The code set changed in January. Most models still assume 2025.
CMS added six new remote monitoring codes effective January 2026, and the important one is not a rate increase. It is the floor: a program now bills a device-supply code with as few as two transmitted days, and management time now bills at ten minutes. Short, episodic programs became viable, which changes which conditions are worth running at all.
Two days, not sixteen
99445 for RPM, and 98984, 98985, and 98986 for RTM, cover 2 to 15 transmitted days in a 30-day period. RPM's short-duration code is paid at the same rate as the 16-day code. A two-week postpartum hypertension program is now a funded program.
Ten minutes, not twenty
99470 for RPM and 98979 for RTM cover 10 to 19 minutes of management time, valued at roughly half the 20-minute codes. The light month is no longer an unpaid month.
Mutually exclusive, not additive
You bill the short-duration code or the long one. The 10-minute code or the 20-minute one. Never both in the same period. Every new code came with an exclusion, and stacking them is the most predictable audit finding of the next two years.
Remote physiologic monitoring codes
Vital signs and physiologic parameters from a device meeting the FDA definition of a medical device. Billed by physicians and qualified health professionals.
| Code | What it covers | National avg | Cadence |
|---|---|---|---|
| 99453 | Setup and patient education One-time device setup and patient education per episode of care. | $22 | once per episode |
| 99454 | Device supply, 16-30 days Device supply with daily recordings or programmed alerts, 16 or more days of data in 30. | $52 | per 30 days |
| 99445new 2026 | Device supply, 2-15 days New for 2026. Device supply where 2 to 15 days of data were transmitted in 30. Paid at the same rate as 99454. Mutually exclusive with 99454. | $52 | per 30 days |
| 99457 | Treatment management, first 20 min Clinical staff or QHP time, 20 minutes, with at least one interactive communication. | $52 | per calendar month |
| 99470new 2026 | Treatment management, first 10 min New for 2026. 10 to 19 minutes of management time. Mutually exclusive with 99457. | $26 | per calendar month |
| 99458 | Treatment management, each additional 20 min Add-on to 99457. Reported per additional 20 minutes in the month. | $41 | per additional 20 min |
| 99091 | Data collection and interpretation, 30 min QHP collection and interpretation of physiologic data. Cannot be stacked with 99457/99458 for the same service period. | $58 | per 30 days |
Remote therapeutic monitoring codes
Therapy adherence and therapy response, including self-reported data, across three listed body systems: respiratory, musculoskeletal, and cognitive behavioral therapy. Available to therapists as well as physicians, which is the practical difference that matters most.
| Code | What it covers | National avg | Cadence |
|---|---|---|---|
| 98975 | Setup and patient education One-time setup and education on use of the monitoring equipment. | $21.71 | once per episode |
| 98976 | Device supply, respiratory, 16-30 days Device supply for respiratory system monitoring, 16 or more days of data in 30. Practice-expense-only; CMS cross-walked pricing to 99454. | $52 | per 30 days |
| 98984new 2026 | Device supply, respiratory, 2-15 days New for 2026. Short-duration respiratory device supply. Mutually exclusive with 98976. | $52 | per 30 days |
| 98977 | Device supply, musculoskeletal, 16-30 days Device supply for musculoskeletal system monitoring, 16 or more days of data in 30. | $39.75 | per 30 days |
| 98985new 2026 | Device supply, musculoskeletal, 2-15 days New for 2026. Short-duration musculoskeletal device supply. Mutually exclusive with 98977. | $39.75 | per 30 days |
| 98978 | Device supply, cognitive behavioral therapy, 16-30 days Device supply for cognitive behavioral therapy monitoring, 16 or more days of data in 30. | $39.75 | per 30 days |
| 98986new 2026 | Device supply, cognitive behavioral therapy, 2-15 days New for 2026. Short-duration CBT device supply. Mutually exclusive with 98978. | $39.75 | per 30 days |
| 98980 | Treatment management, first 20 min 20 minutes of QHP management time with at least one interactive communication. | $53.77 | per calendar month |
| 98979new 2026 | Treatment management, first 10 min New for 2026. 10 to 19 minutes of management time with at least one interactive communication. Mutually exclusive with 98980. | $26.05 | per calendar month |
| 98981 | Treatment management, each additional 20 min Add-on to 98980. Reported per additional 20 minutes in the month. | $41.8 | per additional 20 min |
Pairs that cannot both appear
| Short duration | Long duration | Rule |
|---|---|---|
| 99445 | 99454 | Bill one or the other in a 30-day period, never both. |
| 99470 | 99457 | Bill one or the other in a 30-day period, never both. |
| 98984 | 98976 | Bill one or the other in a 30-day period, never both. |
| 98985 | 98977 | Bill one or the other in a 30-day period, never both. |
| 98986 | 98978 | Bill one or the other in a 30-day period, never both. |
| 98979 | 98980 | Bill one or the other in a 30-day period, never both. |
Six rules that decide whether the program survives an audit
Revenue calculator, with the assumptions exposed
Every input is editable, including the rates, because your locality is not the national average. Defaults are deliberately unflattering: they assume real transmission rates and real management-time capture, not a vendor's best case.
Bills the long-duration device code. 60 to 70% is a well-run program.
Bills the short-duration code. Before 2026 this cohort was unpaid.
Requires a documented interactive communication. This is the input people inflate.
Drives the one-time setup code.
Gross allowed amounts before cost. A real program carries device cost, staffing for management time and escalation response, patient coinsurance collection risk, and denial rework. Management time is real clinical labor, so a large fraction of this number is a wage bill, not margin. Treat this as a ceiling and subtract from it honestly.
Rates default to CY2026 national non-facility averages, rounded. Yours differ by locality, payer, and place of service. Nothing here is a prediction of payment.