This comprehensive guide references the five 2025 remote patient monitoring (RPM) CPT codes, corresponding reimbursement rates, and billing requirements. The cost fee structure for the RPM CPT codes in 2025 (99454, 99457, 99458, G0511) was revised, leading to slightly reduced reimbursement rates.
Follow along to ensure your practice maximizes its RPM potential while complying with the latest CMS guidelines.
RPM CPT Codes 2025
Qualified healthcare professionals know the Centers for Medicare and Medicaid Services (CMS) update RPM CPT billing codes yearly to incentivize healthcare providers to implement RPM for their patients. The following sections provide an overview of what the billing guidelines for RPM CPT codes in 2025, including the average reimbursement rate and requirements for RPM programs.
2025 RPM CPT Code 99453
The first of the RPM CPT Codes for 2025 is CPT code 99453. This covers initial one-time per device set-up and patient education on using equipment for remote physiological monitoring, such as blood pressure, pulse oximetry, and blood glucose. Furthermore, this one-time code is billed after the initial 16 days of monitoring in a 30-day period (episode of care days.) The average national payment rate for CPT 99453 is $19.73.*
Rates are based on non-facility national averages and vary by region.
RPM CPT Code 99454
This RPM CPT code 99454 covers the cost of providing devices, transmitting data, data collection, and reporting services. It may be used once per month per patient regardless of the number of devices the patient uses. The patient must use the device for at least 16 days per month. In addition, CPT 99454 is billable every 30 days. The average national payment rate for this code is $43.03.*
Rates are based on non-facility national averages and vary by region.
2025 RPM CPT Code 99457
RPM CPT code 99457 comprises an initial 20 cumulative minutes of RPM services by a physician, clinical staff, or qualified healthcare professional over a 30-day period. An unspecified portion of that 20 minutes must involve interactive remote communication with the patient. There is no explicit explanation of how interactions must be provided. It is assumed that video, phone, email, and text messages all suffice. The average national payment rate for this code is $47.88.*
Rates are based on non-facility national averages and vary by region.
Moreover, RPM CPT code 99457 can be billed as ‘incident to’ under general supervision. This means that Medicare providers can contract third-party RPM companies to outsource and assist with care manager RPM services. Ultimately offering providers the opportunity to manage more patients. Thus resulting in more company revenue without significantly impacting workflow. Code 99457 is billed one time each during a 30-day calendar month.
RPM CPT Code 99458
RPM CPT code 99458 encompasses reimbursement for unlimited additional increments of 20 minutes of RPM services, after the initial 20-minute minimum is met. Similar to 99457, documentation of how the time is distributed is required. The average national payment rate for CPT 99458 is $38.50.*
Rates are based on non-facility national averages and vary by region.
2025 RPM CPT Code G0511 for FQHCs and RHCs
FQHCs and RHCs can bill CPT and HCPCS codes which describe care coordination services rather than just the single code G0511. Allowing FQHCs and RHCs to use existing CPT codes places emphasis on ensuring patients receive the right services, regardless of the time required. Code G0511 can be billed for 20 minutes per month for clinical staff time under the direction of a practitioner at an FQHC or RHC. The average national payment rate for code G0511 is $72.90.*
*Rates are based on non-facility national averages and vary by region.
What are the Billing Requirements for RPM?
All Medicare beneficiaries can participate in remote patient monitoring. Some requirements exist for those who qualify for RPM. A summary of the requirements to bill for RPM CPT Codes in 2025 are as follows:
- An RPM device must fit the FDA’s definition of a medical device.
- The patient must opt-in for the service before ordering the remote patient monitoring device.
- A new patient evaluation is required for a new patient to RPM.
- Patients enrolled in RPM during the Public Health Emergency (PHE) can continue receiving RPM services.
- The patient must use the RPM device for at least 16 days a month to bill for CPT codes 99453 and 99454. This requirement is expected to be removed in January 2026.
- Data collection must be HIPAA-compliant.
Looking for More on Remote Patient Monitoring?
There are many benefits of remote patient monitoring in remote health. Medicare recognizes that RPM programs play a significant role in the future of value-based patient care. By implementing remote patient monitoring solutions, clinicians can improve the quality of care and generate more revenue.
If you are in search of billing requirements and 2025 CPT Codes for remote therapeutic monitoring (RTM) CPT codes, visit this blog post on RTM CPT codes. If you are a chronic care, telehealth, RPM services, or software company member, book a consultation and free demo to learn more about leveraging Tenovi’s remote patient monitoring devices and service solutions.
