Remote patient monitoring (RPM) for diabetes involves using connected devices, such as cellular glucose meters and continuous glucose monitors (CGMs), to automatically transmit a patient’s physiologic data to a care team between visits. In Medicare, RPM is a billable service with its own codes, and it is growing fast: a federal review found Medicare RPM payments exceeded $500 million in 2024, with nearly 1 million enrollees. For 2026, CMS added two new RPM codes that change what a diabetes program can bill.
This guide is for the companies building RPM devices and software. It covers what qualifies as RPM, how Medicare pays for it in 2026, what federal auditors found, and what a diabetes RPM platform needs to do.
What counts as remote patient monitoring for diabetes
Medicare separates two kinds of remote monitoring, and the difference decides which codes apply:
- Remote physiologic monitoring (RPM) involves collecting physiologic data, such as glucose, blood pressure, and weight, using a device and automatically uploading it.
- Remote therapeutic monitoring (RTM) includes non-physiologic data, such as medication adherence and symptoms, that can be self-reported.
For RPM, CMS states that “the device used to collect and transmit the data must meet the definition of a medical device defined by FDA,” and the data must be transmitted automatically rather than entered by the patient.
Common diabetes RPM devices include:
Device | What it sends | Notes |
|---|---|---|
Cellular blood glucose meter | Each finger-stick reading, as it is taken | No phone or app needed, which helps older patients |
Continuous glucose monitor | Readings every few minutes, through the manufacturer’s app and cloud | Rich data; Medicare covers therapeutic CGM for insulin-treated patients and those with problematic hypoglycemia |
Connected blood pressure cuff | Blood pressure and heart rate | Common in diabetes programs, since many patients also have hypertension |
Connected scale | Weight | Useful for type 2 diabetes and obesity programs |
How Medicare pays for RPM in 2026
Medicare pays for RPM through a set of CPT codes covering setup, device supply, and clinical management time. The CY 2026 Physician Fee Schedule, effective January 1, 2026, added two codes for shorter monitoring periods and shorter management time.
Code | What it covers | Notes |
|---|---|---|
99453 | Initial setup and patient education on the device | Billed once per episode of care |
99454 | Device supply with daily recordings or programmed alerts, 16 to 30 days in a 30-day period | The long-standing “16-day” code |
99445 | Device supply with daily recordings or program alerts, 2 to 15 days in a 30-day period | New for 2026. Not billed with 99454 in the same period |
99457 | Treatment management, first 20 minutes in a calendar month, including interactive communication with the patient | Clinical staff time counts |
99458 | Each additional 20 minutes of treatment management | Add-on to 99457 |
99470 | Treatment management, first 10 minutes in a calendar month, with real-time interactive communication | New for 2026 |
The new codes matter for diabetes programs. Before 2026, a patient who transmitted data on fewer than 16 days in a month generated no device payment, and short check-ins below 20 minutes generated no management payment. Code descriptors above follow Noridian’s 2026 RPM guidance; confirm current values with your Medicare contractor.
CMS’s 2026 telehealth and remote monitoring booklet also sets these rules:
- Remote physiologic monitoring “requires an established patient relationship.”
- “Only 1 practitioner can bill for remote monitoring per patient in a 30-day period.”
- RPM and RTM cannot be billed together for the same patient.
- Device codes require data for 2 to 15, 16, or more days out of 30, depending on the code. Management codes 99457 and 99458 have no day requirement.
What federal auditors found
The HHS Office of Inspector General (OIG) has examined Medicare RPM twice since 2024, and its findings shape what payers and auditors will look for.
- September 2024. OIG’s report, Additional Oversight of Remote Patient Monitoring in Medicare Is Needed, found that “about 43 percent of enrollees who received remote patient monitoring did not receive all 3 components of it”: education and setup, device supply, and treatment management. RPM payments had grown from about $15 million in 2019 to more than $300 million in 2022.
- August 2025. OIG’s follow-up, Billing for Remote Patient Monitoring in Medicare, reported that payments exceeded $500 million in 2024 and that nearly 1 million enrollees received RPM. OIG suggested monitoring for patterns such as billing for multiple monitoring devices in a month for a single enrollee, and billing for many enrollees with no prior history with the practice.
For device and software makers, the message is clear: platforms that document every component, accurately count transmission days, and log management time and interactive communication make their customers’ programs easier to defend.
Beyond fee-for-service: the CMS ACCESS model
CMS is also testing a different way to pay for technology-enabled chronic care. The ACCESS Model (Advancing Chronic Care with Effective, Scalable Solutions) launched in July 2026 and runs for 10 years. Its cardio-kidney-metabolic track includes diabetes, chronic kidney disease, and atherosclerotic cardiovascular disease. Participants receive outcome-aligned payments for technology-supported care, which can include FDA-authorized devices.
Fee-for-service RPM pays for activity: days of data and minutes of management. Models like ACCESS pay for results. Diabetes RPM platforms that can show outcomes, such as changes in A1C or time in range, will be better placed under both.
Medicare coverage of the devices themselves also matters. Under Medicare’s CGM coverage policy, therapeutic CGMs are covered for beneficiaries who are insulin-treated or have a documented history of problematic hypoglycemia.
What a diabetes RPM platform needs
Billing rules translate directly into software requirements. A diabetes RPM platform should handle:
- Device connectivity. Support cellular meters for patients without smartphones, and connect to CGM data through each manufacturer’s cloud interface. See our guide to diabetes device interoperability.
- Automatic, auditable data capture. Record when each reading was taken and received, and count the transmission days per patient per 30-day period so the correct device code (99445 or 99454) applies.
- Clinician dashboards and alert triage. Show trends and time in range, flag readings outside thresholds, and route alerts to the right staff member.
- Time and communication logging. Track management minutes and record each interactive communication, as required by 99457 and 99470.
- Enrollment and consent records. Document the established patient relationship, setup, and education for 99453.
- EHR integration. Send summary data and reports into the clinic’s EHR, ideally using the HL7 FHIR CGM Implementation Guide. See why EHR interoperability matters.
- Security and privacy. An RPM vendor that handles patient data for a provider is typically a HIPAA business associate. See our guide to HIPAA in MedTech development.
- A regulatory assessment. Software that only transfers and displays device data may fall outside the FDA’s definition of a device, whereas software that analyzes readings to generate alerts may constitute a regulated device function. Our guide to diabetes management app development explains where the FDA draws the line.
Patient engagement is the hidden requirement. Every day a patient does not transmit data is a day that may not count toward billing, so simple devices, reminders, and clear onboarding matter as much as the clinician tools.
From hospital to home
RPM often starts at discharge. A patient who begins using a CGM during a hospital stay, or is sent home with one, can move straight into a remote monitoring program. For the inpatient side of that transition, see our guide to CGM in hospitals. For the sensor technology behind RPM, see advancements in sensors for remote patient monitoring.
Frequently asked questions
What is remote patient monitoring for diabetes?
It is the use of connected devices, such as cellular glucose meters and CGMs, to send a patient’s glucose and other physiologic data automatically to their care team between visits. In Medicare, it is a billable service when the device meets FDA’s definition of a medical device and the data uploads automatically.
What are the RPM CPT codes for 2026?
The main codes are 99453 (setup and education), 99454 (device supply, 16 to 30 days of data), 99457 (first 20 minutes of management), and 99458 (each additional 20 minutes). For 2026, CMS added 99445 (device supply, 2 to 15 days) and 99470 (first 10 minutes of management).
Can a CGM be used for remote patient monitoring?
Yes. CGMs are FDA-regulated devices that automatically transmit data, so they can support RPM. Medicare covers therapeutic CGMs for beneficiaries who use insulin or have a history of problematic hypoglycemia. Check payer rules on billing RPM codes alongside CGM-specific codes.
What is the difference between RPM and RTM?
Remote physiologic monitoring (RPM) covers physiologic data, such as glucose or blood pressure, uploaded automatically from a device. Remote therapeutic monitoring (RTM) covers non-physiologic data, such as medication adherence or symptoms, which can be self-reported. Medicare does not allow both to be billed together.
Does RPM still require 16 days of data?
Not for every code. Since January 1, 2026, code 99445 covers device supply for 2 to 15 days of data in a 30-day period, while 99454 still requires 16 or more days. Only one of the two can be billed for the same period.
Build your diabetes RPM platform with Sequenex
Diabetes RPM rewards platforms that make good care easy to deliver and easy to document. That means reliable device data, clinician tools that fit real workflows, and records that stand up to an audit.
Sequenex builds software for diabetes and connected devices, from device connectivity to clinical dashboards and EHR integration. See our biosensor and CGM software development services, or contact us to discuss your project.
