Remote Physiologic Monitoring
Codes for supplying a connected device that captures physiologic data (like blood pressure or weight) and for the clinical staff time spent reviewing and acting on it each month.
What it is
Remote Physiologic Monitoring (RPM) covers digitally collecting and analyzing physiologic data, such as blood pressure, weight, glucose, or pulse oximetry, from a connected medical device.
The code family splits into device setup and supply codes (billed once, then monthly for as long as the device is in use) and treatment management codes for the clinical staff time spent reviewing the data and communicating with the patient.
Who qualifies
- Patient has an established relationship with the billing practitioner (an initiating visit may be required for new patients)
- Patient consents to RPM, including any applicable cost-sharing
- A medical device that meets the FDA's definition of a medical device is used to automatically collect and transmit physiologic data
- At least 16 days of data are collected in a 30-day period for the device-supply code 99454 (a short-duration alternative, 99445, applies for 2-15 days); 99453 is a one-time setup code billed once per episode and is not itself tied to a day-count threshold
Codes at a glance
| Code | What it covers | Threshold | Approx. payment | Details link |
|---|---|---|---|---|
| 99453 | Initial setup and patient education on equipment use (one time, per episode of care) | Billed once per episode of care, at setup | ~$22 | Details → |
| 99454 | Device supply with daily recording/alert transmission, per 30 days | ≥16 days of data in a 30-day period | ~$52 | Details → |
| 99445 | Device supply, short-duration alternative to 99454, per 30 days | 2-15 days of data in a 30-day period | ~$52 | Details → |
| 99457 | Treatment management, first 20 minutes, per calendar month | 20 minutes clinical staff/practitioner time plus 1+ interactive communication | ~$52 | Details → |
| 99458 | Treatment management add-on, each additional 20 minutes | Each additional 20 minutes, requires 99457 first | ~$41 | Details → |
| 99470 | Treatment management, short-duration alternative to 99457, per calendar month | 10-19 minutes plus 1+ interactive communication | ~$26 | Details → |
Approximate CY2026 Medicare Physician Fee Schedule national non-facility payment benchmark for non-QP clinicians, before geographic, sequestration, and claim-specific adjustments. Actual reimbursement varies by locality, practitioner status, payer, and billing circumstances. Verify the applicable amount with CMS or your Medicare Administrative Contractor.
What's required to bill
- Documented patient consent to RPM
- A qualifying medical device that automatically collects and transmits physiologic data (not patient self-reported values)
- At least one interactive communication with the patient or caregiver during the month for the treatment management codes
- Data collected across the required number of days within a rolling 30-day period
- Clinical staff or practitioner time spent reviewing data and adjusting the care plan, tracked separately from device-supply time
Documentation checklist
- Consent to RPM services
- Device data showing the number of days of readings collected in the 30-day period
- Time log for treatment management activities, separate from device setup/supply
- Record of at least one interactive communication with the patient during the month
- Care plan updates driven by the monitored data
Common billing mistakes
- Billing 99454 with fewer than 16 days of data in the 30-day period (should use 99445 instead, if 2-15 days were collected)
- Billing 99457 without any documented interactive communication with the patient that month
- Billing 99458 without first meeting the 99457 threshold
- Billing both 99457 and 99470 for the same patient in the same month
- Using patient self-reported values instead of data from a qualifying connected device
FAQ
Can 99454 and 99445 be billed in the same month?
No. They are mutually exclusive alternatives for the same 30-day period: 99454 applies when at least 16 days of data were collected, and 99445 is the short-duration alternative for 2 to 15 days.
Can 99457 and 99470 be billed in the same month?
No. 99470 is a short-duration alternative to 99457 for months where only 10-19 minutes of treatment management time was documented, so only one should be billed per patient per month.
Does RPM require the patient to manually enter their readings?
No. The device must automatically collect and transmit the physiologic data. Manually entered, patient-reported values generally don't meet the RPM device requirement.