Billing & Reimbursement

CPT Codes & Billing Guides.

Medicare billing guides for every reimbursable care management program—RPM, CCM, PCM, BHI, and RTM. CPT codes, reimbursement rates, eligibility criteria, and documentation requirements in one place.

5 programs
01

RPM

Remote Patient Monitoring

Remote Patient Monitoring enables clinicians to monitor patient health data collected via FDA-cleared devices outside of traditional clinical settings. RPM is reimbursed through a set of CPT codes covering device setup, ongoing data transmission, and clinical time spent reviewing and acting on the data.

4 CPT codes$120–$210/mo per patient
02

CCM

Chronic Care Management

Chronic Care Management provides reimbursement for the non-face-to-face care coordination services delivered to Medicare patients with multiple chronic conditions. CCM covers the development and management of comprehensive care plans, medication reconciliation, and coordination across providers and community services.

4 CPT codes$62–$175/mo per patient
03

PCM

Principal Care Management

Principal Care Management provides reimbursement for care management services focused on a single high-risk chronic condition. PCM is designed for patients who need intensive management of one complex condition rather than the multi-condition coordination provided by CCM. It is particularly suited for conditions requiring frequent monitoring and treatment adjustments.

2 CPT codes$70–$137/mo per patient
04

BHI

Behavioral Health Integration

Behavioral Health Integration supports the assessment and management of behavioral health conditions within primary care settings through a psychiatric collaborative care model. BHI enables primary care providers to deliver behavioral health services — including depression screening, anxiety management, and substance use disorder monitoring — with psychiatric consultation support.

1 CPT codes$49–$49/mo per patient
05

RTM

Remote Therapeutic Monitoring

Remote Therapeutic Monitoring enables clinicians to monitor non-physiologic data such as therapy adherence, pain levels, medication response, and functional status using FDA-cleared medical devices or software. Unlike RPM (which monitors physiologic data like blood pressure and glucose), RTM is designed for respiratory, musculoskeletal, and cognitive therapy outcomes tracking.

5 CPT codes$110–$195/mo per patient

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