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MedicaidCoverageMedium impact

Coverage for Remote Physiologic Monitoring

Nebraska Medicaid·NE · Cardiology, OB-GYN, Family Medicine +1 more·Medical Policy
Effective date
Jul 1, 2026
We identified it
Jun 21, 2026
Days to comply
9 days

Summary

Nebraska Medicaid will begin covering Remote Physiologic Monitoring (RPM) services effective July 1, 2026, for patients with heart failure or hypertensive disorders of pregnancy. Six new billing codes (99453, 99454, 99455, 99457, 99458, 99470) are now available with specific documentation and eligibility requirements.

Action Required

Before Jul 1, 2026
By July 1, 2026: Billing team must add RPM codes 99453, 99454, 99455, 99457, 99458, and 99470 to billing system for Nebraska Medicaid patients. Update encounter forms and EMR templates to include required documentation elements: patient consent, FDA-approved device verification, home environment assessment, clinical goals, and monitoring duration. Providers must verify patients have heart failure or hypertensive disorders of pregnancy and are established patients before ordering RPM services.

Affected Billing Codes

99453
99454
99455
99457
99458
99470