What devices do surgical patients receive?

A wearable activity tracker and, for applicable protocols, a connected goniometer app for range-of-motion tracking. No manual logging required for activity data.

Is this billed under RTM instead of RPM?

Yes, musculoskeletal monitoring typically falls under RTM (98975-98981), which covers therapeutic, rather than purely physiologic, data.

How long does monitoring typically run?

Most protocols run 8 to 12 weeks post-surgery, covering the highest-variance window of recovery, though this is configurable per procedure.

How are alert thresholds set?

Per patient, from the provider portal, based on expected recovery curves for the specific procedure and the patient’s baseline function.

For orthopedic practices

Pain scores are self-reported.
Recovery doesn't have to be.
Isabella watches everything else.

A pain score is one number, once a day, filtered by how a patient is feeling when they answer. Ziva adds the objective signal underneath it - activity, sleep, HRV and gait - so a rising pain score is confirmed by the body, not just the self-report.

HIPAA compliant · Activity & PT tracking · Joint replacement, spine & sports medicine protocols · RPM & CCM eligible

Book a demo How Ziva helps →

James O., 64* · TKA, week 3

Escalate

🗣️

Patient-reported pain

Self-reported daily

7/10 ↑

🏃

Activity (wearable)

Objective

↓ 40% vs. wk 2

🌙

Sleep duration

Objective

5.8h ↓

❤️

HRV

Objective

34ms — low

🚶

Gait speed

Phone accelerometer

↓ 15%

Isabella

"James's pain score climbed to 7/10 — and the objective signal agrees: activity down 40%, sleep and HRV both low, gait slower for the second day. Not just a subjective read. Flagged for review."

*Stories are inspired by real patient experiences and health patterns observed in care. Names, images, quotes, and certain details have been changed or combined to protect privacy. Individual experiences and outcomes may vary.

The gap

The data you need arrives
at the next follow-up.

Post-surgical recovery generates daily, objective signal - activity, pain, PT adherence - that most orthopedic panels only see at the two- or six-week follow-up.

Silent complications

Stalled activity and rising pain can signal infection, stiffness, or hardware issues days before a scheduled visit surfaces it.

PT non-adherence

Home exercise adherence drives outcomes as much as the surgery itself, and is invisible between clinic-based PT sessions.

Opioid tapering

Pain trajectory and medication use need daily visibility to taper safely without under-treating.

The continuous care experience

A daily recovery
record for every patient.

Each surgical patient has a daily point of contact and a daily data record. Isabella handles the routine; your team sees the deviations.

Daily activity tracking

Wearable step count and range-of-motion logging sync automatically, no manual entry.

Pain & symptom check-in

Pain score, swelling, and wound status captured daily in plain language.

Isabella correlates

Activity trajectory against pain against PT adherence - the sequence, not just the values.

Coaching between visits

Exercise pacing, icing protocol, and medication timing reinforced daily.

Escalation with the sequence

Your team gets the trend, symptoms, and adherence history together, ready for a same-day check.

How Ziva helps

What Ziva does
for an orthopedic practice.

Objective daily activity plus subjective daily pain plus PT adherence - the three inputs that determine whether recovery is on track.

Joint replacement

Activity & ROM tracking

Daily step count and range-of-motion trended against expected recovery curves for the procedure.

Pain

Pain trajectory monitoring

Daily pain scores flag plateaus or reversals that a two-week follow-up would miss.

Home exercise adherence

Prescribed exercise completion tracked daily, not just recalled at the next PT visit.

Spine

Post-surgical spine protocols

Activity and pain tracking tailored to spine surgery recovery timelines.

Sports medicine

Return-to-play tracking

Objective activity data supports return-to-play decisions beyond subjective report.

Medication

Pain medication tapering

Daily medication logs support safe, monitored opioid tapering.

Impact

Outcomes that matter
in surgical recovery.

Earlier detection changes the response - a PT adjustment or phone call instead of a delayed complication.

Earlier

Complication detection

Activity and pain trajectory flagged days before the next follow-up

Daily

Activity & pain data

Continuous data replaces recall at a two-week visit

Proactive

PT adherence tracking

Home exercise completion visible daily, not just recalled

Illustrative

Program revenue

Modeled RTM revenue for your panel - see reimbursement below

Directional framing based on Ziva's platform capabilities; actual results depend on panel size and payer mix.

Proof

A stalled recovery,
caught at week three.

"His activity had quietly dropped 40% - nobody would have known until the six-week visit."

James's wearable data showed his daily activity falling for a week, alongside rising pain scores. Isabella flagged the pattern as atypical for week 3 post-TKA, and his surgeon's office called to check in - catching early stiffness before it became a bigger problem.

James, 64* — Total knee arthroplasty, week 3

Outcome

PT plan adjusted early. Recovery back on track.

Isabella · Ziva AI

James's activity has dropped 40% from last week with pain climbing to 7/10 at week 3 post-TKA. This combination is atypical for this point in recovery - flagged for review.

Conditions covered

Surgical and comorbid conditions.

Surgical patients often carry weight and cardiovascular comorbidities that affect recovery. Ziva runs concurrent protocols on the same record.

Weight Diabetes Mental health Hypertension All conditions →

Reimbursement

Orthopedics is a strong
fit for RTM billing.

Remote Therapeutic Monitoring (RTM) was written for exactly this use case - musculoskeletal status and therapy adherence tracked between visits.

RPM — 99453 / 99454 / 99457 / 99458

Device-based physiologic monitoring, 16+ transmission days per month

99453One-time setup & patient education — ~$19

99454Device supply + daily transmission — ~$46/mo

99457First 20 min interactive care management — ~$48

99458Each additional 20 min — ~$39

CCM — 99490 / 99439

Patients with two or more chronic conditions expected to last 12+ months

99490First 20 min clinical staff time / month — ~$62

99439Each additional 20 min — ~$47 (up to 2×)

Ziva's time logs, monitoring records and monthly reports supply the documentation these codes require. Confirm eligibility and rates with your billing team and MAC.

Program revenue estimate

Enrolled post-surgical patients 80

10typical enrollment ramp400

Program type

Device supply (99454)—

First 20 min (99457)—

Additional 20 min (99458)—

Estimated monthly program revenue

—

— annually

Illustrative national-average estimates. Actual reimbursement varies by MAC, locality, payer mix and documented time.

Self-pay option

Not billing insurance? Charge patients directly.

Set your own price for a monthly monitoring program, membership or package. Connect your payment system to Ziva and get paid directly, alongside or instead of CPT billing.

Connects with

StripeSquarePayPalYour existing system

See plans →

Get Started

Start with your
joint replacement cohort.

Most orthopedic practices begin with their total knee and hip replacement patients, where recovery variance is clearest, then expand into spine and sports medicine.

✓Cohort selection and eligibility analysis

✓Alert threshold design for your clinical protocols

✓Revenue modelling for your panel

✓Live in 4–6 weeks including device logistics

Request a 30-minute demo

We'll walk through enrolment, alert configuration, and the revenue model for your practice.

Book my demo →

No commitment. We'll follow up within 1–2 business days.

Security & compliance

Built for healthcare.
Trusted by clinical teams.

Ziva was designed from the ground up for clinical environments - not adapted from a consumer app. Every data flow, access control, and integration meets the standards your compliance team requires.

🔒

HIPAA compliant

BAA available. All PHI encrypted in transit and at rest.

✅

End-to-end encrypted

HL7 FHIR R4 compliant data exchange.

🏥

US data residency

All patient data stored and processed within the United States.

📋

Audit-ready logs

Consent records, access logs, and billing documentation stored and exportable.

Questions

Pain scores are self-reported.Recovery doesn't have to be.Isabella watches everything else.

The data you need arrivesat the next follow-up.

A daily recoveryrecord for every patient.

What Ziva doesfor an orthopedic practice.

Outcomes that matterin surgical recovery.

A stalled recovery,caught at week three.

Surgical and comorbid conditions.

Orthopedics is a strongfit for RTM billing.

Start with yourjoint replacement cohort.

Built for healthcare.Trusted by clinical teams.

Orthopedics FAQ

Pain scores are self-reported.
Recovery doesn't have to be.
Isabella watches everything else.

The data you need arrives
at the next follow-up.

A daily recovery
record for every patient.

What Ziva does
for an orthopedic practice.

Outcomes that matter
in surgical recovery.

A stalled recovery,
caught at week three.

Orthopedics is a strong
fit for RTM billing.

Start with your
joint replacement cohort.

Built for healthcare.
Trusted by clinical teams.