RPM Solution
Remote Patient Monitoring Made Simple
Positive Check automates the daily patient engagement your RPM program needs — satisfying CMS interactive communication requirements while generating reimbursable revenue.
$93
Revenue / Patient / Mo
99457
First 20 Min — $52
99458
Add'l 20 Min — $41
99454
Device Supply — $56
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 — satisfying the interactive communication requirement for CPT 99457.
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 satisfy CMS interactive communication requirements
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)?
Remote Patient Monitoring is a Medicare-reimbursed care program where clinical staff review physiologic data (blood pressure, glucose, weight, SpO2, etc.) transmitted from a patient’s connected device and conduct interactive communication with the patient at least monthly. CMS reimburses six codes as of 2026: CPT 99453 (setup), 99454 (device supply, 16–30 days), 99445 (new for 2026: device supply, 2–15 days), 99457 (first 20 minutes of interactive communication), 99470 (new for 2026: first 10 minutes of interactive communication), and 99458 (each additional 20 minutes).
What does the CMS interactive communication requirement mean?
CMS requires that clinical staff (or the physician) have at least one interactive communication with the patient or caregiver each calendar month in which CPT 99457 or 99458 is billed. The interaction can be telephonic, secure messaging, or video — and it must be real-time, two-way engagement that discusses the patient’s physiologic data, symptoms, or care plan. A one-way notification or unresponded message does not satisfy the requirement.
Can AI-powered wellness calls satisfy the interactive communication requirement?
Yes, when the call includes real-time two-way engagement, captures structured clinical content, and supports human escalation. CMS defines "interactive communication" by its content and two-way nature, not by who initiates it. An AI call that asks about symptoms, captures responses, and flags concerns to clinical staff meets the requirement as long as the interaction is documented.
What’s the typical monthly revenue from an RPM patient?
Combined, CPT 99457 (~$52 for first 20 minutes) and 99458 (~$41 for each additional 20 minutes) generate roughly $93 per patient per month in the typical case. Adding CPT 99454 for device supply ($47–$56/month) brings the total per-patient monthly revenue to approximately $140–$150 for a full RPM episode. CPT 99453 is a one-time ~$19 setup fee. Rates vary by locality and update annually.
Which patients are eligible for RPM?
Medicare covers RPM for patients with one or more chronic conditions whose physiologic data informs ongoing care decisions — hypertension, diabetes, heart failure, COPD, and post-surgical monitoring are the most common. The patient must have a connected device capable of transmitting data to the provider, and the provider must document a clinical rationale for monitoring.
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.
Further Reading
Billing guide
CPT 99457 Billing Guide
Interactive communication requirement, 20-minute threshold, documentation, and common errors.
CMS rule
CMS Interactive Communication Requirement
What “interactive communication” means for CPT 99457/99458 and how AI calls satisfy it.
Program design
RPM Patient Selection
Which chronic conditions, demographics, and clinical scenarios drive the best RPM outcomes.
Comparison
AI Engagement vs. Device-Only Monitoring
Why devices alone leave Medicare revenue on the table, and what the interactive layer adds.
Reviewed against current CMS billing guidance. Medicare Physician Fee Schedule. Last updated 2026-04-19.