RPM and Medicare in 2026: A new treatment service management code

How long must physicians and other clinicians meet with patients to count for billing purposes? Similar to the days per month, there is a proposed change for the amount of time spent with patients in remote physiologic monitoring and remote therapeutic monitoring. Lucienne Marie Ide, MD, PhD, is founder and CEO of Rimidi, a company that works with RPM, and the author of an analysis of the 2026 Medicare Physician Fee Schedule. Here she explains a second potential change in RPM time requirements for 2026.

Medical Economics: In your analysis, you also talked about the possibility of a new treatment management service code that is proposed. What would that code do?

Lucienne Marie Ide, MD, PhD: Similar to the data transmission code, there's a code, well, there are two codes, 99457, 99458, which are time-based codes, and they're measured in 20-minute increments of time spent reviewing that patient's data, communicating with that patient, coordinating care regarding that patient. But there was a similar problem, that if the practice didn't meet the 20 minutes, then there was no billable activity. So for instance, they might have been interacting with that patient, reviewing their data and accumulated 15 minutes over the course of the month, and they weren't able to bill anything for that time. So there's a newly proposed code that would allow for 10-minute increments of billing, and again, that may be appropriate for a good number of patients, and will allow those patients to participate in these programs and allow practices to sustain RPM programs for a broader base of patients.