Effective January 1, 2026, CMS has finalized updates to Remote Physiologic Monitoring (RPM) billing codes, expanding reimbursement eligibility and aligning payment policies with real-world clinical practice. These changes create new opportunities for providers to serve more patients, especially those who previously fell outside traditional billing thresholds.

In this comprehensive guide, we’ll break down what’s changing, what’s staying the same, and how to make sure your practice is ready to comply, capture revenue, and deliver quality care.

Why the 2026 RPM Code Changes Matter

The RPM program has steadily grown in importance as a reimbursable digital health service. With healthcare shifting toward value-based models and hybrid care delivery, CMS has introduced two new CPT codes in 2026 to expand flexibility and improve alignment with actual patient behavior.

In short:
The 2026 updates make it easier to bill patients who transmit fewer readings or require shorter management time, two common hurdles in traditional RPM billing.

What’s New in the 2026 RPM CPT Codes?

1. CPT 99445 – For 2–15 Days of Monitoring

This new code allows providers to bill when a patient transmits RPM data on 2 to 15 days in a 30-day period.

• Previously, billing required a minimum of 16 days of transmitted data (CPT 99454).
• Now, patients with intermittent engagement or short-term needs are billable**.**

2. CPT 99470 – For 10–20 Minutes of Management Time

This code supports reimbursement for interactive RPM management time of 10 to 20 minutes per calendar month.

• CPT 99457 still applies for ≥20 minutes.
• This update supports patients who require lighter-touch care, such as post-discharge monitoring or low-acuity chronic conditions.

What’s Staying the Same?

• CPT 99454: Still applies for 16+ days of data collection in a 30-day period.
• CPT 99457/99458: Remain active for ≥20 minutes of care coordination (initial and additional time).
  • CPT 99458 may be billed up to three additional 20-minute increments per calendar month when care time exceeds the initial 20 minutes covered by 99457.
• CPT 99453: Still used for initial RPM device setup and patient education.

CMS has held reimbursement rates steady for existing codes, reversing downward pressure from prior years.

Billing Rules to Remember

CPT Code        Description                                                                    Key Rule

99445                Data transmission on 2–15 days                       Cannot be billed with 99454

99470                10–20 mins of interactive time                         Cannot be billed with 99457

99454                16+ days of data                                                          Cannot be billed with 99445

99457                First 20 mins of care                                                  Cannot be billed with 99470

99458                Each additional 20 mins                                        Must follow 99457 billing

99453                Device setup & education                                    Once per patient lifetime

Mutually exclusive billing means providers must select the correct code based on engagement level each month. These changes are designed to reduce denied claims and simplify compliance.

For interactive time codes (99457, 99458, and 99470), CMS requires live, two-way synchronous communication between the patient and care team for the service to be billable.

How Reimbursement Is Changing

• CPT 99445 is reimbursed at the same rate as 99454.
• CPT 99470 is reimbursed at about 50% of 99457.

This parity reflects CMS’s assumption that practice expenses remain similar, even for shorter monitoring durations. However, it opens new revenue for lighter-engagement patients who were previously non-billable.

Strategic Benefits for Providers

1. More Patients Qualify
   RPM is now accessible for those who can’t commit to daily monitoring or extended monthly engagement.
2. Improved ROI
   Fewer interactions go unpaid. Practices can now bill for shorter, valid clinical encounters.
3. Realistic Workflows
   These codes reflect how RPM is used in real-world care settings. Not every patient transmits daily or engages deeply  and now that variability is reimbursable.
4. Stability in Existing Codes
   No changes to CPT 99453, 99454, 99457, or 99458 means practices don’t need to overhaul existing workflows.

What Practices Should Do Next

To stay compliant and competitive, RPM providers should:

Audit Existing Workflows

Ensure your RPM system tracks:

• Days of data transmission (2–15 vs 16+)
• Interactive care time (10–20 mins vs 20+ mins)

Train Billing Teams

Make sure coders understand when and how to apply 99445 and 99470 without billing overlaps.

Update Contracts if Needed

Depending on your RPM vendor, you may need updated terms for new codes or pricing.

Talk to Your RPM Platform Provider

Platforms like Tellihealth will apply these codes automatically and provide audit-friendly documentation to help you stay compliant.

How Tellihealth Supports the 2026 Transition

Tellihealth is fully prepared for the CPT changes and offers:

• Automatic billing logic updates
• Integrated code selection based on real-time patient data
• Explainer PDFs, talk tracks, and FAQ content for providers
• Updated SOWs or contract terms where needed
• Compliance-friendly reporting and audit support

Whether you’re an existing client or exploring RPM for the first time, Tellihealth ensures a smooth transition into 2026.

FAQ: 2026 RPM Code Changes

Here are some of the most common provider questions about the 2026 updates:  

1. What are the new RPM CPT codes for 2026?

CPT 99445 for 2–15 days of data transmission and CPT 99470 for 10–20 minutes of remote management time.

2. When do the new codes take effect?

The codes are effective January 1, 2026, and will first appear on February 2026 invoices for January services.

3. Can CPT 99445 and 99454 be billed together?

No. They are mutually exclusive, choose one based on total days of transmitted data.

4. Can CPT 99470 and 99457 be billed together?

No. You must select one based on time spent in remote management per calendar month.

5. What are the reimbursement rates?

• CPT 99445: Same rate as 99454
• CPT 99470: About 50% of 99457

Your RPM provider should align billing logic with these rates.

6. Do I need to update my EHR or platform setup?

No. Tellihealth and similar platforms will automatically implement logic updates and billing thresholds.

7. Will existing codes like 99454 and 99457 be impacted?

No changes to existing code criteria or reimbursement, these remain in place and billable as usual.

8. What if a patient transmits data for only 10 days?

Use CPT 99445 — this scenario now qualifies for reimbursement.

9. Is there a documentation change for 99470?

Yes — live, two-way synchronous communication must be documented. Otherwise, requirements are similar to 99457. This same requirement applies to 99457 and 99458.

10. How do I ensure compliance?

Use platforms like Tellihealth to automate code selection and ensure accurate reporting. Keep your clinical and billing teams trained on code thresholds.

Timeline Summary

• Now: Begin training, platform review, and contract discussions
• January 1, 2026: New codes go into effect
• February 2026: First invoices with updated codes will be submitted

Final Takeaway

The 2026 CMS RPM CPT code updates represent a strategic opportunity for providers. With expanded eligibility and better alignment with real-world care, RPM is now more scalable and sustainable than ever. But billing accurately and compliantly requires preparation.

Tellihealth is here to help you make that transition smoothly — with tools, training, and technology to keep your RPM program future-ready.

Ready to Review Your RPM Readiness?

👉 Schedule a Compliance Review with one of our RPM experts
👉 Download the 2026 RPM Code Explainer
👉 Talk to Your Account Manager about contract updates