How CPT 99445 and 99470 Support Expanded RPM Care Models in 2026

For 2026, and courtesy of the 2026 Physician Fee Schedule final rule, Medicare has introduced new RPM CPT codes that meaningfully expand how remote patient monitoring (RPM) can be used in clinical practice. While these updates are especially impactful for organizations with established RPM programs, they are equally important for organizations that are in the process of launching RPM for the first time.

For mature programs, the new codes remove long-standing constraints that limited which patients and care scenarios could be included. For newer programs, they lower the barrier to entry by allowing RPM models that do not require daily monitoring or high-intensity clinical engagement from day one.

In both cases, the central theme is flexibility. The new RPM codes allow organizations to design programs around clinical need, patient readiness, and operational capacity, rather than rigid billing thresholds. This guide explains what the new 2026 RPM codes are, how they work, and how they support clearly compliant clinical applications that can deliver significant value for both patients and providers.

The New 2026 RPM CPT Codes Explained

What is CPT 99445?

CPT 99445 is a new RPM device supply code that applies when physiologic data is collected and transmitted for 2–15 days within a 30-day period.

This code covers the supply of RPM devices that record and transmit patient data through daily recordings or programmed alerts. It is designed to be used in months when continuous daily monitoring is not clinically necessary, but targeted physiologic data remains important to guide care decisions.

Organizations may bill either CPT 99445 or CPT 99454 (the existing RPM device supply code that requires 16 or more monitoring days) in a given 30-day period. Both codes cannot be billed for the same patient in the same month.

The 2026 Medicare reimbursement rate for CPT 99445 is ~$47.

From a program design perspective, this code supports RPM models that are episodic, phased, or condition-specific. It allows organizations to bring patients into RPM earlier, monitor during periods of clinical relevance, and continue care without forcing unnecessary data collection.

What is CPT 99470?

CPT 99470 is a new RPM treatment management code that captures 10–20 minutes of clinical staff, physician, or other qualified health care professional time in a calendar month.

To bill CPT 99470, at least one interactive communication with the patient or caregiver must occur during the month. The code applies when clinical engagement is meaningful but does not reach the 20-minute threshold required for CPT 99457.

The 2026 Medicare reimbursement rate for CPT 99470 is ~$26.

When total RPM management time exceeds 20 minutes in a month, existing RPM billing rules apply. Organizations may bill CPT 99457 for the initial 20 minutes and CPT 99458 for additional time, generally no more than twice per month.

This new code supports RPM programs that include months of lower-intensity engagement, which is common in both early-stage programs and mature programs managing stable patients.

Understanding the Clinical Role of Shorter Monitoring Periods

The introduction of a 2–15 day device supply code has prompted questions about whether limited monitoring still constitutes appropriate RPM. From a clinical and compliance perspective, the determining factor is medical necessity, not the number of days alone.

Shorter monitoring periods are often clinically appropriate when physiologic data is needed during defined windows of care. These windows may include medication changes, post-discharge recovery, symptom escalation, or diagnostic clarification. In these scenarios, daily monitoring across an entire month may add little clinical value and may negatively impact patient adherence.

The new CPT code removes the previous all-or-nothing structure that often forced clinicians to choose between over-monitoring patients or excluding them from RPM entirely. While two days represents the minimum threshold, most well-designed programs will use monitoring durations that align with clinical goals rather than defaulting to the minimum.

Clinical Applications Supported by the New RPM CPT Codes

Medication titration for chronic conditions

Medication titration is one of the most straightforward and widely applicable use cases for the new RPM codes. Patients with hypertension, diabetes, heart failure, and other chronic conditions often require close physiologic monitoring during periods of medication initiation or adjustment.

Under the new framework, clinicians can prescribe daily or near-daily measurements during titration phases and reduce monitoring frequency once control is achieved. CPT 99445 supports months where fewer monitoring days are clinically appropriate, while CPT 99470 captures lighter-touch clinical management when follow-up needs are limited.

This approach allows RPM to support short-term clinical decision-making without locking patients into unnecessary long-term monitoring requirements. It also enables smoother transitions between intensive RPM and other longitudinal care models.

Medical weight loss and GLP-1 therapy monitoring

Medical weight loss programs, including those involving GLP-1 therapies, often involve periods of heightened clinical risk followed by longer phases of stability. Physiologic monitoring is particularly valuable during early treatment, dose escalation, and when side effects are being evaluated.

The new RPM codes allow organizations to deploy monitoring during these higher-value periods without committing patients to continuous daily measurements. Weight, blood pressure, and glucose data can be collected when clinically meaningful, then reduced or paused as patients stabilize.

This flexibility supports patient engagement, improves adherence, and aligns RPM use with how obesity and metabolic care are delivered in real-world settings.

Pulmonary disease monitoring

Pulmonary conditions such as asthma, bronchiectasis, and cystic fibrosis can be effectively supported through RPM using home spirometry and related physiologic measures.

Monitoring needs in these populations are rarely static. Disease activity may fluctuate based on environmental exposures, infections, seasonal triggers, or recent exacerbations. The ability to bill RPM for shorter monitoring periods makes it easier to deploy spirometry monitoring during periods of increased risk and scale back when symptoms are controlled.

This targeted approach supports early intervention and proactive care while avoiding unnecessary data collection that may burden patients or care teams.

Post-acute and transitional care monitoring

Patients transitioning from inpatient to outpatient care often face elevated risk during the weeks following discharge. RPM can be used during this post-acute period to monitor vital signs, symptom progression, or condition-specific parameters that may indicate complications.

Once the patient stabilizes, monitoring intensity can decrease or conclude entirely. The new RPM device supply and management codes support this episodic use of RPM, making it easier for organizations to design transition-of-care programs that are clinically appropriate and financially sustainable.

For organizations launching RPM programs, post-acute monitoring is often a practical entry point that demonstrates value quickly without requiring long-term enrollment.

Longitudinal care with variable engagement needs

Many RPM programs serve patients whose needs vary month to month. A patient may require intensive monitoring and frequent outreach during one period, followed by lighter-touch engagement during another.

The addition of CPT 99445 and CPT 99470 allows RPM programs to accommodate this variability without disrupting billing workflows or care continuity. Monitoring days and clinical time can be adjusted as patient needs evolve, while documentation and reimbursement remain aligned.

This flexibility is particularly valuable for organizations managing diverse patient populations or expanding RPM into new service lines.

Financial Impact for New and Established RPM Programs

For organizations with established RPM infrastructure, the new codes make it possible to capture reimbursement for care that was already being delivered but previously fell below billing thresholds.

For organizations launching RPM programs, the codes reduce pressure to design programs around daily monitoring or high-intensity engagement from the outset. Programs can start with targeted use cases, scale gradually, and expand as operational capacity grows.

In both cases, the result is better alignment between clinical services and financial sustainability, without compromising care quality or compliance. The new codes also make it easier for organizations with RPM programs to generate a stronger return on their investment.

RPM Compliance and Documentation Considerations

As RPM billing becomes more flexible, compliance remains a central consideration. For CPT 99445, documentation should clearly support why the prescribed monitoring duration was medically necessary and confirm that data transmission occurred within the 2 to 15 day window.

For CPT 99470, organizations must document total clinical time spent on RPM-related activities, the nature of those activities, and at least one interactive communication with the patient or caregiver during the month.

Across all RPM services, best practices include accurate time tracking, clear medical necessity documentation, billing under the appropriate provider NPI, and avoiding overlapping or duplicative services.

Technology and workflow design play a significant role in maintaining compliance. Platforms that support proper coding and billing for RPM, automated data capture, structured documentation, and audit-ready reporting can reduce risk as programs expand.

No Better Time to Launch or Expand Remote Patient Monitoring Programs

The 2026 RPM CPT code expansion gives healthcare organizations new options to design RPM programs that reflect how care is actually delivered. These codes support both incremental program growth and thoughtful program launches, allowing organizations to start where it makes sense and scale responsibly.

Prevounce helps healthcare organizations, including primary care providers, specialty practices, federally qualified health centers (FQHC), and rural health clinics (RHC), operationalize RPM in a way that balances clinical value, financial performance, and compliance. If you are looking to expand an existing RPM program or launch a new one using the 2026 codes, seeing how Prevounce supports device management, documentation, and billing workflows can be an important next step.

To learn how Prevounce can help your organization maximize the clinical and financial value of the new CPT codes, schedule a demo of our RPM software.

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Frequently Asked Questions About the 2026 RPM CPT Codes

Q: What are the new RPM CPT codes for 2026?

The new RPM CPT codes effective in 2026 are CPT 99445 and CPT 99470. CPT 99445 covers RPM device supply when physiologic data is transmitted on 2 to 15 days in a 30-day period. CPT 99470 covers 10 to 20 minutes of RPM treatment management time in a calendar month with at least one interactive communication.

Q: Does CPT 99445 replace CPT 99454?

No. CPT 99445 does not replace CPT 99454. CPT 99445 applies when monitoring occurs on 2 to 15 days, while CPT 99454 applies when monitoring occurs on 16 or more days in a 30-day period. Only one device supply code may be billed per patient per month.

Q: Is two days of RPM data acceptable?

Two days is the minimum threshold for CPT 99445, not a recommended clinical standard. RPM is appropriate when monitoring duration is medically necessary and supports clinical decision-making. Most clinically sound programs will use more than the minimum when patient needs warrant it.

Q: When should CPT 99470 be billed instead of CPT 99457?

CPT 99470 should be billed when RPM treatment management time totals between 10 and 20 minutes in a calendar month and includes at least one interactive communication. CPT 99457 applies when treatment management time reaches 20 minutes or more.

Q: What clinical programs are supported by the new RPM codes?

The new RPM codes support medication titration for chronic conditions, medical weight loss and GLP-1 therapy monitoring, pulmonary disease management using home spirometry, post-acute and transitional care monitoring, and longitudinal RPM programs with variable engagement needs.

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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.  
  
The coding options listed here are commonly used codes and are not intended to be an all-inclusive list. We recommend consulting your relevant manuals for appropriate coding options.  
  
The Health Care Provider (HCP) is solely responsible for selecting the site of service and treatment modalities appropriate for the patient based on medically appropriate needs of that patient and the independent medical judgement of the HCP.