Glossary
CPT 99457
CPT 99457 is the Medicare billing code for the first 20 minutes of interactive communication between clinical staff and an RPM patient in a calendar month, reimbursed at approximately $52 and requiring real-time two-way engagement discussing physiologic data, symptoms, or care plan.
Definition
CPT 99457 is the Medicare billing code for the first 20 minutes of interactive communication between clinical staff and an RPM patient in a calendar month, reimbursed at approximately $52 and requiring real-time two-way engagement discussing physiologic data, symptoms, or care plan. It is the first tier of the interactive-communication codes within the RPM billing family.
The 20-minute threshold is cumulative across the calendar month \u2014 multiple short interactions can combine to satisfy the requirement. Clinical staff, physicians, NPPs, or AI-powered calls with human escalation can perform the communication. The 2026 Medicare national average reimbursement for CPT 99457 is approximately $52; rates are updated annually and providers should verify current figures on CMS.gov before projecting program revenue.
Regulatory basis
CPT 99457 is governed by CMS under the Medicare Physician Fee Schedule. The key billing rule is that interactions must constitute real-time, two-way interactive communication \u2014 asynchronous data review time does not count toward the 20-minute threshold. Communication must address physiologic data, symptoms, or the patient\u2019s care plan.
CMS tracks cumulative time within the calendar month. Interactions that are too brief to document clinical content individually may still accumulate toward the threshold provided each interaction qualifies as genuine interactive communication. Annual updates to RPM billing policy are published in the Medicare Physician Fee Schedule final rule.
Who uses it and when it applies
- Physicians, NPPs, or clinical staff under general supervision performing interactive communication
- Patients active in an RPM program (setup completed under CPT 99453, device supply under CPT 99454)
- Calendar month tracking \u2014 the cumulative minute count resets on the 1st of each month
- Billed when cumulative interactive-communication minutes reach 20 within the calendar month
Related terms
- CPT 99458 \u2014 each additional 20 minutes of interactive communication in the same calendar month
- CPT 99454 \u2014 the device supply code billed alongside 99457
- Remote Patient Monitoring \u2014 the broader care model 99457 operationalizes
- Care coordination \u2014 the function interactive communication supports
How Positive Check relates
Positive Check structures daily wellness calls so cumulative interactive-communication minutes reliably reach the 20-minute threshold and carry documented clinical content addressing physiologic data, symptoms, and care-plan adherence. See the Remote Patient Monitoring solution for the full workflow, or the CPT 99457 billing guide for documentation and time-tracking requirements.
Reviewed against current CMS billing guidance. Medicare Physician Fee Schedule. Last updated 2026-04-19.