CPT 99458: Remote Patient Monitoring Treatment Management, Each Additional 20 Minutes
CPT 99458 is an add-on for each additional 20 minutes of remote patient monitoring (RPM) treatment management per calendar month, reported with 99457. In 2026 Medicare pays about $41.42 non-facility (1.24 total RVUs times the $33.4009 conversion factor) and about $26.39 in a facility.
- Code type
- RPM treatment management add-on (+20 min)
- 2026 non-facility
- $41.42 (1.24 RVUs)
- 2026 facility
- $26.39 (0.79 RVUs)
- Reported with
- 99457 (base RPM management)
What is CPT 99458 used for?
CPT 99458 is the add-on for additional RPM treatment-management time. After the first 20 minutes billed with 99457, each further full 20-minute block of management time in the same month is reported with 99458. It scales RPM revenue to match the clinical effort for higher-touch patients.
Because it is an add-on, 99458 never stands alone; it is valid only when reported with a qualifying 99457 in the same calendar month. The interactive-communication requirement is satisfied at the 99457 level, so the additional time captured by 99458 may be data review and care coordination, but every unit still needs a complete, documented 20-minute increment.
How much does 99458 pay in 2026?
99458 carries 1.24 non-facility RVUs and 0.79 facility RVUs. At the 2026 conversion factor of $33.4009 that is about $41.42 non-facility and $26.39 in a facility per unit. Medicare generally allows up to two units per patient per month, so a 60-minute RPM management month reaches roughly $134.61 non-facility. Model the stacked total on the Medicare fee calculator.
How does 99458 stack on RPM management?
| Management time | Codes | 2026 non-facility total |
|---|---|---|
| 20 min | 99457 | ~$51.77 |
| 40 min | 99457 + 99458 | ~$93.19 |
| 60 min | 99457 + 99458 x2 | ~$134.61 |
Example: a patient whose readings prompt two dose changes and extended coordination generates 45 documented minutes in the month. That supports 99457 plus one 99458, about $93.19, but not a second 99458, because the 45 minutes clears only one full additional 20-minute block. Extend that same month to 62 documented minutes and it supports 99457 plus two 99458 units, roughly $134.61, since 62 minutes contains two complete additional 20-minute increments.
The device-supply code 99454 is separate from these management minutes, so a full RPM month often stacks the device supply, the base management code, and one or more 99458 add-ons together. Keeping the management time log distinct from the device-supply period is what lets each of those charges stand on its own.
Frequently asked questions
99458 is an add-on reported only with base code 99457 for each additional full 20 minutes of RPM treatment-management time in a calendar month beyond the first 20. Each unit needs a complete 20-minute increment. Medicare generally allows up to two 99458 units per month, for up to 60 total minutes of RPM management.
The 2026 national non-facility allowed amount is about $41.42 (1.24 total RVUs times $33.4009) and about $26.39 in a facility per 20-minute unit. Stacked on 99457, a 60-minute RPM management month reaches roughly $135 non-facility.
The interactive-communication requirement is satisfied at the 99457 level for the month. The additional time captured by 99458 is treatment-management work, which may include data review and care coordination. Still, keep a running time log so each 20-minute add-on unit is backed by documented, dated activity.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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