RPM · 2026 Medicare final
CPT 99458: RPM treatment management, each additional 20 minutes
CPT 99458 is the Medicare RPM code for treatment management, each additional 20 minutes. The CY2026 national non-facility rate is $41.42. A 99458 claim must pass 3 checks under the CY2026 Medicare final rule; each is below with its source.
CPT 99458 documentation checklist
Why 99458 claims get stopped
- Portal messages onlyRepair
- Note says call, time log says voicemailExpert review
- 2 × 99458 with 42 minutesHold
- No consent on fileRepair
- Consent dated after the first serviceHold
- Consent on file without a dateExpert review
01 · RPM-MGMT-03 · in force from 2026-01-01
At least one live, interactive communication with the patient in the month
“…require a live, interactive communication with the patient/caregiver. The interactive communication contributes to the total time, but it does not need to represent the entire cumulative reported time.”
CMS PFS CY2026 final, 90 FR 49397Examples
- One 11-minute phone callReady
- Video visit countsReady
- Portal messages onlyRepair
- Note says call, time log says voicemailExpert review
02 · RPM-MGMT-04 · in force from 2026-01-01
Each additional 20 minutes after the first 20
- Minutes per unit
- 20
“…each additional 20 minutes.”
CMS PFS CY2024 final, 88 FR 78882Examples
- 42 minutesReady
- 39 minutesReady
- 2 × 99458 with 42 minutesHold
03 · RPM-CONS-01 · in force from 2021-01-01
Patient consent on file, at the latest when the first service is furnished
“…allow consent to be obtained at the time that RPM services are furnished.”
CMS PFS CY2021 final, 85 FR 84544 · MLN901705 p. 13Examples
- Signed consent dated before the first readingReady
- Verbal consent in a note with date and staffReady
- No consent on fileRepair
- Consent dated after the first serviceHold
- Consent on file without a dateExpert review
This page explains Medicare rules; it is not legal or billing advice. Rates are CY2026 national non-facility amounts; your MAC's locality rates differ.