Reimbursement
RPM & CCM reimbursement guide (2026).
The correct, current code sets with approximate national-average rates — plus a calculator to estimate your practice's revenue.
Remote Patient Monitoring codes
| CPT | What it covers | Frequency | Approx. avg* |
|---|---|---|---|
| 99453 | Setup & patient education Initial setup and education on the monitoring device(s). | Once per episode | $20 |
| 99454 | Device supply + data (16+ days) Device supply with daily recordings; requires ≥16 days of readings. | Each 30 days | $45–50 |
| 99445New 2026 | Device supply + data (2–15 days) Device supply when only 2–15 days of readings are collected. New in 2026. Use instead of 99454 when fewer than 16 days of data are collected. | Each 30 days | varies |
| 99470New 2026 | First 10 minutes of management Management with interactive communication; 10–19 total minutes. New in 2026. Mutually exclusive with 99457 in the same month. | Monthly | $10–26 |
| 99457 | First 20 minutes of management Treatment management requiring interactive communication. | Monthly | $48–52 |
| 99458Add-on | Each additional 20 minutes Add-on to 99457 for each additional 20 minutes. Only after the initial 20 minutes (99457) is met. | Monthly (add-on) | $41 |
| 99091 | Physician data interpretation Collection & interpretation of physiologic data by a physician/QHP. | Each 30 days | $50–56 |
Chronic Care Management codes
| CPT | What it covers | Frequency | Approx. avg* |
|---|---|---|---|
| 99490 | CCM — first 20 minutes Clinical staff time directed by a physician/QHP; first 20 minutes. | Monthly | $60–62 |
| 99439Add-on | CCM — each additional 20 minutes Add-on to 99490 for each additional 20 minutes (up to 2 units). | Monthly (add-on) | $45–48 |
| 99491 | CCM by physician/QHP 30 minutes provided personally by the physician or QHP. | Monthly | $82–86 |
| 99437Add-on | CCM by physician/QHP — each additional 30 minutes Add-on to 99491 for each additional 30 minutes of physician/QHP time. | Monthly (add-on) | $58–60 |
| 99487 | Complex CCM — 60 minutes Complex CCM requiring moderate/high-complexity decision making. | Monthly | $130–134 |
| 99489Add-on | Complex CCM — each additional 30 minutes Add-on to 99487 for each additional 30 minutes. | Monthly (add-on) | $70–72 |
Calculator
Estimate your revenue
Enter how many patients you have in each program and adjust the assumptions. For an eligible patient, RPM and CCM can be billed in the same month when the time counted toward each is distinct.
Remote Patient Monitoring
Chronic Care Management
Monthly contribution by CPT code
Adjust 2026 CPT rates ($) & view billing rules
- • 99453 is billed once per newly enrolled patient (setup & education).
- • Device supply each month: 99454 (16+ days of data) or 99445 (2–15 days) — one or the other.
- • Management each month: 99457 (20+ min) or 99470 (10–19 min) — not both; 99458 repeats per extra 20 min.
- • 99091 is a separate physician interpretation of physiologic data.
- • CCM: 99490 + 99439 (clinical-staff time) or 99491 (physician 30 min); 99487 + 99489 for complex CCM.
- • RPM and CCM may be billed together for an eligible patient when the time is distinct.
Estimates use editable, approximate national-average 2026 rates and your adoption assumptions. Actual reimbursement varies by payer, locality, documentation, and medical necessity. Educational only — not billing advice; verify against the current Medicare Physician Fee Schedule.
Sample monthly workflow
Flag abnormal measurement
System immediately identifies values that cross custom specialty-defined thresholds.
Clinical review of data
US-based clinical monitors analyze flags and escalate severe deviations to clinicians.
Document interventions
Keep clear audit trails directly inside the platform for every outbound checking/call action.
Document time & generate codes
Auto-calculate exact clinical monitoring minutes and prep correct monthly claims bills.