
The healthcare industry is evolving rapidly, including the Remote Monitoring Codes. By updating billing codes for Remote Patient Monitoring (RPM) and introducing new Remote Therapeutic Monitoring (RTM) codes, the Centers for Medicare & Medicaid Services (CMS) is enabling healthcare providers to serve patients better while ensuring precise reimbursements. In this article, we’ll explore the changes for 2025-26, provide key insights on billing requirements, and discuss how these updates will impact providers and patients.
The Evolution of Remote Monitoring
RPM (Remote Patient Monitoring) is a significant and cost-effective way of managing health conditions, whether acute or chronic. According to a study by the National Library of Medicine, RPM adoption reduced hospital readmission rates by 38% and improved medication adherence by 67%. This not only improves the outcome but also increases savings. CMS reports that effective RPM can save up to $3,000 per patient.
The current procedural terminology codes and guidelines are very complicated. The CMS update for 2025-26 will allow providers to track time more precisely and expand reimbursement opportunities.
Key Updates to Remote Monitoring Codes:
New Remote Monitoring Codes (Effective 2026)
Code | Description | Duration | Category |
99XX4 | Device supply for 2–15 days of RPM services | First 15 days | RPM |
99XX5 | Treatment management for 2–15 days | First 15 days | RPM |
98XX4 | Respiratory remote monitoring | 2–15 days | RTM |
98XX5 | Musculoskeletal remote monitoring | 2–15 days | RTM |
98XX6 | Cognitive-behavioral therapy monitoring | 2–15 days | RTM |
98XX7 | Remote treatment management | 2–15 days | RTM |
2025 CPT Code Updates:
1. Remote Therapeutic Monitoring (RTM):
Revised Codes:
- 98975: Now includes digital therapeutic interventions.
- 98976–98978: Expanded to cover device supplies required for data access or transmission supporting RTM.
- 98980: Applicable to provider services lasting fewer than 20 minutes.
2. Telemedicine Services:
New Codes:
- 98000–98015: A new range covering audio-video and audio-only telemedicine services. However, Medicare will not recognize these codes.
- 98016: A virtual check-in code set to replace HCPCS code G2012, offering a good option for brief telemedicine interactions.
Augmented Intelligence (AI).
- 0902T and 0932T: Electrocardiogram analysis.
- 0877T–0880T: Chest imaging.
- 0898T: Image-guided prostate biopsy.
2026 CPT Code Updates:
1. Remote Monitoring Services:
- 99XX4: Remote physiologic monitoring device supply for 2–15 days of monitoring.
- 99XX5: Remote physiologic monitoring treatment management services for 2–15 days of monitoring.
- 98XX4–98XX6: Codes for respiratory, musculoskeletal, and cognitive behavioural therapy remote monitoring.
- 98XX7: Remote therapeutic monitoring treatment management services.
2. Revised Codes:
- 99454: Will cover 16–30 days of remote monitoring.
- 99457: This will include 11–20 minutes of interactive communication.
- 99458: An add-on code covering each additional 10 minutes of interactive communication, allowing for more granular billing.
- 98980: Will include 11–20 minutes of provider-patient interaction, lowering the prior 20-minute requirement.
- 98981: An add-on code for each additional 10 minutes of interactive communication.
These updates are mainly designed to operate the coding process and reduce the burden on healthcare providers. Staying informed about the changes in Remote Monitoring Codes is crucial for compliance and optimal reimbursement.
How These Changes Benefit Providers and Patients

1. Improved Billing Processes:
The 2025-26 updates reduce administrative burdens, especially for practices offering a mix of RPM and RTM services. For instance, G0511 allows Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to bill for general care management alongside remote monitoring, enabling a cohesive billing strategy.
With granular time codes and expanded categories, practices can unlock good revenue potential. For example, a small-scale RPM program managing 100 patients could generate an additional $50,000 annually simply by billing for shorter time increments.
2. Improved Patient Outcomes:
Studies show that RPM reduces emergency visits by 25% and improves quality-adjusted life years (QALYs) for chronic disease patients by 33%. The ability to offer short-term monitoring through new codes ensures more patients receive timely, cost-effective care.
CMS Billing Requirements for 2025-26

To ensure successful claims, providers must adhere to CMS’s updated billing requirements:
- Ensure Device Compliance:
Devices must meet FDA standards and transmit data digitally. Manual readings are not billable. - Meet Data Collection Thresholds:
Codes like 99454 require at least 16 unique days of data within 30 days. This threshold must be met to qualify for reimbursement. - Track Time Accurately:
Use software to log clinician-patient interaction time, especially with new 11-minute thresholds for 99457 and 98980. - Verify Eligibility for RTM Codes:
RTM codes are applicable for specific therapeutic areas. Ensure proper documentation and ICD-10 codes to avoid denials.
MIPS Changes and Remote Monitoring Codes
The latest updates in the MIPS (Merit-based Incentive Payment System) aim to integrate remote patient monitoring into healthcare. With new codes coming in 2025-26, providers can now align RPM use with MIPS goals like improving care quality and patient engagement. These changes not only simplify reporting but also reward practices for using innovative tools to enhance outcomes and reduce costs.
Final thought:
The updates to Remote Monitoring Codes for 2025-26 show a significant shift toward healthcare’s digital transformation. By embracing these changes, providers can expand their services, reduce costs, and improve patient outcomes. Whether you’re managing RPM for chronic conditions or diving into RTM for respiratory or cognitive therapies, understanding these codes is key to unlocking their full potential.
Remote monitoring is no longer a “nice-to-have”; it’s a cornerstone of modern patient care. The time to adapt is now.
Why is CloudRCM Solutions the best choice?
Remote monitoring codes require expert and updated knowledge. CloudRCM Solutions has a dedicated team of coders and billers who demonstrate compliance with evolving regulatory policies related to coding and billing. From establishing remote monitoring CPT codes to delivering continuous support and in-depth analysis, our commitment lies in improving your practice’s operational efficiency and financial performance.
FAQs
What are the CPT codes for remote patient monitoring?
The CPT codes for RPM are 99453, 99454, 99457, 99458, and 99091.
What are CPT codes 99453 and 99454?
99453 covers initial setup and patient education for RPM, while 99454 includes device supply and data transmission for 30 days.
What can be monitored by remote patient monitoring?
RPM can monitor vitals such as blood pressure, heart rate, glucose levels, weight, respiratory flow, and oxygen saturation.
What is the CPT code for RTM?
The CPT codes for RTM are 98975, 98976, 98977, 98980, and 98981.
What is procedure code 87426?
CPT 87426 is used for infectious agent detection by nucleic acid (e.g., COVID-19 testing).
What is the difference between RPM and RTM?
RPM focuses on physiologic monitoring (e.g., vitals), while RTM tracks therapeutic responses (e.g., medication adherence, therapy compliance).
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