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RPM · 2026 Medicare final

CPT 99470: RPM treatment management, first 10 minutes

CPT 99470 is the Medicare RPM code for treatment management, first 10 minutes. The CY2026 national non-facility rate is $26.05. A 99470 claim must pass 3 checks under the CY2026 Medicare final rule; each is below with its source.

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CPT 99470 documentation checklist

Why 99470 claims get stopped

  • 9 minutesHold
  • Billed with 99457 in the same monthHold
  • Portal messages onlyRepair
  • Note says call, time log says voicemailExpert review
  • No consent on fileRepair
  • Consent dated after the first serviceHold
  • Consent on file without a dateExpert review

  1. 01 · RPM-MGMT-02 · in force from 2026-01-01

    10 to 19 minutes of management in the calendar month, never with 99457

    Minutes
    10–19 in the calendar month
    “CPT codes 99470 and 99457 are also not additive. Billing practitioners would choose the most appropriate code for the time spent that calendar month.”
    CMS PFS CY2026 final, 90 FR 49397

    Examples

    • 12 minutesReady
    • 9 minutesHold
    • Billed with 99457 in the same monthHold

  2. 02 · 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 49397

    Examples

    • One 11-minute phone callReady
    • Video visit countsReady
    • Portal messages onlyRepair
    • Note says call, time log says voicemailExpert review

  3. 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. 13

    Examples

    • 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

Related RPM codes

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.