2025 RPM, CCM, and APCM: Reimbursement Codes and Amounts

Towards the end of each year, the Centers for Medicare and Medicaid Services (CMS) releases its final Physician Fee Schedule, updating reimbursement policies and rates for the coming year. This year, there were a few notable changes for virtual care and chronic disease management: the introduction of Advanced Primary Care Management (APCM) Codes, and the elimination of G0511 for FQHCs and RHCs in favor of the CPT codes used by other fee-for-service providers.

Below is an overview of the new average national reimbursement amounts for 2025 for Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and APCM. The codes and amounts for specific localities can be found with the Physician Fee Schedule search tool.  

All amounts below are Per Patient Per Month unless otherwise indicated.

2025 Remote Patient Monitoring Reimbursement Amounts

Code: 99453
Description: Initial setup and patient education on device use
Amount: $19.73 per patient, one time.

Code: 99454
Description: Monthly supply of devices and transmission of data
Amount: $43.02

Code: 99457
Description: First 20 minutes of monitoring and intervening
Amount: $47.87

Code: 99458
Description: Additional 20 minutes of monitoring and communication
Amount: $38.49

Note: RPM can be provided by a Qualified Healthcare Professional or auxiliary personal under the general supervision of the billing provider. This allows practices to augment their clinical staff with outsourced nursing teams.

New in 2025: Federally Qualified Health Centers and Rural Health Centers will use the codes above, rather than the G0511 code they previously used.

2025 Chronic Care Management Reimbursement Amounts

Code: 99490
Description: 20 minutes of non-complex CCM per month
Amount: $60.49

Code: 99439
Description: Each additional 20 minutes of non-complex CCM
Amount: $45.93

Code: 99491
Description: 30 minutes of complex CCM provided by the physician
Amount: $82.16

Note: Non-complex CCM can be provided by a Qualified Healthcare Professional or auxiliary personal under the general supervision of the billing provider. This allows practices to augment their clinical staff with outsourced nursing teams.

RPM and CCM can be billed concurrently.

New in 2025: Federally Qualified Health Centers and Rural Health Centers will use the codes above, rather than the G0511 code they previously used.

NEW Advanced Primary Care Management Codes and Amounts

New in 2025, CMS introduced APCM codes, which consolidates elements of CCM, Principal Care Management (PCM), and other care management activities into a streamlined billing approach, eliminates the time-based component of CCM, and enables risk stratification.

APCM Codes Include:

Code: G0556
Description: APCM for patients with 1 or more chronic condition
Amount: $15.20

Code: G0557
Description: APCM for patients with multiple chronic conditions
Amount: $48.84

Code: G0558
Description: APCM for QMB enrollees with multiple chronic conditions, addressing higher complexity due to SDoH
Amount: $107.07

Note: APCM cannot be billed concurrently with CCM, but it can be billed concurrently with RPM.

Visit our RPM and CCM reimbursement calculator, or contact us to learn more today!