a pilot call and we'll tell you honestly.
You're credentialed with Medicare
Medicare and Medicare Advantage cover RTM. Other plans vary.
Your clinicians are master's level or above
LCSWs, LMFTs, mental health counselors and psychologists can bill Medicare for RTM.
Your caseload is full or waitlisted
RTM adds revenue from clients you already see.
Your clients benefit from practice between sessions
Anxiety, stress, caregiver strain and chronic health conditions are a good fit.
You can document medical necessity
A diagnosis and a care plan for skill development, kept in your EHR.
Your clients use text or email
Each Nudge opens from a link on their phone or computer.
Your clinicians stay in charge. Nudge does the rest.
The clinician chooses the program and decides when to change or stop it. Nudge handles delivery, tracking and the records Medicare asks for.
Offer it in session
The clinician offers RTM to clients who need more support between sessions. The client enrolls with a link, by email or text. No app to download.
Clients practice daily
Short exercises and check-ins arrive at a time that suits each client.
Review before the session
Each clinician sees only their own clients: who completed, whose symptoms are trending, and who needs attention. A built-in timer logs review time.
Bill at month end
Nudge counts monitoring days and review minutes, shows which clients are ready for which code, and produces a signed monthly report for your biller.
Prove it with a few clients first
Start with one clinician and a handful of clients. You'll see real engagement and real billing data before you roll it out to the practice.
We set up your programs, train your clinicians, and walk your biller through the codes and the monthly report.
"Between sessions, our patients used to lose momentum. Now they get a breathing exercise or a reflection prompt right when they need it."
Founder, KuduCare
Prefer a full-service partner? KuduCare runs RTM programs on Nudge, including billing training and practice onboarding. Ask us for an introduction.
Built for the claim your biller submits
Nudge doesn't submit claims and doesn't replace your EHR. It gives your biller what the claim needs, and your medical necessity documentation stays where it lives today.
Monthly report per client
Monitoring days, review minutes, interactions and the clinician's signature.
Clear status per client
Which RTM codes each client is ready for this month.
Each clinician's clients kept separate
So each clinician's work is billed under the right NPI.
A record of every response and review
Kept with each client for review and audit.
Questions owners ask
Will I lose money?
Start with a pilot and see your own numbers before you commit. The calculator above gives you a first range.
My biller has never heard of RTM.
That's common, it's a newer service. We'll walk your biller through the codes, the documentation and the monthly report.
My Medicare contractor shows $0 for the monitoring code.
The monitoring codes for CBT-based programs (98978 and 98986) are priced by each Medicare contractor, not nationally, so some fee schedules don't list an amount. Medicare still covers them.
Is it covered outside Medicare?
Medicare Advantage plans cover it, and some commercial plans do. Coverage varies, so check each payer's policy.
Will this increase audit risk?
RTM is reviewed like any Medicare service, and the key is documented medical necessity. Nudge keeps a record of every response and review.
Is Nudge HIPAA compliant?
Yes. We sign a Business Associate Agreement with your practice.
Does RTM need an FDA-cleared device?
RTM needs software that meets the FDA definition of a medical device. Nudge meets that definition. It is not FDA cleared or approved, and Medicare doesn't require clearance.
What about clients in crisis?
RTM isn't a crisis service, and your existing crisis protocols still apply. Our terms tell clients to call 911 in an emergency.
Some of my clients don't use technology.
Those clients may not be a fit, and that's fine. For the rest, there's no app to install: each Nudge opens from a link.
See what RTM could add to your practice
Try the calculator above, or book a 30-minute pilot call and we'll walk through it with your own caseload.
Book a pilot call