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RPMBase2026 Compliant

CPT 99445

2026 Billing Guide

RPM Device 2-15 Days

Reimbursement

$47.43

Threshold

2d

2026 Status

Active

What is CPT Code 99445?

CPT 99445 is defined as: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, for a period of 2 to 15 days of data transmission within a 30-day period.

This code is primarily used for RPM services. It falls under the category of Remote Patient Monitoring (RPM) 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

0

Physician Effort

PE (Non-Fac)

1.41

Practice Expense

Malpractice

0.01

Risk Factor

Total RVU

1.42

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

2026 CMS Policy Intelligence

revenue protection

99445 is a landmark 2026 policy addition that prevents providers from losing all device supply revenue when patients miss the 16-day mark.

efficiency adjustment exemption

As a zero-Work RVU code (PE only), 99445 is not affected by the -2.5% efficiency adjustment applied to physician work values.

conversion factor

Utilizes the 2026 Non-QP rate of $33.40.

Administrative Framework

Place of Service

11 (Office)12 (Home)

NCCI Exclusions

Do not bill with:99454 (mutually exclusive per month)989769897798984

Key Modifiers

N/ATechnical component code; 26/TC modifiers generally not used.

Operational Requirements

transmission threshold

Requires a minimum of 2 days and a maximum of 15 days of data transmission within a 30-day period. This is the 'short-duration' safety net for RPM.

device type

The device must be an FDA-defined medical device (e.g., Bluetooth BP cuff, cellular scale). Manual entry of data into an app does not qualify.

billing interval

Reported once every 30 days per patient, only if the primary 16-day code (99454) is not met.

setup linkage

Must be preceded by an initial setup and education service (99453).

Compliance Checklist

Detailed time tracking (cumulative for the month).
Specific clinical decision-making documentation.
Electronic care plan availability and access log.

Audit Defense

No specific audit defense elements defined.

2026 Update

NEW 2026 CODE. Use for patients who drop compliance mid-month to secure partial reimbursement for device costs.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

Primary CareCardiologyPulmonologyEndocrinology

Typical Clinical Indications (ICD-10)

I10 (Essential hypertension)I50.9 (Heart failure, unspecified)E11.9 (Type 2 diabetes mellitus)

Frequently Asked Questions

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