Remote Patient Monitoring

What it is

Remote Patient Monitoring (RPM) is the collection and interpretation of physiologic data (e.g., blood pressure, weight, glucose, SpO₂) from an FDA-cleared connected device, with treatment management between visits.

RPM bills on a rolling 30-day cycle anchored to the device-setup date (the 99453 bill date) — not the calendar month. Each cycle is evaluated independently for the device-data and management-time codes. Willowbridge handles device pairing and reading thresholds.

Who qualifies

• Patient has ≥ 1 chronic condition appropriate for physiologic monitoring (v1: HTN, T2DM, CHF, COPD, CKD3).
• An FDA-cleared device of an approved type is assigned (BP monitor, glucose meter, weight scale, pulse oximeter, thermometer, spirometer).
• Established patient — a prior E/M within ~12 months satisfies CMS.
• Consent captured (verbal or written) with copay disclosure (per OIG OEI-02-23-00260, Sept 2024 audit defense).
• RPM and RTM are mutually exclusive for the same patient in the same month.

Codes & when to bill them

Each billable code, with the requirements that must be on file to bill it.

• 99453RPM setup and patient education on use of the device(s). One-time, billed contemporaneously with enrollment.
  RequirementsOne-time per monitoring episode; device set up and patient educated.
• 99445RPM device supply with daily recording / programmed alert transmission, 2–15 days within the 30-day cycle (new CY 2026 short-cycle code).
  Requirements2–15 days of FDA-cleared device data transmitted within the cycle; mutually exclusive with 99454.
• 99454RPM device supply with daily recording / programmed alert transmission, each 30 days.
  Requirements≥ 16 days of FDA-cleared device data transmitted within the 30-day cycle.
• 99457RPM treatment management, first 20 minutes of clinical staff/QHP time per calendar month, with interactive communication.
  Requirements≥ 20 min management time in the cycle AND ≥ 1 interactive communication.
• 99458RPM treatment management, each additional 20 minutes (list separately in addition to 99457).
  RequirementsAdd-on to 99457; each additional full 20 min.
• 99470RPM treatment management, 10–19 minutes in the cycle, with interactive communication.
  Requirements10–19 min management time + ≥ 1 interactive communication; mutually exclusive with 99457.

Documentation required every cycle

Each 30-day cycle must show:

1. Device certification — FDA-cleared device, type, serial, 510(k) on file.
2. ≥ 16 days of device data transmitted within the cycle (gates 99454).
3. Interactive communication log — at least one live (phone/video) interaction with the patient/caregiver in the cycle (gates 99457/99458/99470).
4. Device-data snapshot for the cycle (readings evidence).
5. Patient consent with copay disclosure on file.
6. Billing-provider sign-off.

What's new in CY 2026

CY 2026 adds a short-cycle device-supply code (99445) for 2–15 days of data, mutually exclusive with 99454, and a short-management code (99470) for 10–19 minutes of treatment management with interactive communication.

Built-in patient consentWillowbridge exclusive

Every program ships with compliant, CY-2026 patient consent language — read verbatim into the in-app consent capture flow, captured with date + modality, and version-pinned to each claim, so the consent on file always matches the consent that was billed. No more chasing signatures or re-papering when the rule changes.