2026 New Remote Patient Monitoring (RPM) CPT Codes

A Milestone in Digital Healthcare

WIXOM, MI / ACCESS Newswire / December 3, 2025 / The 2026 CMS Final Rule introduces a major milestone in digital healthcare, expanding flexibility and reimbursement options for Remote Patient Monitoring (RPM). As part of the updated Physician Fee Schedule (PFS), CMS has finalized two new CPT codes that give providers more precise billing pathways for shorter monitoring durations and reduced management time, supporting patient-centered care for both chronic and acute conditions.

Introducing CPT 99445
CPT 99445 marks a significant shift in how RPM services can be delivered and reimbursed. This code covers remote monitoring of physiologic data for 2-15 days in a 30-day period, including device supply and data transmission. With an approximate reimbursement of $47, it offers a new billing option for short-term monitoring without requiring a full 16-day threshold. Providers must choose between 99445 and 99454, since they cannot be billed together. This creates a practical model for patients who need temporary or transitional monitoring after procedures, discharge, or acute events.

Introducing CPT 99470
CPT 99470 provides a new way to bill for shorter management durations, covering the first 10 minutes of clinical staff or provider time spent reviewing data and engaging with the patient. It requires at least one real-time audio or video interaction and reimburses approximately $26. This code cannot be billed with CPT 99457, which covers the first 20 minutes of management, but additional time can still be billed under CPT 99458. CMS recognizes that not all RPM encounters require a full 20 minutes, offering a flexible, time-appropriate option that reduces barriers for providers and patients.

Existing RPM Codes Remain Core
The existing RPM code set remains unchanged. The new additions enhance, not replace, the current framework, ensuring providers can still rely on CPT 99453, 99454, 99457, and 99458 as foundational components of RPM programs. CMS has also finalized equal valuation for CPT 99445 and 99454, each reimbursed at approximately $47, reflecting consistent device-related costs regardless of monitoring duration.

Real-Time Communication Requirements
CMS reaffirmed that all RPM management codes-99470, 99457, and 99458-require at least one real-time interaction. Phone or video communication counts toward billable time. This reinforces CMS’s priority on meaningful patient engagement and ensures compliance across RPM workflows.

Impact on FQHCs and RHCs
Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) will continue to bill using individual RPM CPT codes, supporting transparency and financial visibility in community and rural settings. Providers benefit from reduced administrative burden, improved clinical workflows, and expanded eligibility for chronic and transitional care. Patients gain access to short-term monitoring and consistent continuity of care.

Future Evaluation of CMS
CMS will review RPM code values after one year, checking RVUs and usage to ensure fair, sustainable reimbursement and to continue supporting remote care as an important part of value-based healthcare.
Disclaimer: This information is for general use only and is not legal, medical, or billing advice. Please consult official sources.

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Contact Information

Venkataraman Soundararajan
President, Humhealth
marketing@humworld.com
7346660002

SOURCE: Humworld Inc

View the original press release on ACCESS Newswire