The short version
- Remote monitoring means a patient collects health data between visits and you use it to manage their care. Medicare pays for two kinds: remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM).
- Both require a connected medical device that meets the FDA definition of a medical device and transmits the data. PatientPower does not connect to devices or receive device data today, so it does not by itself meet the device requirement for RPM or RTM.
- Care management services (chronic care management and principal care management) do not require a device. They are built on a care plan, patient consent and time spent managing the patient, which is the kind of work PatientPower helps you organise and record.
- Using PatientPower does not make any service billable on its own. It can help you keep the records a payer may ask for.
The services
Who usually provides each one under Medicare. Other payers may differ.
Remote physiologic monitoring (RPM)
Physiologic readings such as blood pressure, weight, blood glucose or oxygen saturation, taken on a connected device that uploads them automatically, for an acute or chronic condition. Requires an established patient relationship.
Remote therapeutic monitoring (RTM)
Non-physiologic data about a therapy: musculoskeletal or respiratory status, adherence and response to treatment, and cognitive behavioural therapy. The data can be self-reported, but it must be collected and transmitted with a qualifying medical device. No established-patient requirement.
Chronic care management (CCM)
Ongoing management for a patient with two or more chronic conditions expected to last at least 12 months: a comprehensive care plan, care coordination and time spent each calendar month. No device required.
Principal care management (PCM)
Management focused on one serious chronic condition expected to last at least 3 months, with a disease-specific care plan and monthly time. No device required.
The billing codes (Medicare, 2026)
Short descriptions only; the full CPT descriptors are published by the American Medical Association. Payment amounts vary by location and setting, so they are not listed here. Look them up in the CMS Physician Fee Schedule look-up tool.
| Code | Service | What it covers | Key requirement |
|---|---|---|---|
| 99453 | RPM | Initial set-up and patient education on the device | From 2026, at least 2 days of monitoring in 30 days (previously 16) |
| 99454 | RPM | Device supply with daily recording or transmission | Data on 16 or more days in 30 |
| 99445 New 2026 | RPM | Device supply, shorter monitoring | Data on 2–15 days in 30; not with 99454 in the same period |
| 99457 | RPM | Treatment management, first 20 minutes in a calendar month | At least one real-time interactive communication with the patient or caregiver |
| 99458 | RPM | Each additional 20 minutes | Billed with 99457 |
| 99470 New 2026 | RPM | Treatment management, first 10 minutes in a calendar month | Real-time interaction; not with 99457 in the same month |
| 98975 | RTM | Initial set-up and patient education on the device | See the 2026 CPT codebook |
| 98976 / 98977 / 98978 | RTM | Device supply: respiratory / musculoskeletal / cognitive behavioural therapy | Data on 16 or more days in 30 |
| 98984 / 98985 / 98986 New 2026 | RTM | Device supply, shorter monitoring | Data on 2–15 days in 30; not added to the 16-day codes |
| 98980 | RTM | Treatment management, first 20 minutes in a calendar month | At least one real-time interactive communication |
| 98981 | RTM | Each additional 20 minutes | Billed with 98980 |
| 98979 New 2026 | RTM | Treatment management, first 10 minutes in a calendar month | Real-time interaction; not with 98980 in the same month |
| 99490 / 99439 | CCM | First 20 minutes of clinical staff time in a calendar month (the billing practitioner's own time can also count if not used for 99491) / each additional 20 minutes | Two or more chronic conditions; comprehensive care plan; consent |
| 99491 | CCM | First 30 minutes provided personally by the billing practitioner | As 99490, but the practitioner's own time |
| 99424 / 99425 | PCM | First 30 minutes provided personally by the practitioner / each additional 30 minutes | One serious chronic condition; disease-specific care plan; consent |
| 99426 / 99427 | PCM | First 30 minutes of clinical staff time / each additional 30 minutes | As 99424, with clinical staff time |
The new 2026 codes were added in the CY 2026 Physician Fee Schedule final rule. Some payers adopt new codes later than Medicare, or not at all.
Medicare rules that apply to remote monitoring
- Patient consent is required, and must be documented. It can be obtained when the service starts, including by staff under general supervision.
- Only one practitioner can bill remote monitoring for a patient in a 30-day period, and RPM and RTM cannot be billed together for the same patient.
- Monitoring must be medically reasonable and necessary.
- The device must meet the FDA definition of a medical device. For RPM, data must be collected electronically and uploaded automatically.
- RPM or RTM can be billed alongside chronic care, principal care or transitional care management, as long as no time or effort is counted twice.
- Clinical staff can provide services under the general supervision of the billing practitioner.
By practitioner type
Physicians, NPs and PAs
Can generally bill RPM, RTM, CCM and PCM under Medicare when each service's requirements are met.
Physical and occupational therapists
Can bill RTM under Medicare, under therapy rules. RPM, CCM and PCM are generally not available to therapists under Medicare. Check private payers separately.
Chiropractors
Medicare covers only manual manipulation of the spine to correct a subluxation (codes 98940–98942). RTM, RPM, CCM and PCM are not covered for chiropractors under Medicare. Some private payers set their own policies; check each payer's policy before offering it.
Mental and behavioural health
RTM includes cognitive behavioural therapy monitoring codes. Eligibility depends on your license and the payer; behavioural health integration has its own codes not covered here.
Where PatientPower fits today
| Requirement | PatientPower today | Notes |
|---|---|---|
| A care plan agreed with the patient | Supports | Goals and home plan set in the Case Manager, shared with the patient, changes recorded. |
| Patient-reported data between visits | Supports | Daily check-ins and logs, dated, visible to you before the next visit. |
| A record of communications | Supports | Reminders and encouragement are logged with dates (link-only; no health details in emails). |
| Your review of the patient's data | Supports | Your actions on a patient's record are logged with dates in the secure audit trail. |
| Documented consent to the monitoring service | Supports | Record consent per service (how it was given, the date, whether cost-sharing was explained) on each patient's 📡 Monitoring & time log page in the Case Manager. |
| Minutes of your time per calendar month | Supports | Log minutes, the activity and whether you or clinical staff did it. Calls and video count as live interactions. PatientPower never estimates minutes from clicks. |
| A monthly summary for each patient | Supports | A printable monthly report: days with check-ins, communications, your review activity and logged time, shown against each service's requirements as met, not met or not recorded. For 99490 the report counts clinical staff minutes only; count your own time toward 99490 from your records. Items PatientPower cannot see, such as device data or whether the patient's conditions qualify, are always shown as not recorded for you to confirm from your own records. It is documentation support, not a claim. |
| Real-time interactive communication | Not provided | Phone or video calls happen outside PatientPower; log them in the time log so they appear in the monthly report. |
| An FDA-defined medical device that collects and transmits data | Not provided | PatientPower does not connect to devices or record device data. RPM and RTM need a qualifying device from another source. |
More for practices: PatientPower for practitioners · RPM vs RTM vs CCM billing codes explained (2026).
Before you bill: a checklist
- Confirm the payer covers the service for your license type and in your state.
- Confirm the service is medically necessary for this patient and the condition qualifies (for example, two chronic conditions for CCM).
- Record the patient's consent before you start, including any cost-sharing they may owe.
- For RPM or RTM, make sure a qualifying medical device collects and transmits the data, and count the days with data.
- Log your time and what you did, and log any live call or video with the patient.
- Check that no other practitioner is billing remote monitoring for the same patient in the same period, and that no time is counted twice.
- Have a certified coder review your first claims and your documentation template.
Sources
- CMS Medicare Learning Network, Telehealth & Remote Monitoring (MLN901705), December 2025: remote monitoring definition, FDA device, consent, one practitioner per 30 days, 2–15 and 16+ day rule.
- CMS Medicare Learning Network, Chronic Care Management Services (MLN909188), June 2025: CCM time rules, including billing-practitioner time toward 99490 when not used for 99491.
- CY 2026 Physician Fee Schedule final rule (Federal Register, 5 November 2025): new codes 99445, 99470, 98979, 98984–98986.
- CMS, Remote Patient Monitoring: Use & Bill Correctly.
- CMS, Medicare Benefit Policy Manual, Chapter 15, §240 (chiropractic services).
- American Physical Therapy Association, Practice Advisory: RTM Codes Under Medicare.
- CMS, Physician Fee Schedule look-up tool for current payment amounts by location.
CPT is a registered trademark of the American Medical Association. Code descriptions above are short summaries, not the official descriptors. PatientPower is software that helps licensed practitioners organise care and share educational information; it does not diagnose or treat.