RPM Solution

Remote Patient Monitoring Made Simple

Automated voice and SMS outreach for consistent RPM engagement, documentation, and care-team follow-up.

Outreach

Routine patient check-ins

Review

Call summaries for staff

Alerts

Concerns for your care team

Follow-up

Practice-owned next steps

2026 CMS Final Rule update

Two new RPM codes effective January 1, 2026

The CY 2026 Medicare Physician Fee Schedule Final Rule (published November 5, 2025) introduced two new CPT codes that lower the thresholds for billable RPM services. Providers can now capture revenue from patients who don’t meet the full 16-of-30-day or 20-minute thresholds under the legacy codes.

CPT 99445 — device supply when data is transmitted on 2–15 days within a 30-day period (alternative to CPT 99454, which still covers 16–30 days).
CPT 99470 — first 10 minutes of treatment management per calendar month (alternative to CPT 99457, which still covers the first 20 minutes).

The new codes are mutually exclusive with their legacy counterparts in the same billing period—providers select one based on actual transmission days or cumulative time.

What Is Remote Patient Monitoring?

Remote Patient Monitoring (RPM) allows healthcare providers to track patient health data between office visits using connected devices and structured communication. Medicare reimburses providers for RPM services under CPT codes CPT 99457, 99458, and 99454 when clinical staff spend time reviewing data and interacting with patients.

The challenge: CMS requires documented interactive communication with each patient — phone calls, secure messages, or video — at least once per billing period. For practices managing hundreds or thousands of RPM patients, this is operationally demanding.

How Positive Check Supports RPM

Our AI-powered daily calls handle the patient engagement your RPM program requires.

Daily Wellness Calls

Automated voice calls collect vitals, symptoms, and wellness data for clinical-staff review and follow-up.

Structured Summaries

Call results are organized into trend reports that reduce clinical review time, making the additional 20 minutes for CPT 99458 highly productive.

Consistent Cadence

Every enrolled patient receives regular outreach without gaps — ensuring your practice meets the monthly engagement threshold.

HIPAA-Compliant

All calls, transcripts, and data transmissions meet HIPAA standards. Business Associate Agreements available for all provider partners.

RPM Billing Codes

2026 Medicare national average reimbursement rates for Remote Patient Monitoring.

CPT Code	Description	2026 Rate
99457	RPM — first 20 min clinical staff time per month	$52
99458	RPM — each additional 20 min clinical staff time per month	$41
99454	RPM — device(s) supply with daily recordings or alert transmission, each 30 days	$56
Combined Monthly Revenue (99457 + 99458)		$93/patient

Why Providers Choose Positive Check for RPM

Scale RPM to thousands of patients without adding staff

Automated daily calls support practice-owned interactive communication workflows

Structured call summaries reduce clinical review time

Real-time alerts flag patients who need immediate attention

HIPAA-compliant platform with BAA support

Integrates with existing EHR and billing workflows

$8-$16/patient/month — a fraction of the reimbursement generated

Launch in days, not months

Frequently Asked Questions

What is Remote Patient Monitoring (RPM)?

RPM uses automatically transmitted physiologic data to support management of an acute or chronic condition. Its codes distinguish device setup and collection periods from treatment-management work. In 2026, shorter collection and management pathways are also available. Check each code independently; qualifying management includes required communication rather than only call duration.

What does the CMS interactive communication requirement mean?

RPM management requires a real-time, two-way conversation with the patient or caregiver under applicable personnel and service requirements. Video or other data may enhance the conversation. Do not assume every responsive text chat or automated call qualifies. The communication component and total qualifying management time are separate checks.

Do AI-powered wellness calls independently satisfy the interactive communication requirement?

CMS has not established that a fully automated AI interaction independently satisfies the requirement. Positive Check can support practice-owned RPM workflows by collecting structured responses, documenting outreach, and escalating concerns, but the billing practice must determine which clinical-staff activities and patient interactions meet current CPT, CMS, MAC, and payer requirements.

What’s the typical monthly revenue from an RPM patient?

There is no guaranteed monthly revenue per enrolled patient. Payment depends on the actual qualifying services, service year, payer, locality, and setting. Verify current fee-schedule information and include retained staffing, device, software and quality-review costs. Neither call volume nor a vendor projection determines whether an individual claim qualifies.

Which patients are eligible for RPM?

RPM can be medically necessary for an acute or chronic condition when transmitted physiologic measurements inform management. CMS also requires an established relationship and consent, alongside the applicable device, personnel, supervision and service requirements. A diagnosis or connected device alone does not establish that a particular claim qualifies.

Does HIPAA permit AI-powered RPM wellness calls?

Yes, when the vendor operates under a signed Business Associate Agreement (BAA) and the platform implements HIPAA technical safeguards — encryption in transit and at rest, role-based access, audit logging, and minimum-necessary data handling. Positive Check operates under a BAA for all provider engagements.

See all Remote Patient Monitoring questions