99457
RPM treatment mgmt 20 min/mo
Remote physiologic monitoring treatment management services, first 20 minutes of clinician or clinical staff time per calendar month, requiring at least one real-time interactive communication with the patient or caregiver. CMS 2026 wRVU 0.61, paid using the national GPCI and the 2026 conversion factor of $33.4009.
Billing guidance for 99457 is locked
- When to use it: the exact clinical situations that support billing 99457
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 5 mistakes that get 99457 downcoded or denied
Payer notes
Medicare and Medicare Advantage cover 99457 with standard cost share; consent at RPM enrollment should disclose it. Commercial coverage is widespread. Because clinical staff time qualifies under general supervision, the marginal cost of the 20 minutes is low and the code stacks with the rest of the monthly care management suite (CCM, BHI) as long as time logs stay exclusive. CPT 2026 introduced a shorter companion management code for 10 to 19 minutes; verify payer adoption before billing sub-20-minute months.