New CPT Codes Expand Access to Remote Patient Monitoring

CPT Codes 99445 and 99470 Take Effect on Jan. 1, 2026

The Centers for Medicare & Medicaid Services (CMS) has finalized two new CPT codes for Remote Patient Monitoring (RPM), effective January 1, 2026. These new codes, 99445 and 99470, represent a major step forward in making RPM services more flexible, accessible, and aligned with the real-world needs of patients and providers.

This update reflects a growing recognition of the role remote care plays in improving outcomes and lowering overall costs. By expanding reimbursement opportunities, these changes empower healthcare organizations to deliver more proactive and personalized care across diverse patient populations.

Get the Basics on the New CPT Codes

Greater Flexibility with CPT 99445

The new CPT code 99445 addresses a long-standing gap in RPM reimbursement. Previously, providers could only bill for RPM device and data transmission if a patient transmitted at least 16 days of data in a 30-day period. Now, with CPT 99445, providers can be reimbursed for patients who transmit data for as few as 2 to 15 days in a 30-day period.

This change offers much-needed flexibility, enabling providers to tailor monitoring to the specific clinical needs of each patient. It is particularly beneficial for:

• Patients with episodic or acute conditions who may not require daily monitoring.
• Individuals managing chronic conditions who have achieved stability but still benefit from periodic check-ins.
• Post-discharge monitoring to ensure a smooth transition from hospital to home.

By recognizing the value of shorter-term monitoring, CMS is empowering providers to use their clinical judgment to determine the appropriate level of care for each individual.

Explore CPT 99445 in More Detail

Reimbursing Shorter Interactions with CPT 99470

The second new code, CPT 99470, allows for reimbursement for the first 10 minutes of RPM care management services. This is a crucial addition, as it acknowledges that even brief interactions can be highly valuable in managing a patient’s health.

This code will support providers in:

• Proactively addressing patient concerns before they escalate.
• Providing timely feedback on patient-generated health data.
• Building stronger patient-provider relationships through more frequent, albeit shorter, touchpoints.

CPT 99470 ensures that providers are compensated for the valuable time they spend engaging with patients, no matter how brief the interaction.

Explore CPT 99470 in More Detail

What This Means for the Future of Remote Care

The introduction of these new CPT codes is a clear indicator that the healthcare industry is embracing a more connected and patient-centric future. By expanding reimbursement for RPM, CMS is paving the way for:

• Increased adoption of RPM across a wider range of clinical scenarios.
• Improved management of chronic conditions, leading to better patient outcomes and reduced hospitalizations.
• Greater efficiency for providers, allowing them to care for more patients effectively.

Explore Revenue and Care Impact

Empowering Providers for the Next Era of Remote Care

100Plus is at the forefront of this transformation. Our comprehensive, AI-assisted RPM platform is designed to be flexible and scalable, and we are fully prepared to support our partners in leveraging these new codes. We are committed to providing the technology and services that enable our partners to deliver the best possible care in this new era of remote care.

Read Our Implementation Tips

Explore these New CPT Codes in Greater Detail

For years, healthcare providers have faced a critical barrier in Remote Physiologic Monitoring (RPM) reimbursement: the 16-day minimum data transmission requirement. Patients who would benefit from long-term RPM programs but didn’t need 16 readings per month – those managing stable chronic conditions through weekly check-ins, maintaining controlled hypertension with periodic monitoring, or tracking weight with consistent but less frequent readings – fell through the cracks. These patients would still benefit from continuous remote monitoring between office visits, but providers were left in the dark about their status and unable to bill for the valuable clinical services they were providing when patients submitted fewer than 16 days of readings.

That changes January 1, 2026.

The Centers for Medicare & Medicaid Services (CMS) has finalized two groundbreaking CPT codes that represent one of the most significant expansions of RPM since the program’s original launch.” CPT codes 99445 and 99470 introduce flexible reading requirements that unlock reimbursement for patient populations on long-term maintenance programs who were previously ineligible under traditional RPM codes, creating substantial new opportunities for healthcare organizations to serve more patients while improving outcomes.

CPT 99445: Flexible Reading Frequency Device Supply

CPT 99445 covers remote physiologic monitoring device supply for 2-15 days of data transmission within a 30-day billing period. This represents a fundamental shift from CPT 99454, which requires 16-30 days of monitoring, enabling practices to bill for patients on ongoing monthly programs who need fewer readings.

Key features:

• Monitors vital signs including weight, blood pressure, pulse oximetry, and respiratory flow rate
• Requires minimum of 2 days (previously 16 days) of data transmission
• Billing limit: Once per patient per 30-day period
• Reimbursement rates have not yet been released but are expected to align with CPT code 99454.

CPT 99470: Flexible Duration Treatment Management

CPT 99470 covers remote physiologic monitoring treatment and management services requiring 10-19 minutes of interactive communication with patients or caregivers per calendar month.

Key features:

• Initial 10-19 minutes of logged interactive communication (previously 20-minute minimum under CPT 99457)
• RVU value: 0.31 reflecting reimbursement scaled appropriately for shorter service duration
• Can be provided by clinical staff under general supervision
• Proportional reimbursement for shorter engagement periods

Why This Matters: The 16-Day Barrier Is Gone

Before 2026, Medicare required patients to transmit monitoring data for at least 16 days within a 30-day period to qualify for RPM reimbursement under CPT 99454. This rigid threshold excluded significant patient populations who needed ongoing monitoring but with fewer readings:

• Patients with controlled hypertension on stable medications monitoring blood pressure 8-12 times per month
• Stable heart failure patients tracking weight 2-3 times per week (8-12 readings/month)
• COPD patients with intermittent pulse oximetry monitoring several days per week
• Type 2 diabetes patients on maintenance therapy with weekly to bi-weekly glucose checks
• Weight management program participants with consistent weekly weigh-ins (4 readings/month)

Now, as few as 2 days of data transmission qualifies for reimbursement, fundamentally expanding RPM’s ability to serve patients on long-term maintenance programs who need ongoing monitoring with fewer readings per month.

Key Differences: New Codes vs. Existing RPM Codes

Understanding when to use CPT 99445 and 99470 versus traditional codes is critical for maximizing reimbursement:

Critical note: CPT 99445 and 99454 are mutually exclusive within the same 30-day period. Providers should bill CPT 99454 if patients meet the 16-day threshold; use CPT 99445 only when monitoring spans 2-15 days.

Clinical Use Cases: Long-Term Maintenance with Flexible Reading Requirements

The flexibility of CPT 99445 and 99470 opens doors to serving patients on ongoing RPM programs who need fewer than 16 readings per month – scenarios that were previously unbillable despite their clinical value:

Controlled Hypertension Maintenance

Patients with well-controlled blood pressure on stable medications don’t need daily readings. Six to twelve readings per month often suffice to monitor durability, track adherence, and detect gradual drift – keeping providers informed of trends between quarterly office visits without burdening patients with excessive daily monitoring.

Stable Heart Failure Monitoring

Heart failure patients in stable condition benefit from ongoing fluid status tracking through 2-3 weight checks per week, plus symptom monitoring. This 8-12 reading per month approach surfaces early decompensation patterns while avoiding the fatigue of daily measurements that can reduce long-term adherence.

COPD with Intermittent Symptoms

Patients with chronic obstructive pulmonary disease using pulse oximetry several days per week, combined with symptom diaries, can help providers detect seasonal patterns or infectious flare indicators. This ongoing monitoring of 8-15 readings monthly provides valuable longitudinal data without daily burden.

Type 2 Diabetes Maintenance

For patients using traditional glucometers rather than continuous glucose monitors, targeted fasting and post-prandial checks several days per week support medication adherence and lifestyle coaching. Weekly to bi-weekly testing (4-8 readings/month) maintains provider visibility into glucose control trends.

Chronic Kidney Disease and Resistant Hypertension

Patients under nephrology care benefit from intermittent home blood pressure monitoring that fills gaps between specialist visits. Regular but not daily monitoring (10-12 readings/month) complements lab-driven management with valuable trend data.

Weight Management Programs

Patients managing obesity, cholesterol, or weight-related conditions through structured programs benefit from consistent weekly weigh-ins. Just 4 readings per month (once weekly) provides sufficient data for coaching and trend analysis – yet these patients previously fell below the 16-day threshold and couldn’t be billed despite active program participation.

Revenue and Care Impact: What Healthcare Providers Should Know

The introduction of CPT 99445 and 99470 represents more than just two new billing codes—it brings both clinical and financial implications that strengthen the long-term viability of Remote Patient Monitoring programs.

Broader Access, Better Alignment

The new CPT codes broaden reimbursement eligibility by allowing coverage for patients who submit fewer than 16 readings per month. This shift enables providers to include long-term maintenance and lower-intensity monitoring programs that were previously excluded under older RPM requirements. If reimbursement aligns with existing RPM codes such as CPT 99454, these changes could enhance both patient access and the financial sustainability of RPM programs.

Operational Efficiency Gains

Shorter monitoring periods and reduced time requirements (10-minute vs. 20-minute minimums) lower the operational burden on clinical staff. This means:

• More patients can be monitored with existing resources
• Better alignment between monitoring intensity and clinical needs
• Reduced staff burnout through more manageable engagement requirements

Growing Use of RPM Underscores a Changing Healthcare Landscape

Remote Patient Monitoring continues to gain momentum as part of the broader telehealth landscape. As of 2023, 74.4% of physicians report using telehealth, and by 2022, 30% were already using remote monitoring devices. More than half (53%) of providers use RPM specifically for managing chronic patients. This steady adoption signals strong market growth and underscores the importance of expanding access to patients who require ongoing but less frequent monitoring, ensuring more inclusive and flexible models of care delivery.

Implementation Tips: Preparing for January 1, 2026

Healthcare providers should take these steps now to maximize the new codes’ impact:

Update Billing Systems

Work with your RPM platform vendor and billing team to ensure systems support CPT 99445 and 99470. Verify that documentation workflows capture:

• Days of data transmission (to distinguish 2-15 days vs. 16-30 days)
• Minutes of interactive communication in 10-minute increments
• Medical necessity for monitoring period length

Train Clinical Staff

Educate care teams on when to use codes based on patient reading frequency. Key decision points:

• Use CPT 99445 for 2-15 days of monitoring; CPT 99454 for 16-30 days
• Use CPT 99470 for 10-19 minutes; CPT 99457 for ≥20 minutes
• Document all interactive communication with timestamps

Identify Target Patient Populations

Review your patient census to identify cohorts on long-term maintenance programs who would benefit from ongoing monitoring but need fewer than 16 readings per month:

• Patients with controlled hypertension requiring periodic drift detection
• Stable heart failure patients with 2-3 weight checks per week
• COPD patients with intermittent symptom monitoring
• Type 2 diabetes patients on maintenance therapy
• Weight management program participants with weekly check-ins

Ensure Compliance and Documentation

The Office of Inspector General (OIG) has prioritized RPM billing audits. Maintain thorough documentation:

• Written or verbal patient consent
• Qualified healthcare professional orders for monitoring
• Logs of interactive communication (type, duration, timestamps)
• Medical necessity justifications for monitoring duration

Leverage Technology Partners

Partner with RPM solution providers that offer:

• Automated data transmission tracking
• Time-logging features for interactive communication
• Billing support and compliance guidance
• Interoperability with your EHR system

The Bottom Line: A Major Step Forward for RPM

The introduction of CPT 99445 and 99470 represents a watershed moment for remote physiologic monitoring. By eliminating the 16-day barrier and introducing flexible reading requirements, CMS has opened the door to serving patients on long-term chronic disease maintenance programs who need fewer readings per month – scenarios that were financially unviable under previous coding structures despite their clinical value.

For healthcare organizations, this means:

• Access to patient populations on long-term maintenance programs who benefit from ongoing monitoring with fewer readings.
• Potential for reimbursement rates that align with existing RPM codes, supporting sustainable program growth.
• Operational flexibility through reduced time and reading frequency requirements.
• Better clinical alignment between monitoring frequency and actual patient needs.

As Remote Patient Monitoring adoption continues to rise across the healthcare industry, organizations that adapt early to these new codes will be best positioned to reach more patients, enhance outcomes, and strengthen the long-term success of their programs.