TELEHEALTH CLINICAL SOLUTIONS
Remote Patient Monitoring (RPM)
Remote patient monitoring (RPM) is a healthcare delivery method that uses digital technology to monitor patients outside traditional clinical settings, such as at home. RPM involves the use of connected medical devices-like blood pressure monitors, blood glucose meters, pulse oximeters, weight scales, and wearable sensors-to collect a wide range of physiological and health data from patients. This data is then electronically transmitted to healthcare providers for ongoing assessment and management.
| CPT Code | Requirements | Basic Description (2026) | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 99453 | One-time setup | Initial setup and patient education on use of RPM device(s); | $22 one-time |
| 99445 | 2–15 days | Device supply and data transmission for 2–15 days of RPM readings in a 30-day period. | $47 pppm |
| 99454 | 16+ days | Device supply and data transmission for 16 or more days of RPM readings in a 30-day period. | $47 pppm |
| 99470 | First 10–19 min | First 10–19 minutes of clinical staff/physician/QHP time in a calendar month, requiring at least one real-time interactive communication with the patient/caregiver. Cannot be billed with 99457 in the same month. | $26 pppm |
| 99457 | First 20 min | RPM treatment management; first 20 minutes of clinical staff/physician/QHP time per calendar month, requiring interactive communication. | $52 pppm |
| 99458 | Each additional 20 min | Add-on RPM treatment management; each additional 20 minutes of clinical staff/physician/QHP time in the same month, requiring interactive communication. | $41 pppm |
Chronic Care Management (CCM)
Chronic Care Management (CCM) is a structured healthcare service designed to support individuals with two or more chronic health conditions that are expected to last at least 12 months or until the patient’s death, or that place the patient at significant risk of death, acute exacerbation, or functional decline. CCM is covered by Medicare and most private insurance providers.
| CPT Code | Time per month | Basic Description | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 99490 | First 20 minutes of clinical staff time | Chronic care management for patients with ≥2 chronic conditions; non-face-to-face clinical staff time directed by a physician/QHP, with a comprehensive care plan established, implemented, revised, or monitored. | $66.00 pppm |
| 99439 | Additional 20 minutes of clinical staff time | Add-on CCM code for each additional 20 minutes of non-face-to-face clinical staff time in the same month; billed only in conjunction with 99490. | $50.00 pppm |
Remote Therapeutic Monitoring (RTM)
Remote Therapeutic Management (RTM) is a healthcare service that uses digital technology to remotely monitor and manage a patient’s therapy, particularly for chronic conditions affecting the musculoskeletal or respiratory systems. The primary focus of RTM is on collecting and assessing non-physiological patient data-such as symptoms, therapy adherence, medication response, and self-reported outcomes-rather than physiological metrics like blood pressure or glucose levels.
| CPT Code | Time per Month | Basic Description (2026) | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 98975 | One-time setup | Initial setup and patient education for RTM device(s); once per 30-day episode when required days of data are met. | $21 one-time |
| 98978 | CBT / behavioral device supply, 16–30 days | RTM device supply for cognitive behavioral therapy (therapy adherence/response, digital CBT), once every 30 days when criteria met. | $50 pppm |
| 98980 | First 20 min | RTM treatment management services; requiring at least one interactive communication with patient/caregiver. | $54 pppm |
| 98981 | Each additional 20 min | Add-on RTM treatment management; each additional 20 minutes in same month, same requirements as 98980. | $41 pppm |
Prinicpal Care Management (PCM)
| CPT Code | Description | Est. 2026 Medicare Payment |
|---|---|---|
| 99424 | First 30 minutes of PCM per month, provided by MD or QHCP | $82 pppm |
| 99425 | Each additional 30 minutes of PCM per month add-on to 99424 | $57 pppm |
| 99426 | First 30 minutes of PCM per month by clinical staff under general supervision of MD or QHCP | $65 pppm |
| 99427 | Each additional 30 minutes of PCM per month add-on to 99426 | $54 pppm |
Resources
Remote Patient Monitoring (RPM)
Chronic Care Management (CCM)
