CMS has delayed by two years its plan to stop paying for remote patient monitoring services delivered by third-party vendor staff. The start date moves from Jan. 1, 2027, to Jan. 1, 2029, under the calendar year 2027 Medicare Physician Fee Schedule final rule, which CMS released Nov. 4.
Starting in 2029, practices can bill Medicare’s remote physiologic monitoring and remote therapeutic monitoring codes only when the clinical staff delivering the services are direct employees of the billing practitioner or practice. CMS said the delay gives practices time to hire and train staff for in-house workflows. The agency also plans to issue subregulatory guidance clarifying acceptable clinical staff arrangements before the deadline.
Practices can still get devices, software, connectivity, data hosting, cybersecurity and technical support from outside companies. The restriction targets only vendors that supply clinical staff time. Many commenters had asked CMS to push the requirement to at least Jan. 1, 2028.
Other remote monitoring changes take effect Jan. 1, 2027. Practitioners must hold a face-to-face initiating visit, in person or via telehealth, before billing for remote monitoring. Remote therapeutic monitoring is also now limited to established patients. Patients enrolled in remote monitoring before Jan. 1, 2027, are exempt from the initiating visit requirement.
CMS also finalized lower practice expense inputs for several device supply and setup codes. The reductions will be phased in, with no single-year cut above 19%. The agency dropped a proposal to strip practice expense inputs from treatment management codes after commenters said clinical staff typically perform that work.
CMS tied the changes to HHS Office of Inspector General reports, including one that found 43% of Medicare enrollees who received remote patient monitoring did not get all three components of the service.
The American Medical Association’s valuation committee will review practice expense for all 19 remote monitoring codes in January 2027.
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