2026 Billing Codes For RPM, CCM And PCM
What each code covers, what it requires, and the approximate Medicare national-average rate. For 2026, CMS added 99445 and 99470 for shorter monitoring months.
Remote Patient Monitoring (RPM)
Paid for each 30-day period based on days of device data and minutes of treatment management.
| CPT Code | What it covers | Time / requirement | Est. reimbursement* |
|---|---|---|---|
| 99453 | Initial setup & patient education | Once per episode of care | ~$19.65 |
| 99454 | Device supply & transmission | 16+ days of readings in 30 days | ~$48.80 / 30 days |
| 99445New 2026 | Device supply & transmission | 2–15 days of readings in 30 days | ~$28.50 / 30 days |
| 99470New 2026 | Treatment management, first 10 minutes | 10–19 minutes of staff time in a month | ~$29.20 / month |
| 99457 | Treatment management, first 20 minutes | 20 minutes with an interactive communication | ~$48.30 / month |
| 99458 | Treatment management, each additional 20 | Each additional 20 minutes after 99457 | ~$38.75 / unit |
| 99091 | Physician data interpretation | 30 minutes of physician or QHP time in 30 days | ~$54.40 / 30 days |
Chronic Care Management (CCM)
For patients with two or more chronic conditions. Billed once per calendar month based on documented time.
| CPT Code | What it covers | Time / requirement | Est. reimbursement* |
|---|---|---|---|
| 99490 | Non-complex CCM, first 20 minutes | 20 minutes of clinical staff time in a month | ~$62.40 / month |
| 99439 | Non-complex CCM, each additional 20 | Each additional 20 minutes (up to 2 units) | ~$47.90 / unit |
| 99491 | CCM by physician, first 30 minutes | 30 minutes personally spent by physician or QHP | ~$85.50 / month |
| 99437 | CCM by physician, each additional 30 | Each additional 30 minutes of physician or QHP time | ~$60.20 / unit |
| 99487 | Complex CCM, first 60 minutes | 60 minutes with moderate or high complexity decisions | ~$132.80 / month |
| 99489 | Complex CCM, each additional 30 | Each additional 30 minutes after 99487 | ~$71.50 / unit |
Principal Care Management (PCM)
For patients with one complex, high-risk condition. Billed per calendar month in 30-minute increments.
| CPT Code | What it covers | Time / requirement | Est. reimbursement* |
|---|---|---|---|
| 99424 | PCM by physician, first 30 minutes | 30 minutes personally spent on one complex condition | ~$83.50 / month |
| 99425 | PCM by physician, each additional 30 | Each additional 30 minutes of physician or QHP time | ~$60.20 / unit |
| 99426 | PCM by clinical staff, first 30 minutes | 30 minutes directed by the billing practitioner | ~$62.80 / month |
| 99427 | PCM by clinical staff, each additional 30 | Each additional 30 minutes of clinical staff time | ~$48.50 / unit |
*Reimbursement figures are approximate 2026 Medicare national-average non-facility rates for educational purposes only and are not billing, legal, or financial advice. Rates change annually and vary by payer and locality. Verify against the current Medicare Physician Fee Schedule before billing. CPT® is a registered trademark of the American Medical Association.
Billing Rules At A Glance
Can RPM and CCM be billed in the same month?
Yes, when each service has its own documented time. Twenty minutes for 99457 and twenty for 99490 means 40 minutes of separate work. Document distinct goals: RPM for reviewing readings, CCM for broader care coordination.
Can 99454 and 99445 be billed together?
No. A 30-day period qualifies for one or the other: 16 or more days of readings for 99454, or 2 to 15 days for 99445.
Can CCM and PCM be billed together?
By different practitioners treating different conditions under separate care plans, for example primary care for CCM and a specialist for PCM.
Can RPM be billed with RTM?
No. Remote patient monitoring and remote therapeutic monitoring cannot be billed together.
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