RPM Billing Codes & CPT Guidelines 2025: Updated Reimbursement Rules, CPT List & Compliance Insights

Providing proactive healthcare services beyond the clinic walls is now complemented with consistent reimbursements for Remote Patient Monitoring (RPM) services. Most providers view RPM services as an opportunity to receive consistent proactive reimbursement on high-impact billing for the healthcare services provided.

Decoding the reimbursement workflows for every CPT code can be complex, tedious, and exhausting. Understanding the billing rules involves working with the medical-finance dialect.

This guide articulates all RMP billing codes, reimbursements, and policies effective in 2025. Its purpose is to assist you in simplifying and clarifying even the 'knotty' aspects of the process.

What is Remote Patient Monitoring (RPM)?

Its purpose is to assist you in simplifying and clarifying even the 'knotty' aspects of the process.

Remote Patient Monitoring (RPM) systems use medical devices to track patients' health with vital signs like blood pressure, glucose, and oxygen levels outside the clinic. These systems include Remote Patient Monitoring.

When the information is sent electronically to a provider or RPM platform, it is chargeable using prescribed CPT codes.

Learn more about Telehealth best practices.

How RPM Works Step-by-Step

1. A patient uses an RPM device (like a blood pressure cuff or glucose meter).
2. Data automatically transmits to the provider's system.
3. The provider reviews the data and contacts the patient as needed.
4. The entire process—from setup to review — is covered under specific RPM CPT code descriptions.

Complete List of Remote Patient Monitoring CPT Codes (2025 Edition)

Below is the complete list of RPM CPT code descriptions for 2025, showing their billing frequency and approximate reimbursement rates.

Tip: These five core CPT codes represent the entire RPM workflow—from setup (99453) to monthly data management (99457/99458) and clinical interpretation (99091).

RPM CPT Codes Explained
 

99453 CPT Code Description – Initial Setup & Patient Education

CPT 99453 covers the initial time and effort to teach patients how to use RPM devices properly. It's billed once per patient when the device setup and onboarding are complete.
 This code ensures you're reimbursed for the educational time spent before monitoring starts.
 Standard error: Billing it more than once—CMS only allows this code per episode of care.

99454 CPT Code Description – Device Supply and Data Transmission

This code covers providing the RPM device, collecting and transmitting patient data for at least 16 days in 30 days, and generating reports.
 Data must be automatically uploaded to qualify—handwritten logs or self-reported data don't count.

99457 CPT Code Description – First 20 Minutes of Treatment Management

CPT code 99457 pertains to the first 20 minutes per month a provider spends analyzing Remote Patient Monitoring (RPM) data, determining treatment, and engaging with the patient.
 To bill for the service, the provider must have interactive communication through telephone, messaging, or video.

Pro Tip: This code bridges patient engagement and revenue. Even a brief check-in counts if appropriately documented.

99458 CPT Code Description – Add-On for Each Additional 20 Minutes

Additional codes have been assigned to designated visits where a provider spends over 20 minutes with a patient within a 30-day cycle.
 Furthermore, if your team engages in 40- or 60-minute intervals discussing the data, you may append CPT 99458 for every additional 20 minutes of work performed.
 This code is most frequently used together with 99457 for the patients who require more intensive intervals of care coordination.

99091 CPT Code Description – Physician Review and Interpretation

CPT 99091 reimburses physicians or qualified professionals for at least 30 minutes per month spent analyzing RPM data.
 It's best used for complex cases or where the provider personally reviews multiple data streams from RPM devices.

New AMA CPT Code Updates for 2025

The American Medical Association's CPT Editorial Panel approved several new codes in 2024 that will take effect in January 2026, streamlining RPM and RTM billing.

What's New

• New 10–19-minute management codes (proposed 99XX5, 98XX7).
• New 2–15-day data collection codes, in some instances, remove the strict 16-day requirement.
• Broader eligibility for short-term and acute care monitoring.

These adjustments focus on flexibility and… for RPM billing, especially for follow-up monitoring of… surgical, or short-term cases.

For further official information, you can review the CMS guidelines.

Remote Therapeutic Monitoring (RTM) CPT Codes

RTM involves monitoring non-physiological data, including therapy adherence, pain, and… exercise activities.
 Here's the complete RTM CPT code description list for reference:

Note: RTM allows self-reported data unlike RPM and doesn't always require automatic device uploads.

Telehealth and Communication Codes Supporting RPM

RPM often overlaps with telehealth services. These telephonic CPT code descriptions apply to phone-based assessments and virtual care coordination.

Pro Tip: Use these codes for separate, documented telehealth sessions from RPM monitoring time.

RPM Billing Rules and Documentation Requirements

Billing correctly for RPM services requires careful documentation that is aligned with CMS rules.

1. The 16-Day Rule

To bill 99454, data must be collected for at least 16 unique days within a 30-day window.

2. The 30-Day Billing Period

RPM codes follow a rolling 30-day billing cycle—not a calendar month. Track your time carefully.

3. The One-Provider Rule

Only one provider can bill RPM codes per patient within the same 30-day period. The first claim submitted is honored.

4. Documentation Must Include

• Time spent on management
• Communication logs
• Device data reports
• Patient consent
• Clinical notes or updates

Tip: Solid documentation is the difference between a paid and denied claims.

Learn how efficient revenue cycle management ensures accuracy and compliance in medical billing workflows.

RPM Billing for Different Care Settings

FQHCs and RHCs

Federally Qualified Health Centers and Rural Health Clinics can bill RPM and RTM services using:

Even though these are bundled codes, accurate recordkeeping and 30-day cycle tracking are still required for compliance.

RPM Reimbursement Rates for 2025

Here's a quick reference of estimated RPM reimbursement rates 2025, based on the latest CMS Physician Fee Schedule.

Compliance and Audit Readiness

The Office of Inspector General (OIG) found that nearly 30% of RPM claims had missing documentation or invalid device data. Avoid denials by staying proactive.

Compliance Checklist

• Obtain written patient consent
• Log transmission data (≥16 days)
• Record communication and management time
• Use FDA-cleared devices
• Audit claims quarterly for accuracy

The Future of Remote Patient Monitoring

RPM rapidly expands into new specialties—from chronic care to behavioral and preventive health.

Key 2025–2026 Trends

• Short-duration CPT codes for acute monitoring (10–19 minutes).
• AI-driven device integration for data interpretation.
• Expanded CMS reimbursement for RTM and behavioural data.
• Value-based care aligns with RPM outcomes.

Providers adopting compliant, tech-driven RPM programmes early will see the most significant revenue growth.

How MedSole RCM Simplifies RPM Billing

Invoicing various CPT codes, overseeing 30-day cycles and documentation, and handling multiple documentation are convoluted and easily result in disarray.

Regarding the automation of eligibility checks, time log management, and one-time, precise claims coding, MedSole RCM assists the healthcare segment in streamlining the RPM billing process.

Your practice can avoid denials and maintain efficient reimbursement with expert oversight and
compliance reassurance.

Quick Reference: CPT Code Descriptions Summary

An understanding of each RPM CPT code description is vital in maintaining appropriate billing processes, avoiding rejection of claims, and capturing all the revenue which is rightfully theirs.

Conclusion

As the RPM is likely to expand, the result of tracking shifting CPT codes and billing instructions will be tangible in the speed of payment to the providers.

Practices will avoid billing and revenue risks while taking full advantage of revenue opportunities through compliance and revenue optimization.

When you have specialized support for your revenue cycle management, you can concentrate on what matters most—positive patient outcomes, not tedious documentation.

Disclaimer

Information is based on CMS and AMA updates for 2025. Reimbursement values vary by location and payer.

FAQs

Q1. What is RPM in medical billing?
 RPM in medical billing is the collection of patients’ health data through digital devices (e.g., blood pressure or glucose monitors) and billing those services for reimbursement using specific CPT codes.

Q2. Can CCM and RPM be billed together?
 Yes, chronic care management and remote patient monitoring can be billed at the same time as long as all of the criteria are fulfilled, but the reduction in the time allocated for each service should be recorded and billed as separate entities.

Q3. How to bill for Remote Therapeutic Monitoring (RTM)?
 CPT codes 98975 to 98981, which include billing for the monitoring of the pain, movement of the patient, and general observation of a patient, as well as the paying of devices and education, apply.

Q4. What is the difference between RPM and RTM?
Remote Patient Monitoring captures and processes data of a patient’s heart rate or blood pressure from devices that are in use, while Remote Therapeutic Monitoring assesses and records data about the patient in regard to their physical activity or other actions that are medication-related and are often self-reported by the patients.