Medicare covers Georgia Remote Patient Monitoring (RPM), but it bills as a recurring monthly cost, not the one-time charge most people expect. If your doctor sends you home with a connected blood-pressure cuff, scale, or pulse oximeter that reports your readings back to the clinic, Part B pays for it, and you usually owe 20% coinsurance every month the program runs. This guide explains what you will actually owe, the rules that change your bill, and how a QMB or Medigap plan can bring it to zero.

What Georgia Medicare remote patient monitoring covers

Remote Patient Monitoring (RPM) is a set of Medicare Part B services, covered since 2019, that pay a physician or qualified health professional to collect and act on physiologic data sent from a connected device at your home. Typical readings are blood pressure, weight, blood glucose, and oxygen saturation, used to manage conditions such as hypertension, heart failure, diabetes, and chronic obstructive pulmonary disease (COPD).

Medicare pays for RPM through four billing codes, and it helps to know them because each one can show up as a separate line on your statement:

  • CPT 99453 covers the one-time set-up of the device and teaching you how to use it.
  • CPT 99454 covers the device supply and data transmission, and generally requires at least 16 days of readings within a 30-day period.
  • CPT 99457 covers the first 20 minutes of your care team's monitoring and treatment-management time in a calendar month.
  • CPT 99458 covers each additional 20 minutes beyond that first block.

RPM must be ordered by a physician or qualified health professional, it requires your consent obtained at the time the service is furnished, and only one practitioner may bill RPM for you in a 30-day period. The data has to come from a connected medical device that records and transmits automatically; a number you type into an app or read over the phone does not qualify as RPM.

What you will actually pay each month

Here the numbers matter. RPM sits under the Medicare Parts A, B, C, and D framework as a standard Part B service, so it carries standard Part B cost-sharing. In 2026, you first meet the $283 annual Part B deductible; after that, you pay 20% of the Medicare-approved amount.

RPM also recurs. In most months your care team bills the device code (CPT 99454) and at least the first management code (CPT 99457), and your 20% applies to each, every month the program continues. A device you were handed once can therefore generate a small bill month after month. Over a year of active monitoring, that adds up, which is why it is worth knowing before you enroll rather than after the third statement.

Two things can bring your share to zero. If you qualify for Qualified Medicare Beneficiary (QMB) status through a Medicare Savings Program, Georgia Medicaid pays your Part B deductible and coinsurance, so you owe nothing for RPM. In 2026, Georgia's QMB income limit is $1,350 a month for a single person and $1,824 a month for a married couple, with a resource limit of $9,950 single and $14,910 for a couple. Those are the federal standards, not absolute cutoffs: states can effectively raise them by disregarding certain income and resources, so apply rather than rule yourself out. A Medigap (Medicare Supplement) policy can also cover the 20% coinsurance, depending on your plan letter.

The rules that quietly change your bill

Three RPM rules decide whether a charge appears at all, and they explain the partial or confusing bills Georgia beneficiaries sometimes see.

The 16-day rule can drop the device charge. CPT 99454 can only be billed in a 30-day period that has at least 16 days of readings. If you travel, are hospitalized, or simply stop using the device for part of the month and fall under 16 days, that device charge cannot be billed for that month, even though the management time (CPT 99457) may still be billed if your care team spent at least 20 minutes on it. That is why a bill can look different from one month to the next.

Only one practitioner bills RPM per 30 days. If more than one of your doctors is involved in your care, only one can bill RPM for you in a 30-day period. If you see a bill from an unexpected office, it is worth a call to sort out who is running the program.

You have to consent, so you can say no. RPM requires your consent at the time the service is furnished. You are allowed to ask what it will cost, decline to enroll, and ask your care team to stop the program if it is not helping. Consent is not a formality the practice can skip.

Remote Patient Monitoring (RPM) versus Remote Therapeutic Monitoring (RTM)

Georgia Medicare has a second, similar benefit that is easy to confuse with this one: Remote Therapeutic Monitoring (RTM), covered since 2022. The difference is what gets monitored and who can bill for it.

  • RPM tracks objective physiologic data (blood pressure, weight, glucose, oxygen) from a connected device, and is billed by physicians and qualified health professionals under codes 99453 to 99458.
  • RTM tracks non-physiologic therapeutic data, such as musculoskeletal or respiratory status and therapy adherence, under codes 98975 to 98981, and can be billed by therapists including physical therapists, occupational therapists, and speech-language pathologists.

Both rest on the same Medicare physician-services authority (the Social Security Act section 1861(s)(2)(B) and the "incident to" rules at 42 CFR 410.26) and both carry the standard 20% Part B coinsurance. They are not billed for the same monitoring activity. For the therapy-and-adherence side of this, see our guide to Georgia Medicare Remote Therapeutic Monitoring (RTM).

How to start Georgia Medicare remote patient monitoring without a surprise bill

1
Step 1

Ask your Georgia care team whether RPM fits your condition

RPM is meant for a specific acute or chronic condition your doctor is managing, such as high blood pressure or heart failure, not general wellness tracking. Ask what they would monitor and why.

2
Step 2

Ask what it will cost you before you consent

Because RPM recurs monthly, ask which codes they expect to bill and confirm that, in 2026, your share is 20% of the approved amount after the $283 Part B deductible.

3
Step 3

Check whether QMB or Medigap covers your share

If your income is near the limits, call GeorgiaCares, Georgia's free State Health Insurance Assistance Program, at 1-866-552-4464 to see whether a Medicare Savings Program would zero out your RPM cost.

4
Step 4

Give informed consent, and keep using the device

Once you agree, use the device on at least 16 days a month so the monitoring works and the device code can be billed correctly. You can ask to stop at any point.

5
Step 5

Read your Medicare Summary Notice

Watch for the RPM codes each month, and call the billing office or Palmetto GBA, Georgia's Medicare contractor, if a charge looks wrong.

Your next step Before you consent to RPM, call your doctor's billing office and ask which codes they will bill and what your monthly share will be, then call GeorgiaCares at 1-866-552-4464 to check whether a Medicare Savings Program can cover it.

Where to get help in Georgia

GeorgiaCares (Georgia SHIP) Free, unbiased Medicare counseling, including Medicare Savings Program screening. 1-866-552-4464https://acl.gov/programs/connecting-people-services/state-health-insurance-assistance-program-ship aging.georgia.gov/georgia-ship
Medicare Coverage questions and your Medicare Summary Notice. 1-800-633-4227https://www.medicare.gov/talk-to-someone www.medicare.gov
Palmetto GBA (Georgia Medicare contractor) Questions about how a specific RPM claim was processed. 1-866-238-9650 www.palmettogba.com
Georgia Medicaid Member Services Verify QMB or other Medicare Savings Program coverage. 1-866-211-0950https://www.gabar.org/about-the-bar/contact-us dch.georgia.gov

Frequently Asked Questions

Does Medicare cover remote patient monitoring in Georgia?

Yes. Remote Patient Monitoring (RPM) has been a covered Medicare Part B service since 2019. It pays your physician or qualified health professional to collect and manage physiologic data (such as blood pressure, weight, glucose, or oxygen) sent from a connected device, using CPT codes 99453, 99454, 99457, and 99458.

How much does RPM cost me each month?

RPM carries standard Part B cost-sharing. In 2026, after you meet the $283 annual Part B deductible, you pay 20% of the Medicare-approved amount, and because the device and management codes are billed monthly, that 20% recurs each month the program runs.

Can I avoid paying for RPM?

Often, yes. If you have Qualified Medicare Beneficiary (QMB) status, Georgia Medicaid pays your Part B deductible and coinsurance, so RPM costs you nothing. In 2026, Georgia's QMB income limit is $1,350 a month single and $1,824 a month for a couple. A Medigap policy can also cover the coinsurance.

What is the 16-day rule?

The device-supply code (CPT 99454) can only be billed in a 30-day period with at least 16 days of readings. A month under 16 days cannot carry that device charge, though the management code (CPT 99457) may still apply if your care team spent at least 20 minutes.

Can I decline remote patient monitoring?

Yes. RPM requires your consent at the time the service is furnished, so you can decline to enroll and ask your care team to stop it later. It is not automatic.

What is the difference between RPM and RTM?

Remote Patient Monitoring (RPM) tracks physiologic device data (codes 99453 to 99458) and is billed by physicians. Remote Therapeutic Monitoring (RTM), covered since 2022, tracks therapeutic data such as therapy adherence (codes 98975 to 98981) and can be billed by physical, occupational, and speech therapists. They are not billed for the same activity.

Learn More

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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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