CMS 2027 RPM and RTM CPT Codes: What's Changing and What Billing Teams Should Review Now

The CMS CY 2027 Physician Fee Schedule proposed rule does more than change who can perform Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services. It also proposes changing the codes themselves, how they are valued, and potentially how many of them exist at all.

If your practice bills RPM or RTM today, this article walks through exactly which codes are affected, what CMS is proposing to do to each one, and what your billing and coding team should be reviewing before the final rule is published.

For the broader staffing, initiating visit, and operational changes in the same proposed rule, explore our foundational breakdown in the CMS 2027 RPM Update: What Physicians and Practices Need to Know. Furthermore, if you are evaluating the financial impact of clinical labor shifts, check out our guide on CMS 2027 RPM Practice Cost Forecasting.

Quick Answer: What Is Changing With RPM and RTM Billing Codes in 2027?

CMS is proposing two separate but related coding changes for 2027:

• Change how much some codes are worth: CMS believes the cost of monitoring devices and equipment has dropped since these codes were first priced, and wants to update the payment amounts to match.
• Possibly replace the current codes with four new ones: CMS is asking for public feedback on whether to combine the existing set of RPM and RTM codes into just four new billing codes.

Neither of these is decided yet. Both are still proposals under review.

The Current RPM and RTM Code Family

Before looking at what might change, it helps to see the full list of codes under review across both monitoring categories.

Remote Physiologic Monitoring (RPM) Codes

Remote Therapeutic Monitoring (RTM) Codes

That is 16 individual codes across both code families, plus 99470, for a total of 17 codes CMS has flagged as part of this proposal.

1. How CMS Is Proposing to Revalue These Codes

CMS is not proposing a single across-the-board cut. Instead, the agency is proposing two different adjustments depending on what type of code it is.

Setup and Device Supply Codes: Crosswalked to Lower-Cost Codes

CMS is proposing to reassign, or "crosswalk," the practice expense inputs of certain RPM and RTM codes to other existing CPT codes that carry lower resource assumptions:

• The initial setup and education codes, 99453 (RPM) and 98975 (RTM), would be crosswalked to CPT 99473 (self-measured blood pressure patient education and device calibration).
• The RPM device supply codes, 99445 and 99454, would be crosswalked to CPT 99474 (self-measured blood pressure data collection and reporting).
• The RTM device supply codes (98976, 98977, 98978, 98984, 98985, and 98986) would be crosswalked to CPT 93270 (24-hour attended external electrocardiogram event recording).

In practical terms, this means CMS wants to value the work and supply cost of setting up and maintaining RPM or RTM devices using the cost profile of a different, generally lower-cost service, rather than the cost data originally used to build these codes.

Treatment Management Codes: Practice Expense Removed Entirely

For the treatment management codes (99457, 99458, 99470, 98979, 98980, and 98981), CMS is proposing something more direct: eliminating the practice expense component entirely, while keeping the existing physician work values and time components in place.

CMS's stated reasoning is that these codes already reflect physician or qualified healthcare professional work, and that the resource costs are captured there rather than in separate clinical staff time. Practices should understand what this means for their financial modeling: if finalized, this proposal would strip out the portion of the code's value tied to clinical staff time even though clinical staff time is central to how most practices actually deliver treatment management services.

This is a meaningful distinction. It is not simply an across-the-board rate reduction; setup and supply codes may be pegged to lower-cost codes, and treatment management codes may lose their clinical staff cost component altogether. For a deeper breakdown of how this interacts with staffing requirements, see our physician guide to the CMS 2027 RPM update.

2. The Proposed Four-Code Bundle

Separately from the revaluation proposal, CMS is seeking public comment on collapsing the 17 codes above into four new HCPCS Level II G-codes, generally understood to correspond to two codes for RPM and two for RTM.

What this would likely mean, based on how CMS frames the request:

• A significant simplification of the current fragmented code family.
• New codes intended to more clearly separate the work performed by the billing practitioner from time spent by clinical staff.
• A structural change that would affect claims systems, EHR order sets, and payer contracts built around the current 17-code structure.

What we do not yet know:

• The specific descriptions, time thresholds, or valuations of the proposed G-codes.
• Whether all 17 existing codes would be eliminated or whether some would remain alongside the new codes.
• How commercial payers that currently mirror Medicare's RPM/RTM coding would respond if CMS finalizes a new structure.

Because CMS has only requested comments on the concept, not published draft code language, practices should not assume any specific G-code definitions at this stage.

What Should Practices Actually Do Right Now?

While you shouldn't overhaul your systems prematurely, there are three proactive steps to complete during the comment period:

1. Know where these codes live in your systems: Make a list of every place 99453, 99454, 99457, 99458, 98975 through 98981, and related codes appear in your EHR templates, superbills, and billing software. You won't be scrambling to find them if CMS finalizes changes on a tight timeline.
2. Model more than one financial outcome: Rather than assuming your revenue stays flat, build realistic financial models. You can utilize our step-by-step framework in the CMS 2027 RPM Practice Cost Forecasting Guide to calculate conservative, expected, and optimized scenarios.
3. Check your commercial payer contracts: Some commercial insurers set their RPM and RTM rates by referencing Medicare's code structure. If Medicare's codes change, those contracts may need a second look independent of Medicare itself.

Do not overhaul your billing system based on a proposal. Wait for the final rule. Making permanent changes now, based on proposed language that could still shift after public comments, creates unnecessary work and risk.

CMS 2027 RPM and RTM Coding FAQs

Final Takeaway

The coding portion of the CMS 2027 proposed rule is easy to undersell as a simple valuation update, but it represents a structural shift. CMS is proposing to revalue setup and device supply codes using cost data borrowed from unrelated services, strip practice expense entirely from treatment management codes, and explore replacing the entire 17-code RPM/RTM family with four new codes.

For billing and coding teams, the immediate mandate is preparation, not implementation: audit code utilization in your EHR, model financial scenarios, and track commercial payer alignment. For more details on clinical staffing rules and initiating visit requirements, refer to our companion analysis on CMS 2027 RPM Policy Updates.

Authoritative Sources

• Centers for Medicare & Medicaid Services — CY 2027 Medicare Physician Fee Schedule Proposed Rule Fact Sheet
• Federal Register — CY 2027 Payment Policies under the Physician Fee Schedule and Other Part B Payment Policies
• HHS Office of Inspector General — Reports concerning Medicare Remote Patient Monitoring