Updated for 2026. Remote Physiologic Monitoring (RPM) now has two device-supply reporting pathways based on the number of qualifying monitoring days in a 30-day period. CPT 99445 applies to shorter monitoring periods of 2–15 days, while CPT 99454 continues to cover longer monitoring periods.
For practices managing RPM patients, understanding the difference between these codes is important for documentation, billing workflows, and accurate claim submission.
CPT 99445 vs CPT 99454 at a Glance
CodeMonitoring DaysPurpose994452–15 daysRPM device supply and data transmission for shorter monitoring periods9945416 or more days within a 30-day periodRPM device supply and data transmission for longer monitoring periods
Noridian's 2026 Medicare guidance states that CPT 99445 should not be reported together with CPT 99454 for the same monitoring period. Only the code corresponding to the applicable monitoring duration should be reported.
What Is CPT 99445?
CPT 99445 was introduced for 2026 to address RPM situations where qualifying physiologic data is collected for at least 2 days but fewer than 16 days during a 30-day monitoring period.
This creates a reporting pathway for patients who may benefit from RPM but do not achieve the longer data-collection threshold associated with CPT 99454.
What Is CPT 99454?
CPT 99454 is used for qualifying RPM device-supply services involving longer monitoring periods. Current Medicare guidance describes the code as requiring data collection for 16 or more days during a 30-day period.
The service generally involves a connected medical device that digitally collects and transmits physiologic data to the patient's care team.
The Main Difference: Number of Monitoring Days
The most important distinction between CPT 99445 and CPT 99454 is the number of qualifying monitoring days.
Example 1: 10 Days of RPM Data
A patient with hypertension uses a connected blood-pressure monitor and successfully transmits qualifying readings on 10 days during the monitoring period.
If all other Medicare and payer requirements are met, CPT 99445 may be the applicable device-supply code because the patient generated data on 2–15 qualifying days.
Example 2: 22 Days of RPM Data
Another patient transmits qualifying readings on 22 days during the same type of 30-day monitoring period.
In this situation, the practice would evaluate CPT 99454 because the patient met the longer monitoring threshold.
Can You Bill CPT 99445 and 99454 Together?
No. Noridian's 2026 RPM guidance specifically states that CPT 99445 should not be billed together with CPT 99454 for the same monitoring period.
Your billing workflow should determine the number of qualifying monitoring days and then select the appropriate device-supply code based on the services actually provided and documented.
What Counts as a Qualifying RPM Day?
RPM generally involves physiologic data collected through an eligible connected medical device and digitally transmitted to the healthcare provider. Practices should maintain documentation showing the dates on which qualifying data was received.
Examples of physiologic measurements commonly associated with RPM may include:
- Blood pressure
- Weight
- Pulse oximetry
- Heart rate
- Other qualifying physiologic parameters when medically appropriate
Other RPM Requirements Still Apply
The monitoring-day threshold is only one part of RPM billing. Practices should also consider medical necessity, device eligibility, patient consent, documentation, payer coverage, and other applicable coding requirements.
Medical Necessity
The treating practitioner should determine that remote physiologic monitoring is reasonable and necessary for the patient's condition.
Connected Medical Device
Medicare RPM generally relies on an eligible medical device that digitally collects and transmits physiologic information rather than relying only on manually reported measurements.
Patient Consent
Patient consent should be obtained and documented according to applicable Medicare and payer requirements.
Documentation
Practices should retain documentation showing the condition being monitored, device setup, qualifying monitoring days, transmitted data, and other services furnished as part of the RPM program.
Device Supply vs Treatment Management
CPT 99445 and CPT 99454 relate to the device-supply and data-transmission component of RPM. They should not be confused with treatment-management codes.
For 2026, CPT 99470 also introduces a new pathway for the first 10 minutes of qualifying RPM treatment-management services. CPT 99457 continues to apply to longer treatment-management time when its requirements are met.
Why This Change Matters for Practices
Before 2026, practices commonly focused on achieving the longer monitoring threshold for RPM device-supply billing. CPT 99445 provides another reporting option for shorter qualifying monitoring periods.
This can be particularly relevant when patients:
- Are newly enrolled in RPM partway through a monitoring period
- Have temporary connectivity or adherence issues
- Require clinically appropriate shorter monitoring periods
- Do not reach 16 qualifying days despite ongoing care-team engagement
However, practices should not reduce monitoring simply to qualify for a particular code. The monitoring plan should remain clinically appropriate for the patient.
How ChronicSync Can Help
ChronicSync helps care teams organize Remote Patient Monitoring workflows and maintain visibility into patient activity across an enrolled population.
A structured RPM platform can help practices identify patients who are approaching monitoring thresholds, follow up when data is missing, and keep documentation organized for billing review.
Start your ChronicSync Free Pilot and explore a more organized approach to RPM and chronic care workflows.
Frequently Asked Questions
What is the difference between CPT 99445 and 99454?
CPT 99445 is the 2026 RPM device-supply code for 2–15 qualifying monitoring days. CPT 99454 applies to the longer monitoring duration of 16 or more days within a 30-day period.
Can 99445 and 99454 be billed in the same monitoring period?
No. Current Noridian guidance states that the two codes should not both be reported for the same monitoring period.
Does 99445 replace 99454?
No. CPT 99445 supplements the existing RPM code structure by covering shorter monitoring periods. CPT 99454 continues to apply when the longer monitoring threshold and other requirements are met.
Does meeting the monitoring-day requirement guarantee payment?
No. Medical necessity, device requirements, patient consent, documentation, coverage rules, and payer-specific billing requirements must also be satisfied.
Sources
- Noridian Medicare: Remote Physiologic Monitoring 2026 Updates
- CMS: Telehealth and Remote Patient Monitoring
This content is educational and does not constitute medical, legal, coding, or billing advice. Medicare and payer requirements may change. Verify current requirements with CMS, your Medicare Administrative Contractor, and applicable payers before submitting claims.