How Cloud‑Connected Devices Unlock New Reimbursement Streams

Your up‑to‑date cheat‑sheet for every Remote Physiologic Monitoring (RPM), Remote Therapeutic Monitoring (RTM), and virtual check‑in code—what Medicare pays in 2025 and the new codes already approved for 2026.

Market Momentum

CMS Part B paid an estimated $910 million for RPM/RTM services in 2024, up from $712 million in 2023. (CMS Physician & Other Practitioners Utilization Data)

1. Remote Physiologic Monitoring (RPM) Codes — CY 2025 status

Code	Descriptor	CY 2025 national avg. rate*	Key billing rules
99453	Device set‑up & education	$19.73	Once per episode (≥ 16 days of use in first 30 days)
99454	Device supply & transmission	$48.79	≥ 16 days of data every 30 days
99457	RPM management ≥ 20 min	$47.87	Includes ≥ 1 live communication; per calendar month
99458	Add’l ≥ 20 min	$43.02	Add‑on to 99457; stackable

2. Remote Therapeutic Monitoring (RTM) Codes — CY 2025 status

Code	Descriptor	CY 2025 national avg. rate*	Typical data stream
98975	RTM set‑up & education	$19.73	Respiratory or musculoskeletal devices
98976	RTM supply — respiratory	$47.12	PEF, inhaler‑usage counters
98977	RTM supply — MSK	$47.12	Motion sensors, orthopedics
98980	RTM management ≥ 20 min	$47.30	Includes ≥ 1 interactive session
98981	Add’l ≥ 20 min	$39.65	Stackable add‑on

3. New & Revised Codes Approved for CY 2026 (draft rates)

Code change	Effective Jan 2026	Draft national avg. rate*	Why it matters
99XX4 (RPM ≤ 15 days)	Short‑term device supply	≈ $44	Makes 5–15 day studies billable
99XX5 (RPM mgmt 10‑19 min)	Mgmt bracket below 99457	≈ $29	Lower time threshold
Unified RTM supply	Merges 98976/77	≈ $47	Simplifies DTx billing
HCPCS G0X12 (virtual check‑in 11‑20 min)	Replaces G2012	≈ $37	Maintains short tele visits

*Medicare national‑average, non‑facility payment rates for CY 2025. 2026 figures are preliminary estimates; CMS will publish final rates in the CY 2026 Physician Fee Schedule.

4. Revenue Snapshot — Monthly Potential per Patient

Use‑case	Codes billed	Medicare $/30 days*	Data requirement
Hypertension RPM	99454 + 99457	$96.66	≥ 16 BP readings + ≥ 20 min review
Post‑op MSK RTM	98975 + 98977 + 98980	$114.15	Exercise counts & adherence logs
Cardiac patch (est. 2026)	99XX4 + 99XX5	$73–85	5–15 days ECG data + ≥ 10 min review

Conclusion

Remote‑care reimbursement keeps expanding. Align your device data streams with the correct CPT codes, meet the day‑count and time requirements, and you’ll open durable revenue channels for providers and device makers alike.

Abbreviations

CPT – Current Procedural Terminology |  HCPCS – Healthcare Common Procedure Coding System |  RPM – Remote Physiologic Monitoring |  RTM – Remote Therapeutic Monitoring |  MSK – Musculoskeletal |  DTx – Digital Therapeutics |  PEF – Peak Expiratory Flow |  CMS – Centers for Medicare & Medicaid Services |  AMA – American Medical Association |  PFS – Physician Fee Schedule