A closer look at measurement
Remote patient monitoring for small practices in 2026: codes, platforms and build or buy
What changed in 2026 Medicare RPM billing, how full-service, software and device-API platforms differ, and when a small practice should build its own monitoring app.
Why 2026 changed the math for small programs
Remote patient monitoring (RPM) used to require at least 16 days of readings in a 30-day period before a practice could bill for device supply, and 20 minutes of management time before the first management code applied. Both thresholds excluded many patients whose engagement was real but uneven.
The CPT 2026 code set and the 2026 Medicare Physician Fee Schedule added codes for shorter periods: 99445 for device supply with 2 to 15 days of data in 30 days, and 99470 for the first 10 minutes of treatment management in a calendar month with an interactive communication. The existing codes continue: 99453 for setup and education, 99454 for 16 to 30 days of data, 99457 for the first 20 minutes and 99458 for each additional 20.
Sources: AMA: CPT 2026 code set · CMS: 2026 Physician Fee Schedule final rule · CCHP summary of the 2026 final rule (PDF)
RPM billing codes in 2026
Payment amounts vary by locality. Look up current rates in the CMS Physician Fee Schedule tool rather than relying on vendor estimates.
| Code | What it covers | New in 2026? |
|---|---|---|
| 99453 | Initial setup and patient education | No |
| 99445 | Device supply with 2–15 days of data in 30 days | Yes |
| 99454 | Device supply with 16–30 days of data in 30 days | Revised |
| 99470 | First 10 minutes of management in a month, with interactive communication | Yes |
| 99457 | First 20 minutes of management in a month | No |
| 99458 | Each additional 20 minutes | No |
What is proposed for 2027
The proposed 2027 fee schedule, released in July 2026, would change RPM again, including a separately reportable initiating visit, limiting remote therapeutic monitoring to established patients, requirements about staff employment and a lower valuation of device costs. These are proposals; wait for the final rule before changing staffing plans.
Three kinds of RPM platform
Vendors differ less in dashboards than in how much of the work they do. The market has also consolidated: Health Recovery Solutions acquired Rimidi in March 2026, ChartSpan acquired Validic in June 2026, and Accuhealth became TelliHealth after merging with Signallamp.
| Type | Examples | What you still do | Suits |
|---|---|---|---|
| Full service: devices, software and monitoring staff | HealthSnap, 100Plus, TelliHealth | Clinical decisions and billing sign-off | Practices without spare nursing time |
| Software and devices, your staff monitor | Prevounce | Daily review, outreach and time logging | Practices with a care manager |
| Devices and data API through partners | Tenovi, Validic | Choose or build the software layer | Practices or partners building their own program |
Sources: HealthSnap · 100Plus · TelliHealth rebrand · Prevounce RPM software · Tenovi · Rimidi acquisition · ChartSpan acquires Validic
When building your own makes sense
Buying is usually right for a standard hypertension or diabetes program. Building becomes reasonable when your protocol is specific: a post-surgical recovery check-in, a pharmacist-led anticoagulation program or a coaching model with its own thresholds. The monitoring logic is then yours, and you can pair it with cellular devices from a device-API vendor.
App builders have lowered the cost of trying this. Panaceum, for example, offers diabetes remote monitoring, hypertension coaching and post-surgery check-in templates with clinician and patient views. It is in early access, so HIPAA apps currently run on synthetic data until its HIPAA hosting launches; a practice can design and test the workflow now and move it to real patients later.
Sources: Panaceum · Tenovi device API
A checklist for any RPM program
Whichever platform you choose, the same operational basics decide whether a program is safe and billable.
- Document patient consent and who is responsible for monitoring.
- Have clinicians set alert thresholds, and decide how out-of-hours readings are handled.
- Track days of data per patient so you bill 99445 or 99454 correctly.
- Log management time and interactive communications as they happen.
- Confirm that every vendor that touches patient data has signed a business associate agreement.
- Review each patient’s continued need for monitoring at regular intervals.
Questions about this guide
Can I bill RPM for patients who send only a few days of readings?
From 2026, code 99445 covers device supply when there are 2 to 15 days of data in a 30-day period. Check payer policies beyond Medicare.
Do I need an outside company to run RPM?
No. Some practices monitor with their own staff using software and cellular devices; others outsource monitoring. The right choice depends on your staff time.