This content is for informational purposes only and should not be considered legal advice or interpreted as establishing an attorney-client relationship. There is no guarantee of reimbursement.
Vivo Care is a remote patient monitoring (RPM) and chronic disease solutions platform, covering Chronic Care Management (CCM), Principal Care Management (PCM), and Advanced Primary Care Management (APCM), for physician practices across the United States. Vivo Care has supported 120K+ patients cumulatively across 350+ healthcare organizations, with U.S.-based care navigators working as an extension of the provider team.
Year-to-date 2026, 96.9% of billable patients on the Vivo Care platform met the CMS adherence floor of two or more days of readings per month. That floor is new for 2026, and it changes how CPT code 99454 works.
What Is CPT Code 99454 and When Do You Use It?
CPT code 99454 pays for RPM device supply and data transmission when a patient sends readings on 16 or more days in a 30-day period. Patients with 2 to 15 days are billed under 99445, new for 2026 and paid at the same rate as 99454. Vivo Care treats the two codes as one line, device supply and data transmission, because only one applies per patient per period.
- CPT® code 99453 for initial patient set-up and education
- CPT® code 99454 for 16 or more days of data transmission in a 30-day period, or 99445 for 2 to 15 days (new for 2026)
- CPT® codes 99457 and 99458 for clinical monitoring time per calendar month
CPT® Code 99454: What’s New in 2026
- Who can order 99454? An ordering provider (a physician or other qualified healthcare provider) can order RPM for the patient. The ordering provider should only prescribe an RPM program to a patient if they believe the remote physiologic monitoring is medically necessary. Common conditions monitored via RPM include hypertension, diabetes, chronic kidney disease, and chronic or congestive heart failure.
- The 16-day requirement. To bill 99454, the patient must transmit at least 16 days of readings within 30 days. These readings must be taken on separate days, so if a patient takes readings twice a day for 10 days, that counts as 10 days of readings. The reading days do not need to be consecutive, but patients are more likely to be successful if they take their readings each day. Starting in 2026, a patient who transmits 2 to 15 days is billed under 99445 instead, so fewer than 16 days no longer means no device supply payment. During consent and onboarding, Vivo Care encourages patients to take readings daily or twice daily.
- Billable every 30 days. 99454 can be billed once every 30 days. It is not tied to the calendar month, though many practices choose to bill on a calendar basis to simplify billing.
- Patients with multiple devices. If a patient has multiple devices, the total days of readings still must be 16 to bill 99454. Readings from both devices count toward the 16-day requirement. For example, if a patient takes a blood pressure and weight reading on the same day, that counts as one day of readings. If a patient takes 8 days of blood pressure readings and 10 days of weight measurements, that counts as 18 days, as long as the days are not double counted. All devices must meet the FDA definition of a medical device, and we recommend choosing an RPM partner that provides FDA-regulated devices for at-home use.
- Reimbursement rates. Under the CY2026 Medicare Physician Fee Schedule, the national non-facility rate for 99454 is $52.10, and 99445 pays the same. Rates vary by geography and locality. Vivo Care does not interpret or define the CMS RPM codes and recommends that you refer to your billing specialist or MAC office for guidance. Local reimbursements can be located at the CMS.gov physician fee schedule.
Vivo Care’s Best Practices for Meeting CPT® Code 99454 Requirements
- Build trusted relationships. Patients are more likely to take regular readings when they have strong relationships with their monitoring team. We recommend calling patients at least once a week so they feel more connected to their providers and become more invested in improving their own health.
- Allocate sufficient monitoring staff. Building trusted relationships with patients requires time, so we strongly recommend dedicating clinical staff time to the program so they can focus on providing the best remote care experience for your patients. One full-time clinician dedicated solely to RPM can monitor 150 to 200 patients. If your practice does not have sufficient clinical resources, consider an RPM partner that provides clinical monitoring. Your partner’s clinical team can act as an extension of your own practice and expand your capacity without adding overhead costs. The more your patients interact with their monitoring team, the more likely they are to take more readings.
- A good platform should continually track patient adherence. Your RPM platform should make it easy to filter and sort which patients are adhering to their RPM program. After addressing critical and out-of-threshold readings, the monitoring team can use daily workflow to look for patients who are not on track with the prescribed number of readings and should be prioritized for additional outreach.
- Ask questions to understand non-adherence. If patients are not taking regular readings, the monitoring team should try to uncover why. Sometimes the right question surfaces a simple reason. Ask patients whether their device is still working, whether they truly understand how to use it, whether it needs new batteries, whether they have been traveling, or whether anything in their personal life is making readings harder. To maximize patient engagement, we recommend many of the best practices covered in the definitive guide to CPT® code 99453.
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