Short answer: RPM (99453, 99454, 99445, 99457, 99458, 99470) pays for physiologic readings, such as blood pressure, from a connected medical device. RTM (98975-98981, 98984-98986) pays for therapy data such as musculoskeletal, respiratory or CBT status, which can be self-reported but must still be sent by a connected medical device. CCM (99490, 99439, 99491) pays for monthly care-management time for patients with two or more chronic conditions. It needs no device but does need consent, a care plan and certified EHR technology.
Remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) both pay for data a patient collects at home, and both require a connected medical device that transmits the data; CMS's remote monitoring booklet lists, among its requirements, that the device meet the FDA definition of a medical device. Chronic care management (CCM) pays for monthly care-management time, with no device. Under Medicare, a practice can bill either RPM or RTM alongside CCM for the same patient, but not RPM and RTM together, and no minute can be counted twice.
This page summarises Medicare (CMS) rules as published for 2026. It is general information, not billing, coding or legal advice. Private insurers, Medicare Advantage plans and state Medicaid programs set their own rules. Whether a service is billable depends on your license, your state, the payer, the patient, and how the service is delivered and documented. Confirm with the payer and a certified coder before you bill.
The three services side by side, under Medicare rules for 2026. The sources for each row are listed at the end of the page.
| Remote physiologic monitoring (RPM) | Remote therapeutic monitoring (RTM) | Chronic care management (CCM) | |
|---|---|---|---|
| What is monitored or managed | Physiologic readings such as blood pressure, weight, blood glucose or oxygen saturation | Non-physiologic therapy data: musculoskeletal or respiratory status, cognitive behavioural therapy, adherence and response to treatment | Two or more chronic conditions expected to last at least 12 months, or until death, that put the patient at significant risk |
| Device required? | Yes. A medical device that meets the FDA definition must collect the data and upload it automatically | Yes. The data can be self-reported, but a connected medical device must send it | No |
| Established patient? | Required | Not required | Initiating visit required for new patients and for patients not seen in the past year |
| Who can bill under Medicare | Physicians and other practitioners who can bill evaluation and management (E/M) services | Physicians and other E/M-eligible practitioners; also physical and occupational therapists and speech-language pathologists, under a therapy plan of care, for the RTM codes CMS designates 'sometimes therapy' | Physicians, NPs, PAs, clinical nurse specialists and certified nurse-midwives |
| Time period | Device days are counted per 30 days; treatment-management minutes per calendar month | Device days are counted per 30 days; treatment-management minutes per calendar month | Minutes per calendar month |
| Main codes | 99453, 99454, 99445, 99457, 99458, 99470 | 98975, 98976-98978, 98984-98986, 98980, 98981, 98979 | 99490, 99439, 99491, 99437 (complex CCM: 99487, 99489) |
The table covers the main device-supply, set-up and treatment-management codes. The remote monitoring family in the CY 2026 rule also includes 99091, 99473 and 99474, which are not covered here. These are short summaries only. The full CPT descriptors are published by the American Medical Association, and CMS adopted the 2026 CPT codebook's remote monitoring descriptors and guidelines in the CY 2026 Physician Fee Schedule final rule. Payment amounts vary by location and setting, so none are 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 to 30 days in 30 |
| 99445 (new 2026) | RPM | Device supply, shorter monitoring | Data on 2 to 15 days in 30; bill either 99445 or 99454 for the period, not both |
| 99457 | RPM | Treatment management, first 20 minutes in a calendar month | Includes a live, interactive communication with the patient or caregiver |
| 99458 | RPM | Each additional 20 minutes | Billed after 99457 |
| 99470 (new 2026) | RPM | Treatment management, first 10 minutes in a calendar month | Live, interactive communication; choose 99470 or 99457 for the month, not both |
| 98975 | RTM | Initial set-up and patient education on the device | Check the 2026 CPT codebook for the minimum days of monitoring |
| 98976 / 98977 / 98978 | RTM | Device supply: respiratory / musculoskeletal / cognitive behavioural therapy | Data on 16 to 30 days in 30 |
| 98984 / 98985 / 98986 (new 2026) | RTM | Device supply, shorter monitoring: respiratory / musculoskeletal / cognitive behavioural therapy | Data on 2 to 15 days in 30; bill either the shorter-monitoring code or the matching 16-to-30-day code for the period, not both |
| 98980 | RTM | Treatment management, first 20 minutes in a calendar month | Includes a live, interactive communication with the patient or caregiver |
| 98981 | RTM | Each additional 20 minutes | Billed after 98980 |
| 98979 (new 2026) | RTM | Treatment management, first 10 minutes in a calendar month | Live, interactive communication; choose 98979 or 98980 for the month, not both |
The CY 2026 Physician Fee Schedule final rule, published in the Federal Register on 5 November 2025, adopted new CPT codes for shorter monitoring periods and shorter treatment management. Before 2026, the device-supply codes required data on at least 16 days in a 30-day period, and treatment management started at 20 minutes. From 2026 there are device-supply codes for 2 to 15 days of data (99445 for RPM; 98984, 98985 and 98986 for RTM) and treatment-management codes for the first 10 minutes in a month (99470 for RPM; 98979 for RTM).
CMS explained in the rule that the 2-to-15-day codes and the 16-to-30-day codes are not a base code plus an add-on: you bill one of them, depending on how many days of data were transmitted in the 30 days. The 10-minute and 20-minute treatment-management codes work the same way: you choose the one that fits the time spent that month, and add 99458 or 98981 only for time beyond the first 20 minutes. The set-up codes changed too. CMS confirmed it is adopting the CPT change under which the set-up code 99453 needs 2 days of monitoring in a 30-day period instead of 16.
On the live-communication requirement, CMS adopted the CPT wording that the treatment-management codes require a live, interactive communication with the patient or caregiver, which counts toward total time but need not make up all of it. CMS did not list further exclusions, so check the CPT guidance and your payer on which kinds of communication qualify. Some payers adopt new codes later than Medicare, or not at all.
CCM codes are based on time per calendar month and on who does the work. 99490 covers the first 20 minutes and +99439 each additional 20 minutes; they count clinical staff time, and the billing practitioner's own time can also count if it is not used to report 99491. 99491 covers the first 30 minutes provided personally by the billing physician or other qualified health care professional, and +99437 each additional 30 minutes; only the practitioner's personal time counts toward them. Complex CCM (99487 for the first 60 minutes of clinical staff time, +99489 for each additional 30 minutes) also requires moderate- or high-complexity medical decision-making. You cannot report non-complex and complex CCM for the same patient in the same month.
Clinical staff time for 99490, 99439, 99487 and 99489 is billed under general supervision, so the billing practitioner does not have to be physically present. Time counted toward a CCM code cannot also be counted toward any other billed code.
CMS's chronic care management booklet (MLN909188) lists several requirements beyond time. The patient needs two or more chronic conditions expected to last at least 12 months, or until death, that put them at significant risk of death, acute exacerbation or decompensation, or functional decline. New patients, and patients not seen in the past year, need an initiating visit: a face-to-face E/M visit, annual wellness visit or initial preventive physical exam at which CCM is discussed.
Before billing, you must get the patient's written or verbal consent and document that you told them: that the service is available; that they may owe cost-sharing; that only one practitioner can bill CCM in a month; and that they can stop at any time, effective at the end of the calendar month. You must also document that you explained this and whether the patient accepted or declined. Consent is needed only once unless the patient switches to a different CCM practitioner. The practice must also record the patient's demographics, problems, medications and medication allergies using certified electronic health record (EHR) technology. It must keep a patient-centred electronic comprehensive care plan that is available inside and outside the practice, and give patients 24/7 access to a practitioner or clinical staff for urgent needs.
Principal care management (PCM, codes 99424 to 99427) is the single-condition counterpart, for one high-risk chronic condition expected to last at least 3 months. PCM cannot be billed for less than 30 minutes in a calendar month, and needs a new initiating visit after a year. Medicare also pays for advanced primary care management (APCM, G0556 to G0558), a monthly bundle that combines elements of PCM, transitional care management, CCM and other services and does not require counting minutes. Because APCM bundles those services, check the CMS and CPT rules before billing APCM and any of them for the same patient in the same month.
CMS's Telehealth & Remote Monitoring booklet (MLN901705, December 2025) sets out the shared rules. Only physicians and other practitioners eligible to bill E/M services can bill remote monitoring, and RPM must monitor an acute or chronic condition. Only one practitioner can bill remote monitoring for a patient in a 30-day period. RPM and RTM cannot be billed together. Monitoring must be reasonable and necessary. Patient consent is required, and can be obtained when the service starts, including by auxiliary staff under general supervision. Auxiliary personnel can provide remote monitoring under the billing practitioner's general supervision.
Either RPM or RTM, but not both, can be billed in the same period as CCM, transitional care management, behavioural health integration, PCM or chronic pain management, as long as time and effort are not counted twice. During a global surgery period, remote monitoring can be billed only for an underlying condition not linked to the procedure.
Therapists are the exception to the E/M rule for RTM. In the CY 2022 rule CMS designated certain RTM codes as 'sometimes therapy', and the CY 2026 rule gives the same designation to the new codes 98979, 98984 and 98985. That means physicians and certain non-physician practitioners can bill them outside a therapy plan of care. When physical or occupational therapists, therapy assistants under their supervision, or speech-language pathologists furnish them, they are billed under a therapy plan of care with the therapy plan-of-care modifier. When the de minimis standard is met, services by physical and occupational therapy assistants generally also need the CQ or CO modifier on the treatment-management code 98979, but CMS says CQ and CO do not apply to the device codes 98984 and 98985. Medicare covers chiropractic services only for manual manipulation of the spine to correct a subluxation. Chiropractors are not among the E/M-eligible remote monitoring billers or the practitioners CMS lists for CCM, so they cannot bill RPM, RTM or CCM to Medicare. Some private payers set their own policies.
PatientPower records documentation; it never decides whether a service is billable. In the Case Manager, each patient's Monitoring & time log page records consent per service (how it was given, the date, and whether cost-sharing was explained). It also logs the minutes you or clinical staff enter, with the activity and whether a call or video took place. It produces a printable monthly summary of check-in days, communications, your review activity and logged time. The summary lists each service's requirements and shows each one as met, not met or not recorded, based only on what was entered in PatientPower. For example, it shows met when a consent record exists or when the minutes you logged reach a code's time threshold; for 99490 the summary counts clinical staff minutes only, so count your own time toward 99490 from your records. Device, device-day, patient-eligibility, care-plan and other-practitioner items always show not recorded, because PatientPower cannot see or judge them. Met means only that what was entered in PatientPower reaches the listed item; it is not a billing determination, and the summary never says a service is billable. PatientPower never estimates minutes from clicks, and the summary is documentation support, not a claim.
Be clear about the limits. PatientPower does not receive data directly from devices or transmit device data, so it does not meet the device requirement for RPM or RTM; that needs a qualifying device from another source. Patient check-in days in PatientPower are self-reported entries, not device transmissions. Readings a patient types in, photographs or brings in from MyChart (when the patient connects their MyChart account), such as vital signs, are not device transmissions either, so none of them count toward the device-day codes. Automated reminders and encouragement messages are not live, interactive communication. Live calls and video visits happen outside PatientPower, so log them in the time log. PatientPower is not certified EHR technology, so CCM's requirement to record core patient data in certified EHR technology has to be met elsewhere. Using PatientPower does not make any service billable on its own. PatientPower's privacy policy says Business Associate Agreements (BAAs) are available for practitioner accounts. CPT is a registered trademark of the American Medical Association.
| Requirement | PatientPower today |
|---|---|
| Documented patient consent to each service | Records that consent was given, how, when, and whether cost-sharing was explained; record the other required disclosures in the note or your own record |
| Minutes per calendar month, and who did the work | Logs minutes as entered, by practitioner or clinical staff; never estimated |
| Record of communications and the practitioner's review | Reminders, encouragement and review activity are logged with dates; automated messages are not live communication |
| Live, interactive communication | Not provided; log calls or video held elsewhere |
| FDA-defined medical device that collects and sends data | Not provided; RPM and RTM need a device from another source |
| Certified EHR technology (CCM) | Not provided; PatientPower is not certified EHR technology |
| Decision that a service is billable | Never made; the summary shows met, not met or not recorded from entries only, never billable |
Related: Remote monitoring & billing · PatientPower for practitioners.
RPM codes pay for physiologic readings, such as blood pressure, from a connected medical device. RTM codes pay for therapy data, such as musculoskeletal, respiratory or CBT status, which can be self-reported but is still sent by a connected medical device. CCM codes pay for monthly care-management time for patients with two or more chronic conditions. They need no device, but do need consent, a care plan and certified EHR technology.
The CY 2026 Physician Fee Schedule final rule adopted 99445 (RPM device supply, 2 to 15 days of data in 30) and 99470 (RPM treatment management, first 10 minutes). For RTM it adopted 98984, 98985 and 98986 (device supply, 2 to 15 days, for respiratory, musculoskeletal and cognitive behavioural therapy) and 98979 (treatment management, first 10 minutes).
No. CMS says the 2-to-15-day and 16-to-30-day device-supply codes are not additive; you bill one of them for the number of days of data in the 30-day period. The same applies to 99470 and 99457: choose one for the month.
Under Medicare, yes. You can bill RPM or RTM, but not both, in the same period as CCM, as long as no time or effort is counted twice. Only one practitioner can bill remote monitoring for a patient in a 30-day period.
99490 covers the first 20 minutes of CCM time in a calendar month and +99439 each additional 20 minutes. They count clinical staff time, plus the billing practitioner's own time if it is not used for 99491. 99491 (first 30 minutes) and +99437 (each additional 30 minutes) count only time the billing practitioner spends personally.
Yes. CMS says RTM data can be self-reported, but a connected medical device transmits it. Answers typed into an app, without a connected medical device sending the data, do not meet that requirement.
No. PatientPower records consent, entered minutes and communications, and prints a monthly summary showing each requirement as met, not met or not recorded from those entries. It never says a service is billable, does not receive data directly from devices, and is not certified EHR technology. Confirm coverage with the payer and a certified coder.
No. Medicare covers chiropractic services only for manual manipulation of the spine to correct a subluxation, and only E/M-eligible practitioners (plus therapists, for RTM) can bill remote monitoring. Some private payers have their own policies, so check each one.