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Limber Health (acquired by specialty EHR and analytics provider Net Health in June 2025) and Force Therapeutics represent the provider-sponsored, hybrid care tier of digital musculoskeletal (MSK) platforms. Whereas direct-to-employer virtual physical therapy platforms (such as Sword Health or Hinge Health) frequently operate as standalone digital clinics using proprietary motion sensors, Limber Health and Force Therapeutics embed directly into existing outpatient physical therapy clinics, orthopedic practices, and hospital surgical episodes—combining video-based Home Exercise Programs (HEPs), automated Patient-Reported Outcome Measures (PROMs), and CMS Remote Therapeutic Monitoring (RTM) workflows.
1. What Is Limber Health? Architecture and Net Health Integration
Developed by orthopedic surgeons and physical therapists, Limber Health is an FDA-listed Software as a Medical Device (SaMD) platform designed to extend brick-and-mortar outpatient rehabilitation into the patient’s home:
- Hybrid Home Exercise Programs (HEPs) and Care Navigation: Physical therapists prescribe condition-specific, progressive video exercise protocols during an in-clinic evaluation. Between clinic visits, patients log adherence, pain levels, and functional difficulty through the Limber mobile/web application, supported by dedicated remote care navigators (licensed PT/OT clinicians) who triage alerts and conduct monthly interactive check-ins.
- PROMs and FOTO Analytics Integration: Following its June 2025 acquisition by Net Health, Limber Health integrates with Net Health’s outpatient therapy EHRs and the Focus on Therapeutic Outcomes (FOTO) patient-reported outcomes database, automating risk-adjusted functional status scoring for MIPS Quality Payment Program reporting and orthopedic clinical registries.
- Turnkey CMS RTM Compliance Engine: The platform automatically tracks the 16-day data transmission threshold per 30-day period and logs cumulative clinician review and interactive communication minutes required to substantiate CMS Remote Therapeutic Monitoring claims.
2. Force Therapeutics: Orthopedic Surgical Episodes and Hospital EHR Integration
While Limber Health focuses heavily on outpatient physical therapy and hybrid RTM workflows, Force Therapeutics specializes in longitudinal acute-to-post-acute orthopedic surgical episodes (such as Total Hip Arthroplasty [THA], Total Knee Arthroplasty [TKA], and spine procedures) for health systems and Ambulatory Surgery Centers (ASCs):
- Episode-Based Bundled Payment Alignment (CMS TEAM, CJR, and BPCI): Force Therapeutics automates pre-operative patient education, pre-habilitation, post-discharge virtual physical therapy, wound and pain surveillance, and readmission risk stratification—helping hospitals manage post-acute care utilization under mandatory CMS bundled payment models such as the Transforming Episode Accountability Model (TEAM).
- Mandated Registry & CMS Inpatient/Outpatient PRO-PM Capture: Automates longitudinal collection of validated orthopedic instruments—including HOOS, Jr. (Hip Disability and Osteoarthritis Outcome Score for Joint Replacement) and KOOS, Jr. (Knee Injury and Osteoarthritis Outcome Score for Joint Replacement)—within theCMS-mandated pre-operative (`90 to 0 days` prior to surgery) and 1-year post-operative (`300 to 425 days`) windows for the CMS THA/TKA Patient-Reported Outcome-Based Performance Measure (PRO-PM) and the American Joint Replacement Registry (AJRR).
- EHR Interoperability (Epic, Oracle Health, and Xealth): Integrates with enterprise EHRs via HL7 v2 (`ADT` / `SIU` surgical scheduling feeds and `ORU` observation write-backs), HL7 FHIR R4 APIs, and digital health ordering middleware such as Xealth.
3. Comparing Digital MSK Architectures: Limber Health vs. Force Therapeutics vs. Sensor-Based Platforms
| Dimension | Limber Health (Net Health) | Force Therapeutics | Sensor-Based Virtual Clinics (e.g., Sword Health) |
|---|---|---|---|
| Primary Care Model | Provider-sponsored hybrid outpatient PT/OT + remote care navigator RTM | Health-system & ASC perioperative orthopedic surgical episode management | Standalone virtual-first physical therapy clinic (often employer/payer-contracted) |
| Hardware / Modality | Software-only SaMD (progressive video HEP, pain/adherence tracking, PROMs) | Software-only digital care pathways, virtual PT video, and surgical milestone tracking | Inertial motion-tracking wearables / computer-vision biofeedback tablets + remote PTs |
| Primary Reimbursement Pathway | Fee-for-service CMS Remote Therapeutic Monitoring (CPT 98975, 98977, 98980, 98981) | Surgical bundled episode savings (CMS TEAM / CJR), health-system licensing, and RTM | Per-engaged-member or milestone-based employer/health plan contracts |
| Key Clinical Outcomes & Registries | FOTO risk-adjusted functional outcomes, ODI, NDI, LEFS, QuickDASH, MIPS QPP | CMS THA/TKA PRO-PM (HOOS, Jr. / KOOS, Jr.), PROMIS, and AJRR registry submissions | Digital physical therapy clinical trials, VAS pain reduction, surgery avoidance metrics |
4. CMS Remote Therapeutic Monitoring (RTM) vs. Remote Physiologic Monitoring (RPM)
In clinical informatics and revenue cycle workflows, digital MSK platforms rely on the Remote Therapeutic Monitoring (RTM) CPT family established by CMS in 2022, which differs structurally from CPT 99457 and CPT 99454 Remote Physiologic Monitoring (RPM):
- Eligible Billing Practitioners (PTs, OTs, and SLPs): Whereas RPM (`99453–99458`) is classified as an Evaluation and Management (E/M) service restricted to physicians and non-physician practitioners (NPPs), RTM codes (`98975–98981`) are general medicine/therapeutic codes that **Physical Therapists (`-GP`), Occupational Therapists (`-GO`), and Speech-Language Pathologists (`-GN`)** can bill directly under their own therapy Plans of Care.
- Non-Physiologic Self-Reported Data Permitted: RPM requires automated, non-self-reported physiologic sensor transmission (such as blood pressure or pulse oximetry). By contrast, CMS explicitly permits RTM data (under **CPT 98977** for the musculoskeletal system) to include **patient self-reported adherence, pain ratings, and functional status** entered into an FDA-defined medical device / SaMD platform, provided data are collected and transmitted on at least **16 days out of each 30-day period** (for `98975` and `98977`).
- Time-Based Treatment Management (`CPT 98980` & `98981`): **CPT 98980** reimburses the first **20 minutes** of RTM treatment management in a calendar month (and **CPT 98981** each additional 20 minutes), requiring at least one synchronous interactive communication (telephone or video) with the patient or caregiver during the calendar month.
5. Frequently Asked Questions
What is Limber Health?
Limber Health (acquired by Net Health in June 2025) is a hybrid musculoskeletal (MSK) digital care and Remote Therapeutic Monitoring (RTM) platform used by outpatient physical therapy clinics, orthopedic practices, and health systems. It combines clinician-prescribed home exercise video programs, automated patient-reported outcome measures (PROMs), remote care-navigator monitoring, and CMS RTM billing compliance (CPT 98975, 98977, 98980, and 98981).
How is Limber Health (and Force Therapeutics) used in clinical research and healthcare?
In healthcare delivery and clinical outcomes research, Limber Health and Force Therapeutics capture longitudinal patient adherence, pain scores, and validated PROMs (such as FOTO functional assessments, HOOS, Jr., KOOS, Jr., and PROMIS) outside the clinic walls. Integrated with outpatient therapy EMRs and hospital EHRs via HL7 and FHIR APIs, they support CMS RTM reimbursement, mandatory THA/TKA PRO-PM surgical reporting, and pragmatic real-world evidence registries.
