KuduCare
PA · WV · DE · NY
FOR WESTERN PA PRACTICE OWNERS

Highmark changed the math.

RTM (Remote Therapeutic Monitoring) is the reimbursable workflow for the between-session work you're already doing: skill homework, mood logging, adherence tracking. As of February 23, 2026, Highmark pays for it under RP-084.

The order defines the scope. RTM documents and informs over the cycle. It does not page you between sessions, and it does not create a clinical obligation you didn't take on. Your clinical judgment stays yours.

30-second walkthrough. Pause anytime.

What it adds, alongside the work you already do
88%

Weekly engagement across active RTM panels we've helped stand up.

+50%

Lift on session revenue per RTM-enrolled patient. Sessions stay the same. RTM is additive.

$9.5K+

Net-new revenue per year per 10 patients over 12 months. On top of what you bill today. Assumes consistent monthly capture and confirmed coverage.

How the engagement sticks

Methods matched. Humans delivering. A loop that learns.

Personalized CBT and MET microlearning isn't a tagline - it's a delivery system. Three pieces that work together.

01 · The method

Evidence-based methods, deployed

Six named CBT and MET methods. Behavioral activation. Cognitive restructuring. Decisional balance. Change-talk elicitation. The full library carries more.

Each one is a 60-second video from a familiar face, your own provider if you record your own, matched to the moment in front of the client.

02 · The content

Nudge science. Edited by licensed clinicians.

Every micro-lesson is derived from CBT and MET best practices and edited by licensed behavioral health professionals before it ever reaches a patient.

Delivered across formats (video, animation, and text) with tone, length, and reading level tuned to the patient. The library evolves with each patient as engagement signals reveal what lands.

Video
60-second micro-lessons
Animation
concept visualizations
Text
tone and length tuned to the patient

Live auxiliary personnel (clinical staff who perform interactive reviews and, when desired, interactive communication with the patient under your general supervision) is available as a higher-tier service.

03 · The loop

Algorithmic surface. Clinical depth.

Software routes each patient across methods, formats, tone, and length based on response and engagement signals. Your clinical team reviews routing and adjusts when patterns don't stick. Algorithmic matching makes it scale. Clinical judgment makes it work.

Daily engagement signals
Algorithmic routing
Clinical review and adjust
Adjusted match
How a real follow-up adapts

A new client, in the weeks where drop-off is highest.

  1. Day 1
    Two sessions in, she logs after her between-session task: "Didn’t make the walk. Busy week." Self-monitoring keeps the commitment visible.
  2. Day 2
    A 60-second video from a familiar face — her own provider, if you record your own: behavioral activation, why the small action comes before the motivation.
  3. Day 4
    She goes quiet. The drop-off signal, exactly where new clients are lost. An MI-informed prompt invites her to name what brought her in.
  4. Day 5 · the live touch
    She replies: "I don’t know if this is working." This is the rupture point. The app meets the doubt with a cognitive restructuring lesson, and in parallel flags a human: your clinician, or KuduCare auxiliary personnel under your supervision, reaches out and reflects back what she shared. The software surfaces the moment. The person makes the connection.
  5. Day 7
    An if-then plan for when momentum slips. "If I skip the morning walk, I take ten minutes after lunch."
  6. Days 28–30
    Nudge RTM validates the full cycle: confirms the monitoring days, totals the management time, flags the case bill-ready, or surfaces what's missing before the claim goes out.

She never sees the machinery. She sees a familiar face in the week she almost left, and one real conversation when she needed it. You see a retained client and a bill-ready cycle at your next session.

The math

The clinical work is mostly already happening. The billable status is what changed.

$158 baseline session + $96 RTM − $13 to $17 platform fee = +$79 to $83 per patient per month
10 patients over 12 months = +$9,500 to $10,000 per year, additive to sessions. Assumes consistent monthly capture and confirmed coverage.
About a 50% lift on session revenue. Sessions stay the same. The skill homework, mood logging, and adherence work you already do between sessions is what just became structured, monitored, and billable.
Who can bill RTM under RP-084

Built for licensed behavioral health practice owners across the Highmark footprint.

  • -Licensed Clinical Social Workers (LCSW)
  • -Licensed Marriage & Family Therapists (LMFT)
  • -Licensed Mental Health Counselors (LMHC)
  • -Licensed Professional Counselors (LPC)
  • -Clinical Psychologists
  • -Marriage & Family Therapists

We verify your eligibility and the client's benefits before enrollment, so you bill clean from the first cycle.

When your client is also on medication

One RTM clinician of record. The prescriber sees the data.

Many clients in therapy for moderate-to-severe depression or anxiety are also on an SSRI or SNRI. CMS rules say only one treating clinician bills RTM per 30-day episode. Here's how that works in practice.

The order defines the scope. RTM documents and informs over the cycle, for the one clinician of record. It does not create a second clinical obligation for anyone who isn't billing.

Highmark RP-084 + CMS RTM

Remote Therapeutic Monitoring

Effective: Highmark Feb 23, 2026 · CMS RTM since 2022
Covers: Therapeutic data (adherence, response, behavioral skill use) collected via FDA-registered software.
Order required: Physician or QHP, up to 90 days. Established patient relationship.
Reimbursable CPT codes
98975Initial set-up and patient education on the device
98978Device supply, cognitive behavioral therapy - 30 daysBH-specific
98980Treatment management, first 20 minutes per month
98981Treatment management, each additional 20 minutes

RTM also has codes for respiratory (98976) and musculoskeletal (98977) device supply. Not applicable to behavioral health.

CommercialPAWVDENY
Medicare AdvantagePAWVDENY

Anthony Como

Founder & CEO, KuduCare
The KuduCare team has built and scaled CBT and MET-based remote care programs reaching millions of patients inside FDA and CMS regulatory environments, then turned that playbook toward behavioral health.
Pittsburgh, PA · anthony.como@kuducare.com
Want the brief?

The full RTM brief for your practice, in your inbox.

Policy summary, billing math, eligibility checklist. No follow-up calls unless you ask.

We'll add you to one quarterly RTM-policy update email. Unsubscribe in one click.

The ask

Fifteen minutes between operators.

On your calendar.