RESOURCES
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)
| 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)
| 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 |
Patient Information And Consent Form
Virtual Visits In Ophthalmology
RTM & CCM In Ophthalmology
