Understanding RPM, RTM & CCM
A visual guide to Medicare's three remote care programs — what they cover, how they're billed, and what changed for 2026.
RPM
7 codesRemote Patient Monitoring
Monitor physiologic data like CPAP usage, AHI, and leak rates remotely
RTM
10 codesRemote Therapeutic Monitoring
Track therapeutic responses for respiratory, musculoskeletal, and CBT treatments
CCM
6 codesChronic Care Management
Coordinate ongoing care for patients with 2+ chronic conditions
Billing Codes & Rates
National non-facility averages using the 2026 conversion factor of $33.40
Remote Patient Monitoring
7 CPT codes · Monitor physiologic data like CPAP usage, AHI, and leak rates remotely
| CPT Code | Description | Status | 2026 Rate |
|---|---|---|---|
| 99453 | Initial setup & patient education on monitoring equipment One-time; now requires min. 2 days of data (down from 16) | MAINTAINED | ~$22 |
| 99454 | Device supply & daily data transmission, 16–30 days per 30-day period Descriptor revised to specify 16–30 day range | REVISED | ~$47 |
| 99445 | Device supply & daily data transmission, 2–15 days per 30-day period Same rate as 99454; mutually exclusive with 99454 | NEW | ~$47 |
| 99457 | Treatment management services, first 20 min/calendar month Requires ≥1 interactive communication; cannot bill with 99470 | MAINTAINED | ~$52 |
| 99458 | Treatment management, each additional 20 min Add-on to 99457 only | MAINTAINED | ~$41 |
| 99470 | Treatment management services, first 10 min/calendar month Requires ≥1 interactive communication; cannot bill with 99457 | NEW | ~$26 |
| 99091 | Collection & interpretation of physiologic data, ≥30 min physician time 1.10 work RVUs preserved; requires direct supervision | MAINTAINED | ~$56 |
What Changed for 2026
CMS finalized the most significant RPM overhaul since the codes were first created
16-Day Barrier Eliminated
The old 16-day minimum data transmission requirement is gone. Practices can now bill with as few as 2 days of patient data in a 30-day period.
Tiered Data Transmission
New two-tier structure: CPT 99445 covers 2–15 days and 99454 covers 16–30 days. Both reimburse at ~$47 — bill one or the other per period.
New 10-Minute Management Codes
CPT 99470 (RPM) and 98979 (RTM) allow billing for just 10–19 minutes of clinical staff time per month, down from the previous 20-minute minimum.
Higher Conversion Factor
The 2026 non-qualifying APM conversion factor rose to $33.40, a 3.26% increase driven by the One Big Beautiful Bill Act's temporary +2.50% boost.
Example Monthly Revenue Per Patient
Three real-world scenarios showing what a sleep practice can bill under the 2026 fee schedule
New CPAP Patient
5 days data · 12 min clinical time
Previously $0 under 2025 rules
Adherent CPAP Patient
22 days data · 20 min clinical time
RPM + CCM Patient
25 days data · 40 min RPM + 20 min CCM
RPM + CCM can be billed together (no time double-counting)
Key Billing Rules to Know
RPM and RTM cannot be billed for the same patient in the same month
Choose the program that best fits the clinical scenario.
RPM can be billed alongside CCM, PCM, TCM, BHI, and APCM
As long as no clinical time is double-counted across programs.
Interactive communication is required for management codes
At least one live, interactive communication per month. Voicemails count toward total time but do not satisfy this requirement.
General supervision for treatment management codes
The billing practitioner must be available but does not need to be physically present. Supports outsourced RPM models.
Patient consent must be documented
Can be obtained at the time of service. No changes from prior years.
Order entry and medical necessity documentation recommended
A signed order from the billing provider and documentation of medical necessity for remote monitoring should be in the patient's chart to support claims.