A Turning Point for Remote Patient Monitoring
CMS has finalized the 2026 Physician Fee Schedule (PFS), expanding long-term support for virtual and remote care.
Two new Remote Patient Monitoring (RPM) codes take effect January 1, 2026, marking a major shift in how Medicare reimburses technology-enabled care. Besides being great for practices, these changes pave the way for additional patients to be qualified. You can read about some RPM patient success stories here.
This update confirms one thing -> RPM is now a permanent part of modern care delivery.
2026 Remote Patient Monitoring CPT Codes
| Code | Description | Threshold | 2026 Rate* |
|---|---|---|---|
| 99445 | Device supply with daily recording or alert transmission |
2–15 daysin a 30-day period
|
~$47 |
| 99470 | Clinical staff/physician/qualified professional time with ≥1 interactive communication |
10–19 minutes
in a calendar month |
~$26 |
Foundational Codes (Ongoing)
| Code | Description | Threshold | Approx. 2026 Rate* |
|---|---|---|---|
| 99453 | Initial setup and patient education on device use | One-time per patient | ~$22 |
| 99454 | Device supply with daily recording or alert transmission |
16–30 days
in a 30-day period |
~$47 |
| 99457 | First 20 minutes of remote monitoring treatment management | Monthly (≥20 minutes) | ~$52 |
| 99458 | Each additional 20 minutes of treatment management | Per 20-minute increment | ~$41 |
*CMS has not published final amounts for 2026 yet. Rates shown are approximate national averages.
The original CPT Codes remain in place. You can read more on each code here: Overview of CPT Codes – 99453, 99454, 99457 and 99458.
The new codes close long-standing gaps created by the previous “16-day” and “20-minute” requirements, which limited billing for patients needing shorter monitoring periods or less intensive oversight.
Clinicians now have greater flexibility—choosing 2–15 days or 16–30 days for device billing and 10-minute or 20-minute increments for management, overall creating a more adaptable billing framework.
Actionable Steps for Practices
To prepare for 2026 implementation we recommend considering the following:
MOST IMPORTANT —–> Ensure Reading and Communication Capture
Ensure your platform has tracking available for 2–15-day monitoring and for the first 10-minutes of treatment management (with interactive communication).
Educate Billing and Clinical Teams
Ensure your billing team understands when to use 99445 vs. 99454 and 99470 vs. 99457/99458 (note: 99470 and 99457 cannot be billed in the same month). Reference Compliance Reminders below.
Add or Adjust Patient Workflows
There is now more flexibility to designate short-term RPM pathways. Examples may be post-discharge, medication-change use cases or conditions where 16 days is more difficult to obtain (ie, obesity monitoring).
Tighten Documentation
Record medical necessity, device activity logs, cumulative time, and the required real-time patient communication for each billed month.
Confirm Payer Adoption
Verify and track commercial plan acceptance
Closing Thoughts on Next Steps for Practices: If you are working with a third party, ensure you are clear on the contractual changes this change may cause. Many RPM companies are adding additional fees. Interested in how Vivo Care is approaching this change? Click here for a quick, free consult.
Compliance Reminders: Audit Readiness Matters
OIG has signaled increased oversight following reimbursement expansions (National Law Review, Volume XV, 2025). Build compliance discipline now:
Device Transmission Logs: Maintain complete daily records for each billing period (minimum 2 days for 99445).
Time Tracking: Keep detailed logs for 99470, 99457, and 99458, noting dates, staff, and cumulative minutes.
Interactive Communication: Document date, method, and summary of the real-time, synchronous interaction required for management codes. Text messages, voicemails, or manual uploads alone do not qualify.
Proper documentation ensures audit readiness, reduces claim denials, and protects reimbursement integrity.
The Big Picture
The 2026 PFS is more than a reimbursement update; it’s a redefinition of how remote care integrates into everyday practice.
By recognizing shorter monitoring windows and smaller time increments, CMS is rewarding meaningful engagement instead of arbitrary thresholds.
Practices that standardize compliant, flexible RPM workflows today will be best positioned to scale patient-centered, value-based care tomorrow.
Disclaimer
This article is for informational purposes only and does not constitute legal or billing advice. Always confirm coding and reimbursement rules with your payers and the current CPT® manual.