CMS-1848-F · Final CY 2027 rates
What is your RPM program worth in 2027?
Three questions give you your program's Medicare revenue at the final 2027 national rates; your locality, care management and churn make it exact.
What kind of organization runs the program?
This sets a starting panel size. You can change every number on the next screens.
How many patients are in your program?
Patients on the program in a typical month. Planning a new program? Enter the size you are aiming for; you can add a ramp-up later.
Each new patient bills the one-time setup and education code (99453). They replace patients who finish monitoring, so the panel holds steady. We start at 15 for every 200 enrolled.
How do patients engage with the program?
The defaults are where most programs land. Move them if you know your own numbers.
These patients bill the device and readings code (99454). We assume 10% send readings on fewer than 2 days and bill no device code that month, which leaves 20% at 2 to 15 days (99445, same rate).
Clinical staff time reviewing readings and talking with the patient. It bills treatment management (99457).
Your program would earn about $0.00 per patient-month in 2027
That is $0 a year for 200 patients, at national rates.
CMS RVU26D and CMS-1848-F Addendum B and Addendum E. Rates updated November 4, 2026.
An estimate for planning, not a guarantee of payment. Amounts are the full Medicare allowable before coinsurance. Read the notes.
Your enrolled patients every month at these engagement rates, at 2027 national rates, times twelve. A patient-month is one enrolled patient for one month.
Get your locality's exact rates
- Your Medicare locality, one of 109
- Care management stacked with RPM (CCM, PCM or APCM)
- Churn and ramp-up over the year
- A saved scenario, sent to you
Your locality rates are unlocked
Pick your Medicare locality, add care management and churn, and see your full result.
Where does your practice bill Medicare?
Medicare adjusts every rate for local costs in 109 localities. Pick the one on your claims, or keep the national rate.
Do you also bill care management?
RPM and CCM or PCM can be billed in the same month when the time is documented separately. APCM stacks with RPM but not with CCM or PCM.
More about care team time
The second 20 minutes bills 99458. Typical programs see about 30%.
A shorter tier (99470) for patients who need less time in a month. A patient bills this or the 20-minute code, so the two shares add up to at most 100%.
Who does the monitoring work today?
January 1, 2029
From January 1, 2029, Medicare pays for RPM and RTM services only when clinical staff employed by the billing practice furnish them. Which codes this covers is pending the rule text. Until December 31, 2028, contracted staff qualify.
This answer does not change any figure.
How will your panel change over the year?
These turn a steady month into a year that follows your panel month by month.
Your new monthly patients replace those who finish monitoring. Churn is the extra share who drop out, move or stop sending readings, which shrinks the panel each month. 3% is a common starting point.
0 means you are already there. For a new program, enter how many months enrollment will take; the panel grows in equal steps.
Your program would earn about $0.00 per patient-month in 2027
CMS RVU26D and CMS-1848-F Addendum B and Addendum E. Rates updated November 4, 2026.
An estimate for planning, not a guarantee of payment. Amounts are the full Medicare allowable before coinsurance. Read the notes.
Fully implemented is CMS's published value with no transition limits, at the 2027 conversion factor. It is a reference point, not a 2028 or 2029 rate. The next step for the device codes could come as early as 2028 unless the inputs change; the schedule is pending the rule text.
January 1, 2029
From January 1, 2029, Medicare pays for RPM and RTM services only when clinical staff employed by the billing practice furnish them. Which codes this covers is pending the rule text. Until December 31, 2028, contracted staff qualify.
CareSimple customers with an outsourced care-management arrangement will have a migration path before January 1, 2029.
Show the monthly figures
Show the code-level detail
How we calculate
The rate for each code
Medicare prices a code by its relative value units (RVUs) for physician work, practice expense and malpractice. Each is multiplied by your locality's geographic index (GPCI), and the sum by the conversion factor: $33.4009 in 2026 and $32.6286 in 2027. Rates are non-facility (a practice or home setting).
Device codes
By law, a drop of 20% or more in a code's total RVUs is phased in over two years, and CMS limits the first year's drop to 19%. 99454 and 99445 go from 1.56 to 1.26 total RVUs; with the lower conversion factor, payment falls 21.1%. 2026: $52.11; 2027: $41.11.
Fully implemented is CMS's value with no phase-in (0.29 total RVUs, $9.46 nationally), at the 2027 conversion factor. It is a reference point, not a 2028 or 2029 rate.
Treatment and care management
Treatment management (99457, 99458, 99470) is within 1.5% of 2026. Care-management codes had no policy changes; their rates moved with the conversion factor and this year's practice-expense updates, 0.5% to 4.4% lower.
What each share means
- 16 or more days: patients whose device sends readings on 16+ days in a 30-day cycle (99454).
- 2 to 15 days: what is left after the 16+ day share and the patients who send readings on fewer than 2 days (99445).
- 20 minutes: patients with at least 20 minutes of care team time in the month (99457); 40 minutes adds one 99458.
- 10 to 19 minutes: patients with a shorter month (99470), never the same patients as 20 minutes.
- New patients: one setup code (99453) each.
An assumption you can change. They bill no device code that month.
The twelve months
Month 1 starts with your enrolled patients (with a ramp of R months, one R-th of them). Each later month keeps (100% minus churn) of the previous month's patients and, until the ramp ends, adds another R-th. New patients each month scale with that month's panel, and ramp enrollments bill setup too. The annual figure is the sum of the twelve monthly totals; with no churn and no ramp it is twelve times the steady month. The per-patient-month figure is the steady month's total divided by your enrolled patients.
What these figures are
The full Medicare allowable. Medicare pays 80% and the patient or a supplemental plan owes 20% coinsurance. Sources: RVU26D (released 08/26/2026); CMS-1848-F Addendum B with CMS-1848-F Addendum E GPCIs; CMS-1848-F Fully Implemented PE RVUs.