The 2026 CPT Code Changes Every Practice Billing RPM or CCM Needs to Know

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The 2026 CMS Physician Fee Schedule brought more changes to RPM and CCM billing than any year since these programs were introduced. If your charge capture still reflects 2025 rates and codes, you're leaving money on the table — and potentially creating audit exposure. Here's what changed.

New RPM codes:

• CPT 99445 — Device supply with 2–15 days of readings per 30-day period: $52.11/month. Replaces the gap that previously left low-adherence patients unbillable.
• CPT 99470 — Remote monitoring management, 10–19 minutes: $44.28/month. Covers clinical staff time below the 20-minute threshold of 99457.

Updated RPM rates (7–21% increases):

• CPT 99453 (setup): $19.32 → $20.14 (one-time)
• CPT 99454 (16+ days device supply): $50.15 → $52.11/month
• CPT 99457 (first 20 min management): $48.80 → $51.77/month
• CPT 99458 (additional 20 min): $39.65 → $41.42/month

Maximum monthly RPM per patient (99454 + 99457 + 99458): $145.30. Combined with CCM (99490 + 99439): $211+ per patient per month.

Critical FQHC change: The G0511 bundled code for FQHCs and RHCs expired September 30, 2025. As of January 1, 2026, FQHCs must bill individual CPT codes — the same codes private practices use. CPT 99445 is eligible for FQHC billing retroactive to January 1, 2026. Practices that haven't updated their FQHC billing workflows are likely both under-billing and mis-coding.

The documentation requirements for the new codes are specific. For 99445, records must show the exact number of days readings were received. For 99470, time documentation must show 10–19 minutes — not simply "less than 20." Vague documentation is the leading cause of denials and audit findings for RPM in 2026.

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