Skip to content
CareTrack

2026 billing guide · RPM

RPM CPT Codes for 2026: Rates, Rules, and What Changed

Remote patient monitoring is billed to Medicare through a small family of CPT codes that cover device setup, the device and its data transmission, and the clinical time spent managing what the data shows. Practices leave money on the table in two ways: months that miss a threshold and were never billable until now, and management minutes that go undocumented.

2026 is the biggest change to RPM billing since the codes were introduced. CMS added two short-threshold codes, 99445 and 99470, that make previously unbillable months payable: months where the patient transmitted between 2 and 15 days of readings, and months where management time landed between 10 and 19 minutes.

This guide covers every RPM code with its 2026 national payment amount, the documentation each one requires, and the rules for combining RPM with CCM or APCM in the same month.

The 2026 RPM codes at a glance

CodeDescription2026 nat’l avg*
99453Initial RPM setup and patient education$21.71
99454Device supply & data transmission (16+ days per 30)$47.43
99445Device supply & data transmission, short window (2–15 days per 30)$47.43
99457RPM treatment management, first 20 minutes$51.77
99458RPM treatment management, each additional 20 minutes$41.42
99470Short-threshold RPM management, first 10 minutes$26.05
99091Physician/QHP collection & interpretation of physiologic data$55.45
99445 and 99470 are new for 2026 and cover the short-threshold months that were unbillable through 2025. *Approximate 2026 national non-facility Medicare amounts. Actual payment varies by locality, site of service, and payer; verify with the CMS Physician Fee Schedule look-up tool.

Free download

The 2026 Medicare care management rate sheet

Every CCM, APCM, PCM, RPM, and AWV code with its 2026 national rate, plus quick math for common patient months. Two pages, made for the billing office. Updated September 2026.

99453: setup and patient education

Billed once per episode of care when the patient is set up on the device and educated on its use. An episode continues until the treatment goal is met, so switching devices for the same condition does not restart it. CareTrack ships pre-configured cellular devices and handles the onboarding call, so the education requirement is documented from day one.

99454 and the new 99445: the device supply codes

99454 pays for the device and automatic data transmission when the patient transmits readings on 16 or more days in a 30-day period. That 16-day threshold was the biggest revenue leak in RPM: through 2025, a month with 15 transmission days paid nothing.

New for 2026, 99445 covers the 2-to-15-day months. A patient who travels, is hospitalized, or simply lapses no longer produces a zero-revenue month, and the program stays economically viable while your care team works on re-engagement.

99457, 99458, and the new 99470: treatment management time

99457 pays for the first 20 minutes of management time in a calendar month, and it requires live, interactive communication with the patient or caregiver during the month, not just chart review. 99458 adds each additional 20 minutes.

New for 2026, 99470 covers months where management time reached 10 to 19 minutes, which previously paid nothing. Short months happen in every real panel; now they bill.

99091: physician data interpretation

99091 pays for a physician or qualified health care professional personally collecting and interpreting physiologic data over a 30-day period. It cannot be billed in the same period as the RPM management codes for the same time, so most programs use 99457/99458 with clinical staff time instead and reserve 99091 for physician-led review models.

Stacking RPM with CCM or APCM

Medicare allows RPM and CCM (or APCM) for the same patient in the same month, and the combination is where care-management programs become financially meaningful. The constraint is that the same minute can only count once: time counted toward 99457 cannot also count toward 99490.

CareTrack tracks program time separately per patient per program, so stacked billing survives an audit.

What every RPM claim needs behind it

The patient must be an established patient with a condition the data helps manage, must consent to the service (verbal consent documented in the chart is sufficient), and the device must meet the FDA definition of a medical device and transmit automatically. Self-reported readings do not qualify.

Only one practitioner can bill the device supply codes per patient per 30-day period, regardless of how many conditions are monitored.

Model these 2026 rates against your own panel with the ROI calculator →

RPM billing questions, answered

How many days of readings does 99454 require in 2026?

16 or more days of transmitted readings in a 30-day period. Months with 2 to 15 transmission days are no longer lost: they bill under the new code 99445 at the same national rate.

Does 99457 require talking to the patient every month?

Yes. 99457 requires live, interactive communication with the patient or caregiver during the calendar month, in addition to the 20 minutes of management time. Chart review alone does not qualify.

Can we bill RPM and CCM for the same patient in the same month?

Yes. Medicare pays both when each program's requirements are met independently and no minute of clinical time is counted toward both. The same applies to RPM alongside APCM.

What changed for RPM billing in 2026?

CMS added two codes. 99445 pays for device-supply months with only 2 to 15 transmission days, and 99470 pays for management months with 10 to 19 minutes. Both were unbillable through 2025.

Who performs the monitoring if our staff has no capacity?

RPM management time can be performed by clinical staff under general supervision. CareTrack's care team does the monitoring, patient calls, documentation, and time tracking inside your EHR, and your practice bills the codes.

Run RPM without adding headcount

CareTrack's care team delivers the program and the documentation behind every code, inside your EHR.

Book a demo