TELEHEALTH CLINICAL SOLUTIONS
Remote Patient Monitoring (RPM)
Remote Physiological Monitoring (RPM) supports the daily collection and real time review of patient vital signs from the comfort of the patient’s home. We can monitor changes in Blood Pressure, Resting Heart Rate, Blood Glucose, Blood Oxygen, Weight Loss/Gain, and Temperature. Our remote care team monitor the incoming readings daily, email, text, and call patients monthly. We document all findings in the patient’s chart and escalate any concerns to the physician-led care team for rapid response. RPM data serve to inform timely clinical decision-making and enable the Physician-led care team to render optimal disease management.
RPM has the potential to fundamentally transform chronic disease management and patient–health care provider interactions. RPM programs are gaining widespread acceptance among patients and health care providers. Our monthly RPM check-in calls combined with the daily data collection lead to improved adherence to care plans by patients and the favorable impact on health care quality and clinical outcomes – in line with in-person care. https://www.jmir.org/2025/1/e70422
| CPT Code | Requirements | Basic Description (2026) | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 99453 | One-time setup | Initial setup and patient education on use of RPM device(s); | $22 one-time |
| 99445 | 2–15 days | Device supply and data transmission for 2–15 days of RPM readings in a 30-day period. | $47 pppm |
| 99454 | 16+ days | Device supply and data transmission for 16 or more days of RPM readings in a 30-day period. | $47 pppm |
| 99470 | First 10–19 min | First 10–19 minutes of clinical staff/physician/QHP time in a calendar month, requiring at least one real-time interactive communication with the patient/caregiver. Cannot be billed with 99457 in the same month. | $26 pppm |
| 99457 | First 20 min | RPM treatment management; first 20 minutes of clinical staff/physician/QHP time per calendar month, requiring interactive communication. | $52 pppm |
| 99458 | Each additional 20 min | Add-on RPM treatment management; each additional 20 minutes of clinical staff/physician/QHP time in the same month, requiring interactive communication. | $41 pppm |
Chronic Care Management (CCM)
Chronic Care Management (CCM) is a structured healthcare service designed to support patients with two or more chronic health conditions. CCM brings structure to patient care delivered remotely – between office visits. CCM is covered by Medicare and most private insurance providers.
Medicare introduced CCM more than ten years ago to incentivize healthcare providers to maintain monthly contact with patients by phone, email, and text. This high-touch, remote care model improves clinical outcomes through enhanced patient engagement – leading to increased patient adherence to prescribed medications and other guidance outlined in their physician care plan. Adherence to prescribed medications is associated with improved clinical outcomes for chronic disease management and reduced mortality from chronic conditions. Conversely, nonadherence is associated with higher rates of hospital admissions, suboptimal health outcomes, increased morbidity and mortality, and increased health care costs. http://dx.doi.org/10.15585/mmwr.mm6645a2
During our monthly check-in calls, patients share changes to their health – from subtle-to-severe. Early detection by our remote monitoring team leads to early intervention by our physician-led care teams.
| CPT Code | Time per month | Basic Description | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 99490 | First 20 minutes of clinical staff time | Chronic care management for patients with ≥2 chronic conditions; non-face-to-face clinical staff time directed by a physician/QHP, with a comprehensive care plan established, implemented, revised, or monitored. | $66.00 pppm |
| 99439 | Additional 20 minutes of clinical staff time | Add-on CCM code for each additional 20 minutes of non-face-to-face clinical staff time in the same month; billed only in conjunction with 99490. | $50.00 pppm |
Remote Therapeutic Monitoring (RTM)
Remote Therapeutic Monitoring (RTM) supports the daily collection, timely review and actionable analysis of a patient’s non-physiological data. This includes monitoring a patient’s adherence to prescribed medication and other critical aspects of their physician’s care plan. Using mobile-based apps, our remote care team collect patient-reported changes to their symptoms, pain level, mood, mental cognition, and physical mobility. All from the comfort of the patient’s home, office, or while on the go.
RTM data provides critical insights into which therapies and medications are working or not working. By informing care decisions in real time, physician-led care teams intervene early to improve outcomes. For example, RTM integration in care plan management delivers profound reductions in acute care utilization for high-risk cohorts resulting in an 83% reduction in hospital readmissions for patients with heart failure, a 50% reduction in all-cause cardiovascular ER visits, 5.2x more frequent proactive clinical drug adjustments, and 43% improvement in medication compliance for statin therapy.
| CPT Code | Time per Month | Basic Description (2026) | 2026 Reimbursement per patient per month (pppm) |
|---|---|---|---|
| 98975 | One-time setup | Initial setup and patient education for RTM device(s); once per 30-day episode when required days of data are met. | $21 one-time |
| 98978 | CBT / behavioral device supply, 16–30 days | RTM device supply for cognitive behavioral therapy (therapy adherence/response, digital CBT), once every 30 days when criteria met. | $50 pppm |
| 98980 | First 20 min | RTM treatment management services; requiring at least one interactive communication with patient/caregiver. | $54 pppm |
| 98981 | Each additional 20 min | Add-on RTM treatment management; each additional 20 minutes in same month, same requirements as 98980. | $41 pppm |
Prinicpal Care Management (PCM)
Principal Care Management (PCM) is a set of non face‑to‑face care management services for patients who have a single serious or high‑risk chronic condition that is expected to last at least 3 months and requires focused, ongoing management and coordination by one clinician. It is similar to Chronic Care Management but is centered on monitoring one (principal) condition, rather than multiple conditions.
| CPT Code | Description | Est. 2026 Medicare Payment |
|---|---|---|
| 99424 | First 30 minutes of PCM per month, provided by MD or QHCP | $82 pppm |
| 99425 | Each additional 30 minutes of PCM per month add-on to 99424 | $57 pppm |
| 99426 | First 30 minutes of PCM per month by clinical staff under general supervision of MD or QHCP | $65 pppm |
| 99427 | Each additional 30 minutes of PCM per month add-on to 99426 | $54 pppm |
Resources
Remote Patient Monitoring (RPM)
Chronic Care Management (CCM)
