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Last updated November 3, 2025
CPT code 99454 is one of the core remote patient monitoring (RPM) codes that covers the monthly supply of an FDA-approved device and the transmission of patient-generated health data. Unlike CPT 99453, which is billed once for device setup, 99454 is reimbursed every 30 days as long as the device transmits patient health data for at least 16 days within that period. With remote patient monitoring services under increased scrutiny, including audits by the Office of Inspector General (OIG), accurate RPM billing is more critical than ever.
In this post, we take a deep dive into CPT 99454, covering topics including who can bill the code, requirements to bill 99454, and devices that qualify for the CPT code.
99454 is an RPM CPT code that covers the supply and data transmission of an RPM device. Unlike CPT 99453, which is only billed once for device setup and patient education, 99454 can be billed every 30 days as long as the patient meets data transmission requirements.
A unique feature of CPT 99454 is that it is untimed. In other words, it does not require a provider to spend a minimum number of minutes managing the patient for the code to be reportable. Instead, 99454 is based entirely on device-generated data collection for at least 16 days within a 30-day billing period.
CPT 99454 can be billed by:
Only one provider can bill for 99454 per patient per 30-day period, even if multiple RPM devices are used by a patient.
For providers to receive reimbursement for CPT 99454, these conditions must be met:
If the patient does not transmit health data for at least 16 days, CPT 99454 cannot be billed, however if the patient transmits 2-15 days of data, providers can bill 99445.
Not all devices meet the criteria for CPT 99454 reimbursement. The device must be FDA-cleared and capable of automatic data transmission to the provider.
Examples of qualifying RPM devices include:
The key factor in eligibility is that the device must automatically collect and transmit patient-generated health data to the provider. As noted earlier, manual readings do not qualify. To better understand the devices that qualify, and how they work, download our Remote Patient Monitoring Devices Guide.
CPT 99454 is part of the larger RPM billing structure. Understanding how 99454 fits within this structure is essential for proper coding, billing, and reimbursement.
|
CPT Code |
Description |
Avg. Reimbursement (2026)* |
Billing Frequency |
|
Device setup & patient education |
$21.71 |
One-time |
|
|
99454 |
Monthly supply & data transmission (16+ days) |
$47.43 |
Once in a 30-day period |
|
Monthly supply & data transmission (2–15 days) |
$47.43 | Once in a 30-day period | |
|
Initial 10-20 minutes of care management time |
$26.05 |
Once, Monthly |
|
|
First 20 minutes of RPM management |
$51.77 |
Once, Monthly |
|
|
Each additional 20 minutes |
$41.42 |
Monthly |
*Estimated reimbursement values as of November 2025
Per the 2026 Physician Fee Schedule final rule, there are now two RPM codes that are not time based; 99454 and 99445. 99454 is based on the transmission of 16-days of health data within a 30-day billing period, whereas 99445 is based on the transmission of 2-15 days of health data within a 30-day billing period. Providers may not bill both of these codes in the same 30-day period. Note: For a comprehensive overview of all RPM CPT codes and their specific applications, check out our guide here.
CPT 99445 and CPT 99454 cannot be billed for the same patient during the same 30-day period. If a patient meets the 16-day threshold, providers should bill CPT 99454. If the patient transmits data on 2-15 days, CPT 99445 should be billed instead.
Many providers pair remote patient monitoring (RPM) with chronic care management (CCM) as part of a larger, more comprehensive care management program to enhance patient care and increase reimbursement. CPT codes 99454 or 99445 cover the device supply and transmitted health data, while CCM codes like CPT 99490 and CPT 99439 reimburse for time spent reviewing data, adjusting treatment plans, and patient communication. This combination better ensures continuous monitoring with proactive management, leading to improved outcomes and higher revenue.
Here is what the above would look like from a coding and billing perspective:

To ensure you can bill for CPT 99454 and maximize the code’s value, follow these best practices:
Many providers experience claims denials for CPT 99454 due to simple mistakes. Avoid the following errors:
CPT code 99454 is essential for sustaining a RPM program, providing monthly reimbursement for device supply and data transmission. Unlike other RPM codes, it is not time-based and does not require direct provider interaction. It simply requires patients to record and transmit at least 16 days of physiological data per month.
For providers looking to streamline RPM coding, billing, and compliance, Prevounce offers a comprehensive solution:
Prevounce also offers the Pylo FDA-approved devices that would be eligible for CPT 99454.
Schedule a demo with Prevounce to see how our platform simplifies RPM billing, automates tracking, and helps you achieve improved patient outcomes and financial performance. Book your demo today and take control of your remote patient monitoring program.
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Disclaimer
Health economic and reimbursement information provided by Prevounce is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.
Prevounce encourages providers to submit accurate and appropriate claims for services. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently.
Prevounce recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.
Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.
Prevounce Health helps simplify the provision of remote patient monitoring, chronic care management, preventive care, and annual wellness visits while ensuring compliance with regulatory and reimbursement guidelines. Prevounce provides resources and support that are custom-tailored to clients' needs, allowing them to focus on providing good care to patients while reducing time spent on tedious paperwork. Prevounce's goal is to allow provider organizations of all sizes to implement comprehensive patient wellness programs that increase their practice revenue, patient engagement, and clinical staff efficiency.
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