Billing reference • RPM CPT Codes • 2026

2026 Remote Patient Monitoring (RPM)CPT Codes

A clean, implementation-ready guide to the 2026 RPM code updates-thresholds, time requirements, exclusivity rules, and practical billing scenarios.

Effective: Jan 1, 2026CMS PFS (reference)Rates shown are approximate

What Changed in 2026?

CMS introduced two new RPM CPT codes to address gaps in the existing RPM billing structure:

  • A shorter device data threshold for patients monitored fewer than 16 days
  • A shorter clinical management time threshold for RPM services that do not reach 20 minutes

These additions allow RPM programs to bill legitimately for shorter but clinically meaningful monitoring periods.

Complete RPM CPT Codes Table (2026)

Reference table with all RPM codes, thresholds, and approximate 2026 rates. Styled with pill badges and rate indicators using DocToDoor brand colors.

New Codes (Effective Jan 1, 2026)
CodeDescriptionThreshold
99445
Device supply with daily recording or alert transmission
2-15 days
in a 30-day period
99470
Clinical staff/physician/qualified professional time with ≥1 interactive communication
10-19 minutes
in a calendar month
Foundational Codes (Ongoing)
CodeDescriptionThreshold
99453
Initial setup and patient education on device use
One-time
per patient
99454
Device supply with daily recording or alert transmission
16-30 days
in a 30-day period
99457
First 20 minutes of remote monitoring treatment management
Monthly (≥20 minutes)
per calendar month
99458
Each additional 20 minutes of treatment management
Per 20-minute increment
add-on to 99457
*CMS may publish final values after updates. Rates shown are approximate national averages.

Device Supply Codes: 99445 & 99454

99445 - RPM Device Supply (2-15 Days)

  • Requires data/alerts on at least 2 distinct days
  • Maximum 15 days within a 30-day billing window
  • Billed once per 30-day period
  • Cannot be billed together with 99454 in the same period
Typical use cases
Short-term post-procedure monitoring
Medication titration periods
Transitional or episodic monitoring programs

99454 - RPM Device Supply (16-30 Days)

  • Applies when data is transmitted on 16+ days
  • Covers device supply and daily data transmission
  • Billed once per 30-day period
  • Mutually exclusive with 99445

Initial Setup & Education: CPT 99453

99453 - Initial Setup and Education

  • Device provisioning
  • Initial configuration
  • Patient education on device usage

One-time billable per patient (per episode of care). Independent of data transmission thresholds.

Treatment Management Codes: 99470, 99457 & 99458

99470 (10-19 mins)

Requires at least one real-time interactive communication (phone/video). Billed once per calendar month. Cannot be billed with 99457 in the same month.

99457 (first 20 mins)

Covers the first 20 minutes of monthly RPM management time and requires interactive communication.

99458 (add-on)

Add-on to 99457 for each additional 20-minute increment. Requires continued documentation of management activities.

Billing Rules & Constraints

Device supply exclusivity

Only one may be billed per 30-day device period:

99445 OR 99454
Selection depends on the number of distinct days with data recorded/transmitted.

Treatment management exclusivity

Only one base management code per calendar month:

99470 OR 99457
If time exceeds 20 minutes: bill 99457 and add 99458 as needed.

Interactive communication requirement

For 99470 / 99457 / 99458, documentation must include at least one live synchronous interaction (phone or video). Asynchronous messaging alone does not satisfy this requirement.

Practical Billing Scenarios

ScenarioCorrect Codes
8 days of data, 12 minutes of RPM management99445 + 99470
18 days of data, 22 minutes of RPM management99454 + 99457
14 days of data, 42 minutes of RPM management99445 + 99457 + 99458
Setup only (new patient onboarding)99453

Implementation Notes for Engineering & Operations

Track unique data days, not total readings
Track cumulative monthly RPM time
Enforce exclusivity rules at claim-generation level
Store evidence of interactive communication (timestamp + method)
Separate 30-day device periods from calendar-month time tracking
Note: Always validate final payer-specific interpretations before production billing.
Key Takeaways

The 2026 RPM CPT code expansion improves alignment between billing and real-world clinical workflows by supporting short-duration monitoring and allowing billing for shorter but meaningful clinical engagement.

Supports short-duration monitoring
Bills shorter but meaningful engagement
Reduces revenue loss from rigid minimum thresholds