Care Mgmt · CMS status A
99458
RPM treatment mgmt ea addl 20 min
Remote physiologic monitoring treatment management, each additional 20 minutes per calendar month. CMS 2026 wRVU 0.61, paid using the national GPCI and the 2026 conversion factor of $33.4009. Add-on to 99457; commonly accepted up to 2 units per month.
Work RVU
0.61
2026 Medicare pays
$37.07
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 0.61 + Practice 0.46 + Malpractice 0.04 = 1.11 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 99458 is locked
- When to use it: the exact clinical situations that support billing 99458
- Documentation checklist: the 3 elements your note needs before submitting
- Common pitfalls: the 4 mistakes that get 99458 downcoded or denied
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Common ICD-10 pairings
I10E11.65I50.32J44.9
Payer notes
Medicare and Medicare Advantage cover 99458 with the same rules as 99457. At 0.61 wRVU per unit, a fully documented 60-minute management month (99457 + 1 x 99458) carries 1.22 wRVU plus the 99454 device fee, which is why high-touch RPM panels rival CCM for care management revenue. Keep RPM, CCM, and BHI minutes in separate logs; concurrent billing is allowed and double-counting is the thing that unwinds it.
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.