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In CMS’s 2026 Final Rule, there are big changes for the Remote Patient Monitoring (RPM) program with an expanded code set and lower thresholds. There’s also some very exciting increases to reimbursement rates! The new RPM codes, as well as the increased reimbursement rates, will allow providers to grow this valuable program with a lower operational risk. These program changes make it a great time to grow or start a RPM program.
CPT code reimbursement rates are based on national averages, which may vary in by location. For the exact current rate based on your location, visit the Physician Fee Schedule website.
Download a reference guide for the RPM CPT codes.
CPT codes for Remote Patient Monitoring are broken into two categories: device-based and time-based.
Device-Based RPM Codes
CPT Code 99453
First is CPT Code 99453 for the initial setup and education of the provided device. It can only be billed once per device. In previous years, a minimum of 16 days of readings were needed in order to bill this code, but this year the patient must transmit a minimum of 2 days with readings from the provider supplied device in order to bill. If a patient is given multiple devices, this code must be billed on different months for each device. The current national average reimbursement rate for 99453 is $22.
CPT Code 99445
A new code for 2026, 99445 is for 2 to 15 days of monthly monitoring of the provided device or devices. A patient must take at least 2 days of readings in order to bill. This code can only be billed once per month, no matter how many devices the patient is using. If the patient has multiple devices, total the daily readings from those devices to reach the 2 to 15 daily readings. 99445 has a national average reimbursement rate of $47.
CPT Code 99454
Code 99454 is for 16 or more days of monthly monitoring of the provided device or devices. This code can also only be billed once per month, no matter how many devices the patient is using. Again, if the patient has multiple devices, total the daily readings from those devices to reach 16 daily readings. 99454 has a current national average reimbursement of $47.
If a patient gets between 2 to 15 readings in a calendar month, bill code 99445. If they get 16 or more readings, bill code 99454. Both codes can not be billed for the same patient in a month. It’s one or the other depending on their number of readings. Because of this, ThoroughCare recommends waiting until the end of the billing period to drop device reading codes. The addition of the new 99445 code allows for more tailored monitoring for each patient based on their clinical needs and allows providers to be compensated for their services. Be sure to document accordingly to justify the number of days of readings.
Time-Based RPM Codes
CPT Code 99470
First is another new code for 2026, CPT code 99470 for at least 10 minutes of non-face-to-face RPM services per month performed by clinical staff. It has a current national average reimbursement of $26.
CPT Code 99457
Next, is code 99457 for at least 20 minutes of non-face-to-face RPM services per month performed by clinical staff. It has a current national average reimbursement of $52.
CPT Code 99458
And finally is the add-on time code 99458 for 20 additional minutes of non-face-to-face RPM services. Its current national average reimbursement rate is $41. 99458 can be billed an unlimited amount of times per calendar month in 20 minute increments, such as 40, 60, and 80 plus minutes.
It’s important to note that the 10 minute CPT code 99470 can not be billed with the 20 minute CPT code 99457 in the same calendar month. So, the two codes can not be billed if a patient logs 30 minutes of RPM time. Once the 20 minute threshold is met, bill code 99457 and then another 20 minutes must be provided to bill for code 99458. There is no add-on code for 10 minute code 99470. Again, make sure to document accordingly to justify the time spent on services.
With the reimbursement increases this year, as well as the expanded code set, now is a great time to grow your RPM program and offer this valuable service to more patients! If you need help in starting or growing your RPM program, reach out to us at ThoroughCare and we can help. If keeping track of these changes to the RPM program is challenging to do on your own, ThoroughCare’s care management software can simplify the management, time logging, and billing for this program.
