RPM CPT Codes Explained: What Each Code Covers and When to Use It

The RPM CPT codes fall into two groups: codes for the device and its setup, and codes for the time your team spends managing the patient's care. This glossary explains each code and the terms its descriptor uses. It reflects general Medicare guidance, which changes every year. Commercial payers and Medicaid programs may not follow Medicare, so check the current CMS guidance, the current CPT descriptors from the AMA and each payer contract before you bill.

How the RPM codes fit together

Under CMS rules, only one practitioner can bill the device codes for a patient in a period, even when the patient uses more than one device.

The codes, in number order

99091

Collection and interpretation of physiologic data by a physician or other qualified health care professional (QHP), requiring at least 30 minutes of that practitioner's own time in a 30-day period. Clinical staff time does not count toward it. Do not count the same minutes toward 99091 and 99457, and check current guidance on reporting the two for the same patient.

99445

Device supply with daily recordings or programmed alert transmissions, for a 30-day period with 2 to 15 days of readings. CMS added it in the CY 2026 Physician Fee Schedule for patients who do not reach the 16 days 99454 needs. It is billed instead of 99454 for a period, never with it. Check the current descriptor and each payer's coverage before you bill it.

99453

Initial setup of the device and education of the patient on how to use it. It is billed once per episode of care, not every month. Under the long-standing descriptor, it required at least 16 days of readings in the 30-day period. The 2026 changes revisited the day counts for the device codes, so check the current descriptor before you bill the setup code for a shorter period. Document the date, who did the setup and what the patient was taught.

99454

Supply of the device, with daily recordings or programmed alert transmissions, for each 30-day period. It requires readings on at least 16 days of the period. The device must meet the FDA definition of a medical device, and the readings must be sent automatically. Only one practitioner can bill it for a patient in a period.

99457

The first 20 minutes of remote physiologic monitoring treatment management services in a calendar month, by clinical staff, a physician or a QHP. The month must include at least one interactive communication with the patient or caregiver. CMS generally allows clinical staff to furnish this time under general supervision. CMS has described the treatment management codes as time based, without the 16-day rule that applies to the device codes; confirm this with your MAC.

99458

Each additional 20 minutes of treatment management in the same calendar month, billed as an add-on to 99457. A month with 40 minutes supports 99457 plus one unit of 99458. Payers may limit how many units they pay, so check the contract.

99470

The first 10 minutes of treatment management in a calendar month, with an interactive communication, added by CMS for 2026. It is meant for months that reach 10 minutes but not 20. As generally described, it is billed in place of 99457 for the month, not with it. Check the current descriptor and your payers' coverage before you bill it.

Terms in the code descriptors

Calendar month

The period for the treatment management codes (99457, 99458, 99470): the first to the last day of the month. It does not line up with the 30-day period of the device codes, so track the two separately.

Clinical staff

People who work under the direction of a physician or QHP and who may furnish services under state law and practice rules, such as nurses or medical assistants. What each role may do differs by state.

Episode of care

The span from the start of monitoring until the treatment goals are met. 99453 is billed once in it.

Established relationship

CMS requires the patient to have an established relationship with the billing practitioner before RPM. Confirm how your MAC and your payers define it, and document the visit that establishes it.

General supervision

The billing practitioner directs and is responsible for the service but does not need to be in the room or the building while staff do the work. CMS generally allows RPM treatment management by clinical staff under general supervision.

Interactive communication

A real-time, two-way conversation with the patient or caregiver, such as a phone or video call. CMS requires at least one in the month for the treatment management codes. A text or a voicemail generally does not count. Confirm the current definition with your MAC.

Medical device

The device must meet the FDA definition of a medical device and send readings automatically. Readings the patient types in or reports by phone do not count as RPM data.

Physiologic data

Measurements of how the body is working, such as blood pressure, pulse, weight, oxygen saturation or blood glucose.

Thirty-day period

The period for the device codes (99445, 99454). Days with readings are counted inside it.

Billing RPM with other services

Under CMS rules, RPM can be billed in the same month as chronic care management and other care management services, as long as each service meets its own requirements and the same minutes are not counted toward both. Our comparison of RPM vs CCM walks through the split. Before any claim goes out, run the month through the RPM documentation requirements checklist: reading days, minutes, the live conversation, and the setup code only once.

Frequently asked questions

Can 99457 be billed without 16 days of readings?

CMS has described the treatment management codes as time based, without the 16-day requirement of the device codes. The month still needs the minutes and an interactive communication. Confirm this with your MAC and each commercial payer, since their rules can differ.

Can 99454 and 99445 be billed in the same 30 days?

No. As generally described, a 30-day period supports one device supply code: 99454 for 16 or more days of readings, or 99445 for 2 to 15 days. Check the current descriptors.

Do all payers cover 99445 and 99470?

Not necessarily. They were added to the Medicare Physician Fee Schedule for 2026, and Medicare Advantage plans, Medicaid programs and commercial payers decide their own coverage. Check each payer before you bill them.

Who can bill the RPM codes?

A physician or another qualified health care professional who can bill Medicare evaluation and management services, with clinical staff furnishing time under general supervision where allowed. Only one practitioner can bill the device codes for a patient in a period.

Sources

• CY 2026 Payment Policies Under the Physician Fee Schedule (final rule), Federal Register
• Telehealth & Remote Monitoring (MLN901705), CMS
• CY 2024 Payment Policies Under the Physician Fee Schedule (final rule), Federal Register
• Billing for remote patient monitoring, Telehealth.HHS.gov
• 42 CFR 410.26, Services and supplies incident to a physician's services (general supervision), Legal Information Institute at Cornell Law School