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RPMBase2026 Compliant

CPT 99091

2026 Billing Guide

Remote physiologic data interpretation

Reimbursement

$38.41

Threshold

N/A

2026 Status

Active

What is CPT Code 99091?

CPT 99091 is defined as: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days.

This code is primarily used for RPM services. It falls under the category of Medicine / Remote Monitoring and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.1

Physician Effort

PE (Non-Fac)

0

Practice Expense

Malpractice

0.05

Risk Factor

Total RVU

1.15

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency shield

NOT an E/M code; subject to the -2.5% productivity adjustment (Efficiency Shield DOES NOT apply).

value prop

High ROI for specialists who personally review complex data (e.g., continuous glucose monitor tracings or multi-lead ECG) without clinical staff involvement.

Administrative Framework

Place of Service

11 (Office)

Operational Requirements

Standard CMS E/M requirements apply.

Compliance Checklist

Physician/QHP time only (Staff time DOES NOT count).
Record of data received and source.
Detailed interpretation report signed by the provider.

Audit Defense

interpretation depth

Documentation must show 'medical thinking' and interpretation, not just a log of numbers.

time tracking

Exact minutes spent throughout the 30-day period must be logged.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

CardiologyEndocrinologyPulmonology

Typical Clinical Indications (ICD-10)

E11.9 (Diabetes with CGM)I48.91 (Unspecified atrial fibrillation)

Frequently Asked Questions

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CPT Code 99091 for Remote physiologic data interpretation - 2026 Reimbursement & Rules