Remote Monitoring Code Expansions Expected to Greatly Improve Access to Digital Health Management – Releasing January 2026
In September 2024, the latest meeting of the AMA’s CPT® Editorial Panel brought changes to the RPM and RTM code sets that could significantly improve digital health management for patients. The revision and expansion of these billing codes will provide providers with greater opportunities to serve their patient populations.
By removing arbitrary limitations, these changes enable the management of a larger patient population with increased flexibility in care plans tailored to individual patients and their specific medical needs. The updated codes are set for release in January 2026. Here’s a brief introduction to the upcoming 2026 RPM & RTM Codes:
1. New Codes Under RPM - Remote Physiologic Monitoring
- 99XX4
- 99XX5
The new RPM codes aim to remove (or at least lessen) the restrictive RPM data collection requirements for billing device/practice expense codes (CPT 99454), along with modifications to monitoring time requirements under general supervision (CPT 99457 and 99458). We expect these changes to reduce the current monthly data and monitoring requirements.
2. New Codes Under RTM - Remote Therapeutic Monitoring
- 98XX4
- 98XX5
- 98XX6
- 98XX7
The latest RTM codes are intended to expand the data requirements for billing device/practice expense codes, along with adjustments to monitoring time requirements under general supervision for respiratory, musculoskeletal, and cognitive behavioral therapy codes. We expect these changes to lessen the current monthly data and monitoring requirements.
Revisions to Existing RPM and RTM Codes
The CPT® Editorial Panel has also revised several RPM and RTM codes to better align with current clinical practices and technological capabilities. These revisions clarify definitions and, in some cases, modify requirements to meet evolving standards of care.
The goal is to establish clearer guidelines for practitioners, reduce confusion around usage, and promote consistency in coding best practices across the healthcare industry.
For healthcare providers, these additions and revisions mean:
- Enhanced Billing Accuracy: New and revised RTM & RPM billing codes clarify distinctions between device supply, treatment management, and monitoring services, making it easier to accurately bill for services provided.
- Increased Reimbursement Opportunities: With expanded codes for device supply and management services, providers have more opportunities to capture revenue from RPM and RTM services.
- Improved Patient Access: These remote codes enable broader access to specialized care, where telehealth can help bridge care gaps. Code expansions will allow a wider range of services for patients who may not need to track data daily to maintain their care plans.
With these expanded resources and codes, stakeholders can work toward a more integrated, accessible, and effective patient healthcare experience, helping bridge healthcare gaps.
Source: https://www.ama-assn.org/system/files/sept-2024-summary-of-panel-actions.pdf