CPT codes, rates, billing frequency, and concurrent billing rules for all CMS remote care programs. Based on the CY 2026 Medicare Physician Fee Schedule Final Rule.
Which CMS remote care programs can be billed for the same patient in the same month?
| RPM | RTM | CCM | BHI | APCM | |
|---|---|---|---|---|---|
| RPM | — | ✗ | ✓ | ✓ | ✓ |
| RTM | ✗ | — | ✓ | ✓ | ✓ |
| CCM | ✓ | ✓ | — | ✓ | ✗ |
| BHI | ✓ | ✓ | ✓ | — | ✓ |
| APCM | ✓ | ✓ | ✗ | ✓ | — |
✓ = Can be billed concurrently ✗ = Mutually exclusive — = Same program
Source: CY 2026 Medicare Physician Fee Schedule Final Rule. National non-facility averages.
CPT codes, rates, and billing frequency for all CMS remote care programs
Based on CY 2026 Medicare Physician Fee Schedule Final Rule — National non-facility averages
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 99453 | Patient onboarding — device setup & education | $21.71 | One-time |
| 99445 New 2026 | RPM technology, 2–15 days of readings | $52.11 | Monthly |
| 99454 | RPM technology, 16–30 days of readings | $52.11 | Monthly |
| 99470 New 2026 | Clinical monitoring, first 10 min | $26.05 | Monthly |
| 99457 | Clinical monitoring, first 20 min | $51.77 | Monthly |
| 99458 | Additional monitoring, +20 min (max 2×/month) | $41.42 | Monthly |
Monthly revenue range: $120–$210/patient. New 2-day minimum (99445) opens acute and episodic monitoring — GLP-1 weight management, post-discharge follow-ups, medication titration.
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 98975 | Patient onboarding — device setup & education | $21.71 | One-time |
| 98984 New 2026 | RTM respiratory, 2–15 days | $52.11 | Monthly |
| 98976 | RTM respiratory, 16–30 days | $52.11 | Monthly |
| 98985 New 2026 | RTM musculoskeletal, 2–15 days | $52.11 | Monthly |
| 98977 | RTM musculoskeletal, 16–30 days | $52.11 | Monthly |
| 98979 New 2026 | Clinical monitoring, first 10 min | $26.39 | Monthly |
| 98980 | Clinical monitoring, first 20 min | $54.11 | Monthly |
| 98981 | Additional monitoring, +20 min (max 2×/month) | $41.42 | Monthly |
RTM extends monitoring to orthopedics, rehab, PT/OT, behavioral health. Cannot bill RPM + RTM concurrently for same patient/month.
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 99490 | Clinical staff, first 20 min | $66.13 | Monthly |
| 99439 | Additional clinical staff, +20 min (max 2×) | $50.44 | Monthly |
| 99491 | Physician/QHP, first 30 min | $89.18 | Monthly |
| 99437 | Additional physician/QHP, +30 min (max 2×) | $63.13 | Monthly |
| 99487 | Complex CCM, 60 min clinical staff | $144.29 | Monthly |
| 99489 | Additional complex CCM, +30 min | $78.16 | Monthly |
Requires 2+ chronic conditions expected to last 12+ months. 24/7 patient access required. Cannot bill concurrently with APCM.
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 99484 | General BHI, 20+ min | $57.45 | Monthly |
| 99492 | CoCM initial month, 70+ min | $160.32 | Monthly |
| 99493 | CoCM subsequent months, 60+ min | $144.96 | Monthly |
| 99494 | Additional CoCM, +30 min | $61.46 | Monthly |
| G0568 New 2026 | Psychiatric CoCM add-on for APCM (initial month) | $160.32 | Monthly |
| G0569 New 2026 | Psychiatric CoCM add-on for APCM (subsequent months) | $144.96 | Monthly |
| G0570 New 2026 | General BHI add-on for APCM | $57.45 | Monthly |
New G-codes (G0568–G0570) pair BHI directly with APCM — no separate time documentation required.
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| G0556 | Level 1 — 0–1 chronic conditions | $16.37 | Monthly |
| G0557 | Level 2 — 2+ chronic conditions | $53.78 | Monthly |
| G0558 | Level 3 — QMB with 2+ chronic conditions | $117.24 | Monthly |
No time-based documentation threshold. Stacks with RPM, RTM, and BHI. Cannot bill with CCM. Primary care only.
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 99424 | Physician/QHP, first 30 min | $87.51 | Monthly |
| 99425 | Additional physician/QHP, +30 min | $61.46 | Monthly |
| 99426 | Clinical staff, first 30 min | $67.80 | Monthly |
| 99427 | Additional clinical staff, +30 min | $54.11 | Monthly |
Requires 1 serious chronic condition (expected to last at least 3 months).
| CPT Code | Description | Rate | Frequency |
|---|---|---|---|
| 99495 | Moderate complexity — contact within 2 biz days, visit within 14 days | $220.11 | One-time |
| 99496 | High complexity — contact within 2 biz days, visit within 7 days | $298.60 | One-time |
30-day post-discharge program. One-time billing per transition.
Download the complete guide as PDF for offline reference. All rates are national non-facility Medicare averages from the CY 2026 Physician Fee Schedule Final Rule and vary by geographic locality. This is not billing advice. CPT® is a registered trademark of the American Medical Association.
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