How to bill for remote patient monitoring services
Medicare now pays for remote patient monitoring (RPM) under six CPT codes, including two added in 2026 for shorter monitoring periods and lighter months. Here’s what each code covers, what you need to bill it, and the mistakes that most often lead to denials.
Six codes cover RPM in 2026.
Device codes pay for the equipment and data each patient sends. Management codes pay for the time your clinical team spends reviewing that data and talking with the patient.
| Code | What it covers | How often | 2026 avg. |
|---|---|---|---|
| 99453 | Setup and patient education on using the device | Once per episode of care | $21.71 |
| 99454 | Device supply with daily recordings, 16–30 days of readings in 30 days | Once per 30 days | $52.11 |
| 99445 | Device supply, 2–15 days of readings in 30 days (new for 2026) | Once per 30 days, instead of 99454 | About the same as 99454 |
| 99470 | Treatment management, first 10 minutes in a calendar month (new for 2026) | Once per month, instead of 99457 | $26.05 |
| 99457 | Treatment management, first 20 minutes in a calendar month | Once per month | $51.77 |
| 99458 | Treatment management, each additional 20 minutes | Add-on to 99457, per month | $41.42 |
You can only bill one device code (99454 or 99445) per patient per 30 days, and only one practitioner can bill it in that period. For management time, bill 99470 or 99457 in a month, not both.
What you need before you bill.
- An established patient. The billing practitioner must have an existing relationship with the patient.
- Patient consent. Get and record consent before monitoring starts, including that cost-sharing may apply.
- An order from the treating practitioner. RPM must be medically necessary and ordered for an acute or chronic condition.
- A qualifying device. It must meet the FDA’s definition of a medical device and transmit readings automatically, not entered by hand.
- Enough readings. At least 2 days of data for 99445, or 16 days for 99454, in each 30-day period.
- Live interaction for management codes. 99470, 99457 and 99458 each need at least one real-time conversation with the patient or caregiver in the month.
The old version of this article is out of date.
When RPM codes launched in 2019, there were three codes and the device code paid about $69 a month. Today there are six codes, the device payment is lower, and practices can bill for patients who send fewer than 16 days of readings, or who need only 10 minutes of management time.
Five reasons RPM claims get denied.
Not enough reading days
Billing 99454 when the patient sent fewer than 16 days of data. Use 99445 for 2–15 days.
Missing interactive communication
Counting review time without a real-time conversation with the patient that month.
Billing two device codes
Another practice already billed a device code for the same patient in the same 30 days.
RPM and RTM together
Billing remote physiologic and remote therapeutic monitoring for the same patient in the same period.
Thin documentation
No record of consent, the order, reading days, minutes or what was discussed.
Tip: add care management
Eligible patients can be enrolled in CCM or APCM alongside RPM, which adds revenue and support for patients with multiple conditions.
What one patient can bring in each month.
A patient who sends readings on 20 days and gets 25 minutes of management time in a month, including a phone call with a nurse, qualifies for 99454 and 99457: about $103.88 at 2026 national averages. If the team spends 45 minutes, add one 99458 for about $145.30. Setup with 99453 adds about $21.71 once.
Want to see this for your whole panel? Try the revenue calculator.
Medicare has proposed big changes to RPM for 2027.
The proposals cover who can perform monitoring, a required initiating visit, and lower payment for device codes. The final rule is expected around November 1, 2026.
Read what’s changingRates are 2026 Medicare national averages and vary by locality and payer. This article is general information, not billing or legal advice. Confirm requirements with your Medicare Administrative Contractor.
Related resources
2026 RPM billing guide
Every current code, what it covers and how often you can bill it.
What changes for RPM in 2027
The proposed rule, what isn’t changing, and six steps to prepare.
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