Why billing codes shape your product
If your wearable or app will be prescribed and paid for through Medicare, Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) codes decide a lot of your product: how many days of data a patient must send, what counts as interactive time, and whether you need a regulated device at all. The CY 2026 Physician Fee Schedule final rule (published November 5, 2025, effective January 1, 2026) added codes for 2–15 days of data and for 10 minutes of management time, which changes the minimum engagement a product has to drive.
RPM and RTM codes for 2026
| Family | CPT code | What it covers | Billing frequency |
|---|---|---|---|
| RPM | 99453 | Initial setup and patient education on the device | Once per episode of care |
| RPM | 99445 | Device supply with daily recording or programmed alerts, 2–15 days in 30 (new for 2026) | Per 30 days; bill this or 99454, not both |
| RPM | 99454 | Device supply with daily recording or programmed alerts, 16–30 days in 30 | Per 30 days |
| RPM | 99470 | Treatment management, first 10 minutes in a calendar month, with interactive communication (new for 2026) | Per month |
| RPM | 99457 | Treatment management, first 20 minutes in a calendar month, with interactive communication | Per month |
| RPM | 99458 | Each additional 20 minutes of treatment management | Add-on to 99457 |
| RPM | 99091 | Collection and interpretation of physiologic data, 30 minutes, by a physician or other qualified health care professional | Per 30 days |
| RTM | 98975 | Initial setup and patient education | Once per episode of care |
| RTM | 98984 / 98985 / 98986 | Device supply, 2–15 days in 30, for respiratory / musculoskeletal / cognitive behavioral therapy monitoring (new for 2026) | Per 30 days; bill these or the 16–30 day codes, not both |
| RTM | 98976 / 98977 / 98978 | Device supply, 16–30 days in 30, respiratory / musculoskeletal / CBT | Per 30 days |
| RTM | 98979 | Treatment management, first 10 minutes in a calendar month (new for 2026) | Per month |
| RTM | 98980 | Treatment management, first 20 minutes in a calendar month | Per month |
| RTM | 98981 | Each additional 20 minutes of treatment management | Add-on to 98980 |
Why no dollar amounts? Medicare payment varies by locality and setting and is updated every year, so any number we printed would be wrong for most readers and soon out of date. Look up current national and local rates in the CMS Physician Fee Schedule look-up tool. Code descriptors above are summarized; see the final rule and CMS MLN booklet on telehealth and remote patient monitoring for the official requirements. Commercial payers and Medicaid set their own rules.
What your device needs to qualify
- It must be a medical device. CMS requires the device to meet FDA's definition of a medical device. A general wellness product doesn't automatically qualify, so your FDA position and your reimbursement plan have to agree.
- Data must be sent automatically. For RPM the device has to digitally upload physiologic data; readings the patient types in don't count. RTM can include non-physiologic data such as musculoskeletal status, respiratory status, therapy adherence and therapy response.
- The right clinical relationship. RPM requires an established patient relationship. Only practitioners eligible to bill evaluation and management (E/M) services can bill these codes, and patient consent is required.
- One practitioner, one family. Only one practitioner can bill RPM or RTM for a patient in a 30-day period, and RPM and RTM can't be billed together for the same patient.
Sources: CMS MLN901705; CY 2026 PFS final rule.
Product decisions this drives
- Count transmission days, not readings. Device-supply codes count days with data in a 30-day period. Build day-level adherence tracking and show it to clinicians, with a clear line at 2 and 16 days.
- Log interactive time. Management codes are time-based, now starting at 10 minutes. Your clinician dashboard should capture time and interactive communication in a way the practice can audit.
- Choose RPM or RTM on purpose. Physiologic signals (heart rate, blood pressure, SpO2) point to RPM. Therapy-response data, such as range of motion, inhaler use or CBT engagement, points to RTM. Because they can't be billed together, the product should support one clear pathway per patient.
- Plan regulatory status early. If reimbursement is the business model, a wellness-only product won't qualify. That affects claims, validation and timeline.
- Make consent and enrollment part of onboarding. Capture and store consent and the ordering practitioner as data, not paperwork.
For the sensor and validation side, see wearables & neurology. For building the patient app and clinician dashboard, see healthcare mobile app development.
Frequently asked questions
What RPM and RTM codes are new in 2026?
The CY 2026 Medicare Physician Fee Schedule added RPM code 99445 (device supply for 2–15 days in 30) and 99470 (first 10 minutes of treatment management), and RTM codes 98984, 98985 and 98986 (2–15 days for respiratory, musculoskeletal and CBT monitoring) and 98979 (first 10 minutes of management). They took effect January 1, 2026.
Does my device need FDA clearance to be billed under RPM?
CMS requires that the device meet FDA's definition of a medical device and that it digitally and automatically transmit the data. Whether a particular product needs clearance depends on its intended use and claims, so confirm your FDA position before building a reimbursement model around RPM.
How much does Medicare pay for RPM codes?
Payment varies by locality and is updated each year, so we don't publish rates. Use the CMS Physician Fee Schedule look-up tool for current national and local amounts for each code.
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