CMS is proposing a Medicare payment ban for remote patient monitoring services delivered by third-party vendors.
Here are six things to know:
1. The proposed rule, released July 14 as part of the 2027 physician fee schedule, would allow payment for remote physiologic monitoring and remote therapeutic monitoring only when clinical staff employed by the billing practice furnish the services, not contracted third-party companies. Staff would not need to be on-site, but the billing relationship would have to run through the practice itself.
2. CMS said outsourcing remote patient monitoring to a third party “can fragment care, lead to insufficient involvement and oversight of the billing practitioner, or result in services that do not actually represent or facilitate all required aspects” of the services.
3. The agency cited its Office of Inspector General findings, including a 2024 report that found 43% of Medicare enrollees who got remote patient monitoring in 2022 missed at least one required service component, and a 2025 report showing remote patient monitoring payments jumped 31% from $408 million in 2023 to $536 million in 2024.
4. The proposal would also require that remote patient monitoring services go only to established patients, mandate a separately reportable initiating visit before billing, and seek comment on bundling codes.
5. Some industry groups oppose the change. Christopher Adamec, executive director of the Alliance for Connected Care, told TechTarget the proposal “ends RPM, both high quality and low quality,” warning it could cut off access for beneficiaries who rely on vendor-run programs, particularly at smaller and rural organizations.
6. CMS is accepting comments on the proposed rule through Sept. 14, with most provisions set to take effect Jan. 1, 2027.
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