2026 Remote Patient Monitoring Updates: What EHI Needs to Know—and Why It’s a Breakthrough Year for RPM
- Vipal Desai, MD
- 4 days ago
- 4 min read
Remote Patient Monitoring (RPM) has started out as a more connected and proactive model of care. However, the billing structure for RPM has led to a lot of difficulties for providers regarding how to support patients whose patterns of monitoring are short-term or inconsistent. This will change in 2026.
The recent updates to CMS: PFS (Physician Fee Schedule) that go into effect January 1, 2026, will make the RPM landscape more flexible, better aligned to the needs of the patients, and practical. (CMS issues CY 2026 physician fee schedule final rule, 2025) Two of the newly added CPT codes 99445 and 99470, that stand to close the gaps in reimbursement affecting the scalability and access to patients.
The updates provide digital health organizations, such as Enable Healthcare (EHI), the opportunity to improve access, better documentation, program economics, and a more comprehensive model for the remote monitoring program.
Two New RPM Codes for 2026—and Why They Matter
🔹 CPT 99445 — Short-Term or Intermittent Data Monitoring (2–15 Days)
Covers:
The supply of the device and the capture and transmission of physiological data (e.g., blood pressure, weight, oxygen, glucose) when patients send data for a period of 2 – 15 days in 30 days.
Why it matters:
In the past, the only device supply billing option was CPT 99454, which stipulated having 16+ days of data. (CMS Finalizes 2026 Remote Monitoring Reimbursement Updates, 2025) If a patient had only 6, 10, or 12 days of data due to possible medication adjustments, transitional care, recovering from a hospital stay, or even inconsistent adherence, however, there was no reimbursement.
99445 eliminates this barrier.
Now, patients with intermittent needs are eligible, and practices are not disciplined for unpredictable behavior patterns.
2026 national avg reimbursement: ~$47 (non-facility).
🔹 CPT 99470 — Brief RPM Management (First 10 Minutes + 1 Live Interaction)
Covers:
Short-duration clinical management services are provided by physicians, by other qualified professionals, or by clinical staff with at least one real-time interactive communication.
Why it matters:
Previously, to bill for RPM management (CPT 99457), there had to be 20+ minutes of billable time per month. Valuable and often clinical brief touchpoints, like checking if a new medication was prescribed, clarifying device readings, follow-ups on oxygen saturations, or adjusting therapy inputs, were lost. (AMA releases CPT 2026 code set)
99470 ensures these micro-interventions are reimbursable.
2026 national avg reimbursement: ~$26 (non-facility).
The Complete 2026 RPM Code Set
CPT Code Description Est. 2026 Reimbursement*
99453 Initial setup & patient education ~$22
99445 Device + data (2–15 days) ~$47
99454 Device + data (16–30 days) ~$47
99470 RPM mgmt, first 10 min + ≥1 live interaction ~$26
99457 RPM mgmt, first 20 min + live interaction ~$52
99458 +20-min add-on ~$41
*National non-facility averages. Final rates may vary by locality.
How These Changes Strengthen EHI’s RPM Model
1. More Flexibility & Fewer Barriers for Patients
Previously unmonitored patients are now fully eligible for reimbursement from RPM. This includes those who are recently exacerbated, need medication adjusted, or those who transmit data inconsistently.
This is greatly beneficial for RPM of conditions like:
Hypertension
Congestive heart failure
COPD
Diabetes
Post-operative recovery
Transitional care after hospitalization
Short-term monitoring now comes without a financial risk.
2. Clinical Intensity Can Finally Match Patient Need
Not every patient will need the 20+ minutes of clinical review for the month.
Some patients need only brief, but clinically important, check-ins.
99470 supports:
Quick medication-titration conversations
Pulse oximetry check-ins
Short nursing follow-up
Rapid responses to abnormal readings
Reinforcement of care-plan steps
Clinicians’ work should be focused on managing the patients’ needs rather than extending visits just to satisfy the documentation needs.
3. Better Scalability & Revenue Predictability
RPM historically has been dealt with adherence variability.
Minimizing financial volatility is a result of the new codes.
Lowering the required number of monitoring days
Allowing shorter touchpoints to be reimbursed
Supporting episodic or intermittent use cases
More precise forecasting, revenue streams, and growth estimates are all positive effects of this on EHI.
4. Higher Enrollment Eligibility Across the Patient Population
People who lacked eligibility due to intermittent requirements or unusable data are no longer limited in signing up for the program.
Post-discharge monitoring
Short-term COPD flare follow-ups
Newly diagnosed hypertension
Insulin titration periods
CHF patients adjusting to diuretics
This greatly expands EHI’s targeted RPM market share.
Compliance Essentials for 2026
To be compliant with CMS, EHI is expected to have;
FDA-cleared devices with automatic transmission
One live interaction for 99470 / 99457 / 99458
One device-supply code per 30-day period (either 99445 or 99454—not both)
Precise documentation for data days, live interactions, and clinical minutes
Clear medical necessity for patients with intermittent or low-dose monitoring
For more details, CMS provides the full rule documentation on its website:
What This Means for EHI Moving Forward
A larger patient pool
More patients qualify—even those with irregular adherence.
Tiered RPM service models
Ideal for EHI’s structure:
Low-touch: 99445 + 99470
High-touch: 99454 + 99457/99458
Smarter resource allocation
Nurses and other clinicians are now much more able to customize their time based on actual patient needs rather than documentation requirements.
More RPM support for transitional care
Post-discharge care pathways are a perfect fit for short-term monitoring.
Scalable program growth
Increased predictability, decreased risk, and increased operational autonomy.
Final Thoughts
These are the most anticipated RPM updates for 2026. These updates provide some of the earliest and most significant updates in RPM. These new codes allow real-world behaviors and clinical workflows to be incorporated, all while EHI streamlines care in a more personal manner and upholds revenue security.
These changes improve the scope of what RPM is able to accomplish.
They redefine who it can reach.