As part of the Centers for Medicare & Medicaid Services’ (CMS) 2026 updates, CPT code 99470 introduces more flexible reading requirements for remote patient monitoring treatment and management. This expanded reimbursement pathway allows organizations to include patients who previously fell outside traditional RPM criteria, creating new opportunities for healthcare organizations and providers to reach more patients, expand access to care, and improve outcomes across high-risk populations.
Here’s what you need to know about CPT code 99470, from billing requirements to payment details.
What is CPT Code 99470?
CPT 99470 is a newly introduced RPM treatment management code effective 2026. It covers remote physiologic monitoring treatment and management services when clinicians or clinical staff engage in 10–19 minutes of interactive communication with patients or caregivers during a calendar month, reflecting a revised, more flexible standard under RPM.
What Services Are Required for CPT 99470?
Under 99470, billable services include interactive communication, such as telephone calls, secure messaging, video, or other approved methods, between clinical staff (or physician/QHCP) and the patient or caregiver. The total documented interactive time must be 10–19 minutes for the billing period.
These communications must relate to remote physiologic data review, care coordination, and management of the patient’s remote monitoring regimen.
When Can I Bill for CPT Code 99470?
CPT 99470 can be billed in any calendar month when 10–19 minutes of interactive communication are provided. It is mutually exclusive with 99457 (20 minutes or more) for that month; they cannot be billed together.
Billing practitioners must ensure documentation logs the duration, date/time, and type of interactive communication.
Who Qualifies to Bill CPT Code 99470?
Eligible billers include physicians, other qualified healthcare professionals (QHCPs), or clinical staff working under general supervision, consistent with existing RPM billing rules.
RPM services under 99470 can be provided to patients with chronic or acute conditions, including those in long-term maintenance, under updated 2026 guidance.
Billing Criteria and Documentation Requirements
- Minimum time: 10 minutes of interactive communication in a calendar month.
- Time limit for code: 10–19 minutes qualifies for 99470; 20+ minutes should be billed under 99457.
- Billing frequency: Once per patient per calendar month (choose 99470 or 99457 based on time spent).
- Documentation: Must include date, time, duration (in minutes), modality of communication, and summary of content.
- Patient consent and provider order: Must follow RPM program consent and order requirements.
Reimbursement for CPT Code 99470
CPT 99470 carries an RVU value of 0.31, reflecting reimbursement scaled for shorter service duration compared to older RPM time codes.
Providers should confirm reimbursement rates with their region Medicare Administrative Contractor (MAC) or applicable private payers before billing.
How CPT 99470 Differs from Traditional RPM Codes
- Shorter contact time: 10–19 minutes vs.≥20 minutes under 99457.
- Greater flexibility: Allows RPM treatment management for patients needing minimal monthly interaction, ideal for stable conditions or periodic check-ins.
- Scalability: Reduces administrative burden and time commitment, enabling broader reach for RPM programs without sacrificing compliance.
Why CPT Code 99470 Matters
CPT 99470 lowers the barrier for incorporating RPM into long-term care strategies by recognizing that not all patients require intensive monthly engagement. With a shorter time threshold, RPM becomes more accessible, scalable, and aligned with real-world patient needs particularly for maintenance, transitional, or low-touch chronic care. This flexibility supports broader program adoption, sustained patient engagement, and better health outcomes.
CPT 99470 introduces a more flexible option for RPM treatment and management, enabling clinicians to provide remote support with shorter monthly interaction time while remaining compliant. This makes RPM more adaptable for a wider range of patient needs and expands access to these critical care services.
Learn more about the latest code updates@ RPM Reimbursement Expansion: New CPT Codes 99445 & 99470 | 100Plus