Remote Patient Monitoring (RPM) is entering a new phase.

With the 2026 Medicare Physician Fee Schedule (PFS) final rule, the Centers for Medicare & Medicaid Services (CMS) introduced two new RPM CPT codes: 99445 and 99470. These codes fix the painful “16-day” and “20-minute” cliffs that have limited real-world RPM billing for years.

If you are running an RPM program, this is not just a minor coding tweak. The 2026 RPM coding update affects:

• Which patients are a good fit for RPM
• How you design monitoring tiers and care pathways
• How much revenue you recover from “near-adherent” patients
• How your team documents, codes, and bills remote care

In this guide, you will learn exactly what CPT 99445 and CPT 99470 cover, how they fit into the existing RPM code family, and what to change in your workflows to stay compliant and profitable.

👉 Need a baseline first? Start with your original framework here:
RPM Billing Explained: Codes, Rules & Reimbursement 2025

RPM Before 2026: The 16-Day and 20-Minute Pain Points

Before the 2026 update, Medicare RPM billing revolved around a small core of codes:

• 99453 – Initial RPM device setup and patient education (one-time)
• 99454 – Device supply and data transmission for 16 or more days of readings in a 30-day period
• 99457 – First 20 minutes of RPM treatment management time per calendar month
• 99458 – Each additional 20 minutes of RPM management time

On paper, this structure was clear. In practice, it created two harsh cliffs that left a lot of care unpaid.

The 16-Day Device Cliff

If a patient only sent 5, 8, or 12 days of data within a 30-day period, you could not bill 99454 at all, even if those readings supported real clinical decision-making.

The 20-Minute Time Cliff

If your team spent 12 to 15 minutes reviewing RPM data and calling a patient, you could not bill 99457 because the code required a full 20 minutes of logged time.

Those rules were especially punishing for:

• Short-term post-discharge RPM
• Patients with inconsistent device use
• Low-risk patients who only needed brief monthly check-ins

We go deeper into the original rules, pitfalls, and reimbursement ranges in our foundational article:
👉 2025 RPM Billing Guide: Codes, Rules & Reimbursement Basics

The 2026 RPM coding update is CMS’ way of making RPM billing better match real-world adherence and clinical practice.

2026 RPM Coding Update: Meet CPT 99445 and CPT 99470

In the 2026 PFS final rule, CMS finalized two new RPM CPT codes effective January 1, 2026:

• CPT 99445: a device supply code for 2 to 15 days of RPM data
• CPT 99470: a management code for the first 10 to 19 minutes of RPM treatment time

Together, these codes make RPM billing more flexible and better aligned with how clinicians actually deliver care.

CPT 99445 – Short-Duration Device Supply (2–15 Days)

CPT 99445 is a device supply and data transmission code for short-duration RPM monitoring.

In plain language, use 99445 when:

• The patient transmits at least 2 but fewer than 16 days of physiologic data
• Within a 30-day period
• Using an FDA-cleared physiologic device that automatically records and transmits readings (for example, a blood pressure cuff, scale, or pulse oximeter)

Instead of an all-or-nothing device requirement, the RPM device rules now look like this:

• 0 to 1 day of data → no RPM device code
• 2 to 15 days → 99445
• 16 to 30 days → 99454

You can only bill one RPM device code (99445 or 99454) per 30-day monitoring period per patient.

CPT 99470 – First 10–19 Minutes of RPM Management Time

CPT 99470 is a time-based RPM management code. It pays for shorter, but still meaningful, monthly RPM work.

Use 99470 when:

• You log 10 to 19 minutes of RPM treatment management time in a calendar month
• You complete at least one real-time audio or video interaction with the patient or caregiver that is tied to RPM data

After the 2026 update, RPM time codes work like this:

• 10 to 19 minutes → 99470
• 20 to 39 minutes → 99457 (first 20 minutes)
• 40 minutes or more → 99457 + 99458 (additional 20-minute increments)

You do not bill 99470 and 99457 together for the same initial time block. Instead, you choose based on the total minutes logged for that month.

In short, the 2026 RPM coding update finally lets you bill for shorter monitoring periods and shorter management time instead of getting paid only when patients are perfectly adherent.

CPT 99445 in Detail: How the New 2–15 Day RPM Code Works

What CPT 99445 Covers

CPT 99445 is designed for short-duration or partially adherent RPM. You report 99445 when:

• The patient has 2 to 15 days with at least one valid reading per day
• Within a 30-day monitoring period
• Devices are FDA-cleared and automatically log and transmit data

This is the code you use for “real but incomplete” device usage that previously would not support billing under 99454.

99445 vs 99454: Choosing the Right Device Code

Think of 99445 and 99454 as two rungs on the same ladder:

• 99445: short-duration RPM device supply (2 to 15 days)
• 99454: full-duration RPM device supply (16 to 30 days)

You choose between them based solely on how many days of usable data the patient generated within the 30-day period. Only one device code should appear on the claim for that period.

Documentation Checklist for CPT 99445

To support billing CPT 99445, make sure your chart documents:

• The 30-day monitoring window (start and end dates)
• The number of days with at least one reading (confirm it is 2 to 15)
• The device type and confirmation that it is FDA-cleared
• The linked diagnosis and care plan, referencing why RPM is being used

In the first month of monitoring, 99445 can pair with 99453 (for setup and patient education) when the patient records at least two days of data.

Real-World Use Cases for 99445

CPT 99445 works especially well in situations like:

• Post-discharge monitoring
  • Example: 7 to 10 days of daily weight and blood pressure readings after a heart failure admission.
• Medication titration
  • Example: 10 days of blood pressure readings after increasing or starting an antihypertensive.
• Short-term risk windows
  • Example: 2 to 3 weeks of oximetry during a high-risk respiratory season.
• Patients with adherence challenges
  • Patients who regularly send 8 to 12 days of data, but rarely reach 16, can now still support legitimate RPM device billing.

That translates into better alignment between care delivered and revenue captured.

CPT 99470 in Detail: How the 10–19 Minute RPM Time Code Works

What CPT 99470 Pays For

CPT 99470 covers the first 10 to 19 minutes of RPM treatment management time per calendar month.

Qualifying activities include:

• Reviewing and interpreting RPM data
• Assessing trends and risk
• Adjusting care plans or medications
• Communicating with the patient or caregiver
• Documenting your work in the EHR

To bill 99470, you must:

• Log at least 10 minutes of RPM management activities in the month
• Complete at least one real-time audio or video interaction related to RPM findings

99470 vs 99457 vs 99458: Time Thresholds and Pairing

After the 2026 RPM coding update, time-based RPM management looks like this:

• 10 to 19 minutes → 99470
• 20 to 39 minutes → 99457
• 40 minutes or more → 99457 + 99458 (one or more add-on units)

Key rules:

• Choose either 99470 or 99457 for the initial time block in a month, not both.
• Some payers may allow 99470 plus 99458 if your total management time exceeds 30 minutes (10 to 19 minutes plus an additional 20). Always confirm with payer policies.

Documentation Checklist for CPT 99470

Your 99470 documentation should clearly show:

• Total RPM management time for the month (10 to 19 minutes)
• A brief breakdown of what you did (data review, outreach, care plan changes)
• Details of the real-time call or video visit (date, duration, and purpose)
• A clear link between RPM data and your clinical decisions

Also be sure not to double-count that time for CCM, PCM, or E/M codes in the same period.

Real-World Use Cases for 99470

CPT 99470 is built for shorter, focused monthly touchpoints, such as:

• Reviewing moderate amounts of stable data and making minor adjustments
• Short check-ins for low-risk patients who still benefit from ongoing monitoring
• Tight but efficient follow-ups after medication changes

Under the old rules, those months often produced no billable RPM time. With 99470, they now fairly contribute to revenue.

How CPT 99445 and 99470 Change Your RPM Strategy

From One-Size-Fits-All to Tiered RPM

The biggest strategic impact of the 2026 RPM coding update is that you can finally design RPM tiers instead of treating every patient the same.

Here is one example of a tiered model:

• Tier 1 – Short-Term / Transitional RPM
  • Device: 99445 (2 to 15 days)
  • Time: 99470 (10 to 19 minutes)
  • Ideal for: post-discharge monitoring, pre-op optimization, medication titration
• Tier 2 – Standard Chronic RPM
  • Device: 99454 (16 to 30 days)
  • Time: 99470 or 99457/99458 depending on total minutes
  • Ideal for: stable, moderate-risk chronic conditions
• Tier 3 – High-Risk / Complex RPM
  • Device: 99454
  • Time: 99457 + 99458 (40 minutes or more)
  • Ideal for: high-risk, multi-morbid patients needing intensive support

This tiered structure helps you match RPM intensity to patient risk, instead of forcing everyone into a full-intensity model.

Revenue Impact: Capturing “Near-Adherent” RPM Patients

Many RPM programs have a meaningful percentage of patients who:

• Generate some data, but not 16 or more days
• Receive some clinical review, but not 20 or more minutes

Under the old rules, those months were often unbillable. With the 2026 codes:

• CPT 99445 monetizes months where patients send 2 to 15 days of readings
• CPT 99470 monetizes months where your team spends 10 to 19 minutes on RPM management

That means more of the care you already deliver now generates compliant reimbursement.

Compliance Essentials for the 2026 RPM Coding Update

Interactive Communication: What Actually Counts

For RPM management codes like 99470, 99457, and 99458, you must document at least one real-time interactive communication with the patient or caregiver each month.

In practice, that means:

• Phone calls
• Audio-video telehealth visits

Secure messaging and portal chats usually do not count by themselves toward this requirement, so make sure your workflows and documentation reflect a clear live interaction.

Avoiding Double-Counting and Stacking Errors

Common compliance traps to avoid:

• Counting the same minutes toward both RPM time and CCM, PCM, or E/M services
• Billing 99445 and 99454 in the same 30-day period for one patient
• Billing 99470 and 99457 for the same initial time block

Use internal audits and payer feedback to regularly check that your documentation and claims are aligned with these rules.

Medicare vs Commercial Payer Policies

This article is based on Medicare’s RPM rules and national rates. Commercial payers may:

• Adopt CPT 99445 and CPT 99470 on a delay
• Set different fee schedules
• Layer on prior authorization or plan-specific restrictions

Maintain a simple payer policy matrix so your team knows exactly how each plan handles RPM codes in 2026 and beyond.

Implementing CPT 99445 and 99470: A Practical Playbook

Step 1: Update Your EHR and RPM Platform

Work with your billing and IT teams to:

• Add CPT 99445 and CPT 99470 to your charge master and encounter templates
• Configure automatic day counting:
  • 2 to 15 days → prompt for 99445
  • 16 to 30 days → prompt for 99454
• Turn on or refine time-tracking for RPM so staff can easily see when a patient crosses the 10- and 20-minute thresholds

Step 2: Retrain Staff on the 2026 RPM Coding Rules

Update training materials for clinicians, nurses, and coders to cover:

• When to choose 99445 vs 99454
• When to choose 99470 vs 99457/99458
• What documentation is needed for each code
• How to record interactive communication clearly and consistently

For a refresher on existing RPM pitfalls and denials, point them to your 2025 primer:
👉 Common RPM Billing Mistakes & How to Avoid Them (2025 Overview)

Step 3: Build QA and Audit-Readiness Into Your RPM Program

Once the new RPM codes go live:

• Run small monthly audits of 99445 and 99470 claims
• Verify that day counts, minutes, and live interactions are clearly documented
• Track denial reasons by payer and adjust templates or workflows as needed

Consistent, lightweight QA is much easier than large corrective projects later.

Your Complete RPM Billing Playbook: 2025 + 2026

You now have two core assets for RPM billing:

1. The 2025 RPM article, which is your foundation on RPM codes (99453, 99454, 99457, 99458, 99091), rules, and reimbursement basics.
2. This 2026 RPM coding update, which is your roadmap for using CPT 99445 and CPT 99470 to modernize strategy, workflows, and revenue.

Together, they give your team a single, cohesive playbook for RPM billing across 2025 and 2026.

👉 Bookmark both:

• RPM Billing Explained: Codes, Rules & Reimbursement 2025
• This 2026 RPM coding guide on CPT 99445 and CPT 99470

FAQ: Quick Answers About CPT 99445, CPT 99470, and the 2026 RPM Rules

1. What is CPT 99445 for remote patient monitoring?
CPT 99445 is an RPM device supply code for patients who send 2 to 15 days of physiologic data in a 30-day period. It lets you bill for short-duration or partially adherent monitoring that does not reach 16 days.

2. How many days of data are required for 99445?
You must document at least 2 but fewer than 16 days of RPM data within a 30-day period. Fewer than 2 days is not billable. Sixteen or more days should be billed with 99454.

3. What is the difference between 99445 and 99454?
Both are RPM device codes. 99445 covers 2 to 15 days of data, while 99454 covers 16 to 30 days. You choose based solely on the number of days with valid readings.

4. What is CPT 99470 and how is it different from 99457?
CPT 99470 covers the first 10 to 19 minutes of RPM management time per month. CPT 99457 covers the first 20 minutes. Both require at least one real-time interaction. You choose the code based on total minutes logged.

5. Does 99470 require a real-time call or video visit?
Yes. 99470 requires at least one real-time audio or video interaction with the patient or caregiver each month, tied to the RPM data you reviewed.

6. Can I bill 99445 and 99454 in the same month?
No. For any given 30-day monitoring period, you may bill either 99445 or 99454, not both.

7. Can 99470 be billed together with 99458?
Some payers allow you to bill 99470 plus 99458 when your total RPM management time exceeds 30 minutes (10 to 19 minutes plus an additional 20). Always check current payer policies.

8. How much does Medicare pay for 99445 and 99470 in 2026?
Early estimates suggest national non-facility rates of roughly 47 dollars for 99445 and 26 dollars for 99470, with actual payments varying by locality.

Strengthen Your RPM Revenue Cycle and Compliance Before the 2026 Changes Hit

The new CPT 99445 and CPT 99470 codes create a real opportunity to grow RPM revenue if your program is ready.

Medviz Systems can help your clinic become truly audit-ready and aligned with the 2025 to 2026 RPM billing rules by:

• Reducing preventable RPM claim denials
• Improving coding accuracy for 99445, 99454, 99470, 99457, and 99458
• Enhancing documentation quality for monitoring days, minutes, and interactive communication
• Streamlining intake-to-payment workflows across RPM, CCM, and telehealth
• Strengthening payer compliance as Medicare and commercial plans adopt the new codes
• Protecting and growing your recurring RPM revenue

Book a Revenue Leakage Assessment today:

📞 +1 (727) 214-2749
📧 success@medviz.ai

Position your clinic for a stronger, more compliant, and more predictable RPM revenue cycle going into, and beyond, 2026.