Last updated: February 10, 2026
1. Obtain Written Consent: Capture and store patient agreement before starting services. Include revocation rights and data sharing permissions in the documentation.
2. Aggregate OEM Data: Pull Medtronic, Abbott, Boston Scientific, and Biotronik transmissions into a single workflow. This approach prevents missed billable events.
3. Track Transmission Days: Monitor daily data collection. Confirm 16 or more days for 99454 or 2–15 days for 99445 to meet requirements.
4. Document Interactive Communication: Record every patient contact, clinical decision, and care plan change. These records support management codes.
5. Maintain Time Logs: Track clinical staff minutes for each patient. Use these logs to support 99457, 99458, or 99470 billing.
6. Stack Codes Appropriately: Apply modifier -59 when billing CIED codes 93298 or 93299 with RPM codes. This modifier shows that services are distinct.
7. Verify Payer Policies: Confirm commercial payer adoption of the new 2026 codes before rolling them out in your workflows.
8. Integrate EHR Systems: Set up bi‑directional data flow with Epic, Cerner, or other EHR platforms. This integration supports accurate and efficient documentation.
Rhythm360 provides vendor‑neutral automation that ingests data from all major OEM portals. The platform delivers AI‑powered triage that reduces response times by 80% and maintains data capture rates above 99.9%. Automated documentation and billing support help practices achieve 300% revenue increases while maintaining zero claim denials.
A three‑physician electrophysiology clinic struggled with fragmented Medtronic and Abbott portals. The team missed 40% of billable CIED interrogations and RPM opportunities. After implementing Rhythm360’s unified platform, the practice achieved a 300% revenue uplift, zero billing denials, and an 80% reduction in critical alert response times. Automated aggregation captured previously missed 93298 and 93299 quarterly billings while improving 99454 monthly cycles. The clinic recovered $250K in annual revenue within six months.
Check | Yes/No | Evidence Required | Action |
Written consent obtained before service | ___ | Signed consent forms with date stamps | Implement consent workflow if missing |
Minimum data days documented | ___ | Transmission logs showing 2+ or 16+ days | Deploy an automated tracking system |
Interactive communication recorded | ___ | Call logs, secure messages, care notes | Document all patient interactions |
Time tracking for management codes | ___ | Clinical staff time logs with patient IDs | Implement time tracking protocols |
Appropriate modifier usage | ___ | Claims showing -59 for stacked services | Review NCCI edits and modifier rules |
Practices must obtain written patient consent before starting RPM services. The consent should clearly explain the monitoring process, data sharing, and the patient’s right to revoke consent at any time. Staff must store the consent in the patient record with date stamps and signatures. Verbal consent alone does not meet billing compliance standards.
Code 99454 still requires 16 or more days of device data transmission within a 30‑day period. The new 99445 code allows billing for 2–15 days of data collection, which supports episodic monitoring and post‑discharge care. Practices cannot bill these codes together in the same month for the same patient.
CIED interrogation codes can be billed concurrently with RPM codes when the services are distinct. Use modifier -59 to indicate separate clinical needs. CIED codes address device‑specific arrhythmia and threshold data. RPM codes cover physiologic parameters such as blood pressure and weight trends. Documentation must show medical necessity for both services.
Code 99470 requires documentation of 10–19 minutes of clinical staff time spent on patient care management. This work must include live interactive communication with the patient or caregiver. Time logs should list start and end times, clinical decisions, and care plan changes. Practices cannot bill this code with 99457 in the same month.
Medicare has adopted all 2026 CPT changes effective January 1. Commercial payers may follow different adoption timelines and coverage policies. Some payers may keep different day thresholds or require prior authorization. Practices should confirm each payer’s RPM policies and secure written coverage confirmations before using new codes.
The 2026 CPT code changes create new revenue opportunities for cardiology practices through flexible billing options and lower thresholds. Practices that succeed will automate data aggregation, maintain airtight documentation, and use code stacking strategically to increase reimbursement while limiting audit risk. Schedule a Rhythm360 demo today to automate CPT code billing for remote patient monitoring and increase revenue by up to 300%. Put these changes in place now to capture the full financial potential of your RPM program.
