Serna HealthSerna
2026 CMS Rates

Turnkey Remote Care Bible

Every code, rule, and loophole you need — all in one place.

1
The Code

What you submit to CMS

2
The Trigger

What software must detect to unlock the claim

3
The Stack

Whether you can bill concurrently

Device Path Rule

Pick ONE device path per patient: RPM (Medical) OR RTM (Therapy). You cannot bill both in the same month.

RPM
Remote Physiological Monitoring
HypertensionHeart FailureDiabetesCOPD
CodeDescriptionPayTechnical TriggerStacking Rules
99453
Setup & Education1x
$21Device "First Signal" received + "Education Log" timestamped.
Bill once per episode.
99454
Device Supply (Full)MONTHLY
$5216+ unique days of data transmission in 30-day period.
CCMAPCMBHI
99445
994452026
Device Supply (Lite)MONTHLY
$522–15 unique days of data transmission. (Fallback if they miss 16 days).
CCMAPCM
99454
99457
Mgmt (Full)MONTHLY
$5220+ mins clinical staff time + 1 Live Interaction (Call/Video).
CCM
994702026
Mgmt (Lite)MONTHLY
$2610–19 mins clinical staff time + 1 Live Interaction.
99457
99458
Mgmt Add-OnADD-ON
$41Every additional 20 mins of staff time (e.g., 40, 60 mins total).
Unlimited units (theoretically), but audit risk if excessive.
Requirement: FDA-defined medical device (BP Cuff, Scale, Glucometer). Fitbits/Apple Watches do NOT qualify.
RTM
Remote Therapeutic Monitoring
MSKRespiratoryMed Adherence
CodeDescriptionPayTechnical TriggerStacking Rules
98975
Setup & Education1x
$21Device setup + Education log.
Bill once per episode.
98976
Resp. DeviceMONTHLY
$4716+ days of Respiratory data (e.g., smart inhaler usage).
9945498977
98977
MSK DeviceMONTHLY
$4716+ days of MSK data (e.g., steps/ROM for back pain).
9945498976
989842026
Resp. Device (Lite)MONTHLY
$472–15 days of Respiratory data.
98976
989852026
MSK Device (Lite)MONTHLY
$472–15 days of MSK data.
98977
98980
Mgmt (Full)MONTHLY
$5420+ mins clinical staff time + 1 Live Interaction.
CCM
989792026
Mgmt (Lite)MONTHLY
$2610–19 mins clinical staff time + 1 Live Interaction.
98980
Requirement: Device measures "non-physiological" data (adherence, pain) OR therapy response.