Medicare RPM Payment Rates in 2026: What Each Code Pays

Medicare pays about $26.05 for the new 10-minute remote patient monitoring management code (CPT 99470) in 2026, and $51.77 for the 20-minute code (CPT 99457). Those are national non-facility amounts, and the OIG found in a September 2024 evaluation that 43% of Medicare and Medicare Advantage enrollees who received monitoring in 2022 had no claim for at least one of the three billable components.

The payment side is now simple to model. The harder part is billing every component for each enrolled patient, because the gaps in the claims record are where most of the lost revenue sits.

What Medicare pays for each RPM code in 2026

Prescribe FIT, in a January 26, 2026 summary of the CMS final rule, lists 2026 national average non-facility payments of $21.71 for device setup and education (CPT 99453), $51.77 for the first 20 minutes of management (CPT 99457) and $41.42 for each added 20 minutes (CPT 99458). CareTrack, in a post dated January 21, 2026 and updated July 2, 2026, lists the same three amounts. Both sources list $26.05 for CPT 99470.

The two sources disagree on the device supply codes. Prescribe FIT lists $52.11 for CPT 99454 and for the new CPT 99445, while CareTrack lists $47.43 for both. A gap of $4.68 per patient per month adds up across a panel, so check the CMS Physician Fee Schedule look-up tool for your locality before you build a budget.

CPT code	What it covers	2026 national non-facility payment	Source
99453	Device setup and patient education	$21.71	Prescribe FIT, CareTrack
99445	Device supply, 2 to 15 days of data in 30 days	$52.11 or $47.43	Prescribe FIT, CareTrack
99454	Device supply, 16 to 30 days of data	$52.11 or $47.43	Prescribe FIT, CareTrack
99470	First 10 minutes of management	$26.05	Prescribe FIT, CareTrack
99457	First 20 minutes of management	$51.77	Prescribe FIT, CareTrack
99458	Each added 20 minutes	$41.42	Prescribe FIT, CareTrack

What changed on January 1, 2026

Before 2026, a practice could bill the device supply code only after the patient sent readings on at least 16 days of a 30-day period. The new CPT 99445 covers 2 to 15 days. The management side had a floor of 20 minutes, and CPT 99470 now lets a practice bill the first 10 minutes. The OIG report describes the 16-reading rule as the standard that applied to the 2022 data.

Divide each payment by its minutes and the rates come out close to each other. CPT 99470 pays about $2.61 per minute, CPT 99457 about $2.59 per minute, and each added 20-minute block under CPT 99458 about $2.07 per minute. A patient who needs 40 minutes of management in a month yields $93.19 from CPT 99457 plus CPT 99458.

The payment rates sit on top of a conversion factor that rose in 2026. CMS's October 31, 2025 fact sheet sets it at $33.40 for clinicians outside an advanced payment model, up 3.26% from $32.35, and at $33.57 for qualifying participants, up 3.77%. CMS also said it would use hospital outpatient data to set rates for some remote monitoring services.

How fast Medicare RPM use grew

The OIG report, number OEI-02-23-00260, counted slightly more than 570,000 enrollees who received monitoring in 2022, against about 55,000 in 2019. That is more than 10 times as many people in four years. Traditional Medicare grew 9 times and Medicare Advantage 14 times.

Payments rose faster than enrollment. Medicare and Medicare Advantage together paid more than $300 million in 2022, up from $15 million in 2019. The OIG exhibit puts the 2022 total at $311 million, split between $201 million in traditional Medicare and $110 million in Medicare Advantage. Average payment per enrollee doubled, from $266 in 2019 to $545 in 2022.

Patients also stayed on monitoring longer. The average enrollee received it for more than 5 months in 2022 against less than 3 months in 2019. The share monitored for longer than 9 months went from 5% to 25%. Medicare sets no limit on how long a patient can be monitored.

Which patients receive monitoring

The OIG found that 94% of enrollees received monitoring for a chronic condition in 2022 and about 7% for an acute one. More than half were monitored for hypertension. Diabetes with or without complications accounted for 15%, and sleep-wake disorders for 5%.

The OIG notes that more than 60% of all Medicare enrollees have hypertension, so the eligible pool is far larger than the 570,000 enrolled in 2022. Dually eligible enrollees received monitoring at twice the rate of enrollees with Medicare only.

Where practices lose revenue on billing

RPM has three billable parts: education and setup, the connected device with at least 16 readings per 30 days, and treatment management. The OIG found that about 43% of enrollees in 2022 had no claim or encounter record for at least one of them. That is roughly 244,000 people, and about 113,000 of them were missing two components.

By component, about 28% had no record of education and setup, about 23% had no record of a device, and 12% never had treatment management billed by any provider that year. CMS does not require a practice to bill all three. A missing claim line can still mean work that was done and never captured, or a patient who never transmitted enough readings.

The 2026 rules make two of those gaps cheaper to close. A patient who sends readings on 9 days now supports CPT 99445, and a clinician who spends 12 minutes reviewing data now supports CPT 99470. Each of those encounters was unbillable under the 2022 rules the OIG studied.

The OIG also recommended that CMS require an ordering provider on RPM claims and develop ways to identify which health data are monitored. CMS concurred with or said it would consider all five OIG recommendations. A practice that records the order, the condition and the minutes spent on every patient has the fields those changes would ask for.

Sources

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