RPM CPT Codes & Reimbursement Rates

Remote Patient Monitoring (RPM) services are reimbursed by Medicare and many private insurers using specific CPT codes. These codes represent different parts of the monitoring process — from setup to ongoing care — and determine how your clinic gets paid for providing RPM services.

What Are RPM CPT Codes?

RPM CPT codes are used by healthcare providers to bill for monitoring patients outside the clinic using connected devices. These codes track the time spent setting up the service, collecting and analyzing data, and engaging with patients as part of their care plan.

Clinics must meet certain conditions to bill these codes, including using FDA-cleared devices, obtaining patient consent, and maintaining proper documentation of service time and interaction.

Below is a breakdown of the key RPM-related CPT codes, along with their national average Medicare reimbursement rates for non-facility settings.

CPT CodeDescriptionReimbursement AmountBilling Frequency
99453Initial setup and patient education$19.73One-time per patient
99454Monthly remote monitoring with daily recordings from the connected device$43.02Monthly
99457Monitoring and treatment of the patient for at least 20 minutes throughout the month$47.87Monthly

99458Each additional 20 minutes of monitoring $38.49Monthly

Note: All figures listed above are taken from the official CMS Physician Fee Schedule. You can use that tool to search CPT codes and view the latest national and regional Medicare rates.

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CPT Code Explanations

Billing RPM without understanding the differences between CPT codes can result in lost revenue, denied claims, or compliance errors. Each code is tied to a specific task, setup, device usage, clinical time, or patient interaction and must be billed correctly to meet Medicare rules. If your clinic isn’t using the right codes or missing billable time, you’re leaving reimbursable income on the table.

99453 – Initial Setup and Patient Education

This code is used when a patient is enrolled into the RPM program. It includes setting up the monitoring device and explaining how the patient will use it. This is a one-time billable service per patient.

99454 – Device Supply and Daily Data Transmission

This code covers the supply of the monitoring device and the collection, transmission, and storage of data every day for a 30-day period. It is billed once per calendar month if data is collected for at least 16 days.

99457 – First 20 Minutes of Care Management

This code applies when a healthcare provider spends at least 20 minutes in a calendar month reviewing patient data and interacting with the patient or their caregiver. It includes communication via phone or other synchronous methods.

99458 – Additional 20 Minutes of Care Management

This code is used in addition to 99457 when more time is spent on care management. It can be billed for each additional 20-minute block beyond the first 20 minutes in a given month.

Frequently Asked Questions

Yes. 99457 covers the first 20 minutes of patient interaction. If additional time is documented, you may bill 99458 for each extra 20-minute segment.
Yes. Medicare requires documented patient consent before billing any RPM CPT codes. The consent must be obtained once and kept on file.
99454 requires data transmission on at least 16 days in a 30-day period. If the threshold isn’t met, the code should not be billed for that month.
No. While RPM codes are part of Medicare’s reimbursement structure, many commercial payers and Medicaid programs also cover these services. Coverage and rates vary by plan and region.

Ready to Make RPM Billing Easier?

Managing CPT codes, tracking time, and ensuring compliance can take up valuable clinical hours. CandiHealth helps streamline this process — so your team can focus on patient care while staying fully reimbursed for the work you do.

Whether you’re just starting with RPM or want to improve your current billing workflow, our team can walk you through every step.

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