Telehealth Clinical Solutions
Clinical Solutions
Comprehensive remote care services with transparent CPT codes and reimbursement rates for 2026.
Remote Patient Monitoring (RPM)
Remote patient monitoring (RPM) is a healthcare delivery method that uses digital technology to monitor patients outside traditional clinical settings, such as at home. RPM involves the use of connected medical devices—like blood pressure monitors, blood glucose meters, pulse oximeters, weight scales, and wearable sensors—to collect a wide range of physiological and health data from patients. This data is then electronically transmitted to healthcare providers for ongoing assessment and management.
2026 RPM Codes — Standard Compliance
2-15 days of monitoring data with time-based billing codes
| CPT Code | Description | Rate |
|---|---|---|
| 99453 | Initial device setup & patient orientation (one-time fee). Billing prerequisite tied to the first month 99445 is billed. | $22 |
| 99445 | 2-15 separate days of monitoring data collection and review per 30 days. Monitoring data can be accumulated from one or multiple devices. | $52 |
| 99457 | First 20 min of monitoring/care per 30 days. Billing eligibility requires one synchronous phone call with the patient, caregiver, or other authorized person. | $52 |
| 99458 | Additional 20 min of monitoring/care per 30 days. Add-on code to 99457 for each additional 20 min. May be billed more than once per 30 day period. | $41 |
2026 RPM Codes — Alternative Compliance
16+ days of monitoring data with simplified time code
| CPT Code | Description | Rate |
|---|---|---|
| 99454 | 16 or more separate days of monitoring data collection and review per 30 days. Monitoring data can be accumulated from one or multiple devices. | $52 |
| 99470 | 10-19 min of monitoring/care per 30 days. No add-on codes for additional monitoring/care time. | $26 |
Chronic Care Management (CCM)
Chronic Care Management (CCM) is a structured healthcare service designed to support individuals with two or more chronic health conditions that are expected to last at least 12 months or until the patient's death, or that place the patient at significant risk of death, acute exacerbation, or functional decline. CCM is covered by Medicare and most private insurance providers.
2026 Chronic Care Management (CPT) Codes
| CPT Code | Description | Rate |
|---|---|---|
| 99490 | First 20 min of monitoring/care per 30 days. Billing eligibility requires one synchronous phone call with the patient, caregiver, or other authorized person. | $66 |
| 99439 | Additional 20 min of monitoring/care per 30 days. Add-on code to 99490 for each additional 20 min. May be billed more than once per 30 day period. | $50 |
Transitional Care Management (TCM)
Transitional Care Management (TCM) services are a set of structured medical and care-coordination activities that support a patient's safe transition from an inpatient or facility setting (such as a hospital or skilled nursing facility) back to their home, assisted living facility, or other community setting, usually over a 30-day period after discharge without a gap in services. TCM is designed for patients whose medical and/or psychosocial problems require moderate or high complexity medical decision making during this transition period. The main goals are to reduce complications and readmissions, improve continuity of care, and help the patient successfully reintegrate into home or community living.
2026 Transitional Care Management (TCM) Codes
| CPT Code | Description | Rate |
|---|---|---|
| 99495 | Moderate complexity, visit ≤14 days post-discharge | $201-$202 |
| 99496 | High complexity, visit ≤7 days post-discharge | $273 |
Remote Therapeutic Monitoring (RTM)
Remote Therapeutic Management (RTM) is a healthcare service that uses digital technology to remotely monitor and manage a patient's therapy, particularly for chronic conditions affecting the musculoskeletal or respiratory systems. The primary focus of RTM is on collecting and assessing non-physiological patient data—such as symptoms, therapy adherence, medication response, and self-reported outcomes—rather than physiological metrics like blood pressure or glucose levels.
2026 RTM Codes — Standard Compliance
2-15 days of monitoring data with time-based billing codes
| CPT Code | Description | Rate |
|---|---|---|
| 98975 | Initial device or mobile app setup & patient orientation (one-time fee). Billing prerequisite tied to the first eligible month for 98984, 98985, 98976, or 98977. | $21 |
| 98984 | 2-15 separate days of monitoring data collection and review per 30 days (Respiratory). Monitoring data can be accumulated from one or multiple devices or mobile apps. | $47 |
| 98985 | 2-15 separate days of monitoring data collection and review per 30 days (Musculoskeletal). Monitoring data can be accumulated from one or multiple devices or mobile apps. | $40 |
| 98980 | First 20 min of monitoring/care per 30 days. Billing eligibility requires one synchronous phone call with the patient, caregiver, or other authorized person. | $54 |
| 98981 | Additional 20 min of monitoring/care per 30 days. Add-on code to 98980 for each additional 20 min. May be billed more than once per 30 day period. | $41 |
2026 RTM Codes — Alternative Compliance
16+ days of monitoring data with simplified time code
| CPT Code | Description | Rate |
|---|---|---|
| 98976 | 16 or more separate days of monitoring data collection and review per 30 days (Respiratory). Monitoring data can be accumulated from one or multiple devices or mobile apps. | $47 |
| 98977 | 16 or more separate days of monitoring data collection and review per 30 days (Musculoskeletal). Monitoring data can be accumulated from one or multiple devices or mobile apps. | $40 |
| 98979 | 10-19 min of monitoring/care per 30 days. No add-on codes for additional monitoring/care time. | $26 |
Principal Care Management (PCM)
Principal Care Management (PCM) is a healthcare service focused on patients with a single high-risk chronic condition that requires comprehensive care management. Unlike CCM which requires two or more chronic conditions, PCM is designed for patients whose single condition requires frequent medical attention and ongoing management.
2026 Principal Care Management (PCM) Codes
| CPT Code | Description | Rate |
|---|---|---|
| 99426 | First 30 min of monitoring/care per 30 days. Billing eligibility requires one synchronous phone call with the patient, caregiver, or other authorized person. | $62 |
| 99427 | Additional 30 min of monitoring/care per 30 days. Add-on code to 99426 for each additional 30 min. May be billed more than once per 30 day period. | $48 |
Ready to Implement These Services?
Contact us to learn how KaiCare Ai can help your practice implement RPM, CCM, TCM, RTM, and PCM services.