Summary
Independence Blue Cross MA12.010d updates Remote Patient Monitoring (RPM) billing codes effective 01/01/2026. Six new CPT codes (98979, 98984, 98985, 98986, 99445, 99470) have been added for reimbursement consideration, and eight existing codes have had their narratives revised. RPM coverage remains limited to Medicare Advantage members with acute decompensated heart failure in home settings and requires program pre-approval submission to UMprogramsubmission@ibx.com.
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What to do
Action · 6 steps
01Billing team must update billing system to recognize and process the six newly added CPT codes (98979, 98984, 98985, 98986, 99445, 99470) for Medicare Advantage heart failure patients.
02Verify that CPT codes 98976, 98977, 98980, 98981, 99453, 99454, 99457, 99458 are updated in the system to reflect revised narratives.
03Providers must ensure their RPM programs are submitted to UMprogramsubmission@ibx.com for pre-approval BEFORE 01/01/2026 if not already approved; include required documentation (clinical parameters, data transmission methods, device identification, technical support, monitoring frequency of ≥16 days per 30-day period, and outcome tracking).
04Verify claims only process for acute decompensated heart failure (ICD-10 codes I50.1, I50.20, I50.21, I50.22, I50.23, I50.30, I50.31, I50.32, I50.33, I50.40) in home settings.
05Confirm S9110 and CPT 98975 remain non-reimbursable and block these codes in billing system.
06Claims submitted without program approval or for non-heart-failure conditions will be denied.
Codes mentioned
989799898498985989869944599470989769897798980989819945399454994579945898975S9110I50.1I50.20I50.21I50.22I50.23I50.30I50.31I50.32I50.33I50.40
Original notice
MA12.010d, Remote Patient Monitoring
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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Related policy hubs
Independence Blue Cross policiesCardiologyInternal MedicineGeriatricsCritical CareCode 98979Code 98984Code 98985Code 98986Code 99445Code 99470Code 98976Code 98977Code 98980Code 98981Code 99453Code 99454Code 99457Code 99458Code 98975Code S9110Code I50.1Code I50.20Code I50.21Code I50.22Code I50.23Code I50.30Code I50.31Code I50.32Code I50.33Code I50.40