2026 Medicare reimbursement rates for RPM, CCM, PCM & BHI.
Every 2026 CPT/HCPCS rate in one place (RVU × $33.40 conversion factor), plus a calculator to estimate your practice’s annual revenue from remote care management.
Quick Answer
How much does Medicare pay for remote care management in 2026?
In 2026, Medicare reimburses remote care management under the Physician Fee Schedule using a $33.40 conversion factor (each code's rate = its RVU × $33.40). Core recurring monthly rates are approximately: RPM device supply (CPT 99454) $52.11 and treatment management (99457) $51.77; Chronic Care Management (99490) $62.00; Principal Care Management (99424) $88.00; and Behavioral Health Integration (99484) $53.00. RPM and CCM can be billed concurrently for the same patient, so a combined RPM + CCM enrollment generates roughly $1,991 per patient per year.
The Full Table
Every 2026 reimbursement rate.
National non-facility rates from the CMS Medicare Physician Fee Schedule (CY 2026), calculated as RVU × $33.40.
| Code | Program | Description | Frequency | RVU | 2026 Rate |
|---|---|---|---|---|---|
| 99490 | CCM | CCM Initial 20 Minutes | Once per calendar month | 1.86 | $62.00 |
| 99454 | RPM | RPM Device Supply (16+ Days) | Monthly (per 30-day period) | 1.56 | $52.11 |
| 99457 | RPM | RPM Clinical Review (First 20 Min) | Once per calendar month | 1.55 | $51.77 |
| 99453 | RPM | RPM Initial Setup (One-Time) | One-time per episode of care | 0.65 | $21.71 |
| 99458 | RPM | RPM Clinical Review (Additional 20 Min) | Monthly (per calendar month, add-on to 99457) | 1.24 | $41.42 |
| 99491 | CCM | Complex CCM Initial 30 Minutes | Once per calendar month | 2.57 | $86.00 |
| 99424 | PCM | PCM Physician Base (30 Min) | Once per calendar month | 2.63 | $88.00 |
| 99484 | BHI | BHI Care Management (20 Min) | Once per calendar month | 1.59 | $53.00 |
| 99492 | BHI | CoCM Initial Month (70 Min) | Once per CoCM episode — the initial month only (subsequent months bill 99493) | 4.88 | $163.00 |
| 99493 | BHI | CoCM Subsequent Month (60 Min) | Monthly, in each month after the initial 99492 month | 3.89 | $130.00 |
| 99494 | BHI | CoCM Add-On (Each 30 Min) | As needed, in 30-minute increments, in the same month as 99492 or 99493 | 1.98 | $66.00 |
| 99437 | CCM | Complex CCM Add-On (Each 30 Min) | Monthly, as needed, in addition to the base 99491 | 1.89 | $63.00 |
| 99439 | CCM | CCM Add-On (Each 20 Min) | Up to 2 units per calendar month, in addition to the base 99490 | 1.50 | $50.00 |
Tap any code for its full billing guide, documentation requirements, and scenarios.
Revenue Calculator
Estimate your annual revenue.
Enter your eligible Medicare panel, choose your programs, and see the recurring revenue at 2026 rates.
Your practice
Programs
Estimated annual revenue
| Program | Monthly | Annual |
|---|---|---|
| Remote Patient Monitoring (RPM) | $10,388 | $124,656 |
| Chronic Care Management (CCM) | $6,200 | $74,400 |
Estimate assumes 100 patients enrolled in each selected program at base recurring codes. RPM and CCM may be billed concurrently for the same patient. Add-on codes (e.g. 99458, 99439, 99437) and one-time setup (99453) can increase totals. Actual payment varies by locality (GPCI) and payer.
FAQ
2026 reimbursement questions.
How much does Medicare pay for RPM in 2026?
In 2026, recurring RPM reimbursement is about $103.88 per patient per month — CPT 99454 (device supply, $52.11) plus 99457 (treatment management, first 20 minutes, $51.77) — plus a one-time $21.71 setup (99453). Each additional 20 minutes (99458) adds $41.42. Over a year that's roughly $1,268 per enrolled patient before any add-on codes.
How much does Chronic Care Management (CCM) reimburse in 2026?
Standard CCM (CPT 99490, first 20 minutes of clinical staff time) reimburses about $62.00 per patient per month. Each additional 20 minutes (99439) adds $50.00 (up to twice). Complex/physician-provided CCM (99491) reimburses about $86.00, with a $63.00 add-on (99437) for each additional 30 minutes.
Can you bill RPM and CCM for the same patient?
Yes. RPM and CCM are separate services with separate CPT code families and can be billed concurrently for the same patient in the same month, as long as the time counted toward each is distinct and documentation supports both. Many practices combine RPM + CCM to maximize per-patient revenue and clinical value.
What is the 2026 Medicare Physician Fee Schedule conversion factor?
The 2026 Medicare Physician Fee Schedule conversion factor is $33.40 for non-qualifying providers ($33.57 for qualifying APM participants). Every code's national rate is its RVU value multiplied by this conversion factor, then adjusted for your locality (GPCI).
How much revenue can a remote care program generate?
It depends on panel size, enrollment, and program mix. As a benchmark, a single patient enrolled in both RPM and CCM generates roughly $1,991 per year in recurring reimbursement (RPM 99454+99457 plus CCM 99490). Use the calculator above to model your own practice.
Sources & Compliance
Reimbursement. Figures are CCN Health estimates based on the CMS Medicare Physician Fee Schedule (CY 2026) using published RVU values and the 2026 conversion factor of $33.40. Final payment varies by locality (GPCI), facility status, and payer contract. Fee schedules, RVUs, and conversion factors are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use.
CPT® notice. CPT is a registered trademark of the American Medical Association. CPT codes and descriptions only are copyright 2026 American Medical Association. All rights reserved. The plain-language descriptions shown are CCN Health’s editorial summaries, not the official AMA long descriptors.
Sources. CMS Medicare Physician Fee Schedule, CY 2026 (cms.gov); AMA CPT 2026 Code Set (ama-assn.org).
Disclaimer. This page is informational and does not constitute billing, clinical, or legal advice. Verify all codes, modifiers, and amounts against your contracted payer agreements and official CMS publications before billing.