Clinical services
Remote monitoring in 2027: what the final Medicare rule changed
CMS tightened RPM and RTM rules for 2027 but gave practices two more years before a ban on vendor-supplied clinical staff.
CMS released the 2027 Medicare Physician Fee Schedule final rule on November 4. A year after expanding remote monitoring, it is now tightening the rules. Here's what changed for remote patient monitoring (RPM) and remote therapeutic monitoring (RTM).
Effective January 1, 2027
- Initiating visit required. A practitioner must hold a face-to-face initiating visit, in person or by telehealth, before billing remote monitoring. Patients enrolled before January 1, 2027 are exempt.
- RTM limited to established patients.
- Lower device-supply payments. CMS finalized lower practice expense inputs for several device supply and setup codes. Cuts phase in, and no single-year reduction exceeds 19%.
Delayed to January 1, 2029
CMS had proposed ending payment for RPM and RTM services delivered by third-party vendor clinical staff starting in 2027. The final rule pushes that to 2029. When it takes effect, billing practices must use their own employed clinical staff for monitoring. Outside companies can still supply devices, software, connectivity and data hosting. CMS says it will issue guidance on acceptable staffing arrangements before the deadline.
What stays the same
The short-duration codes added for 2026 remain in place. They pay for 2–15 days of monitoring data in a month and for 10 minutes of management time.
Why CMS acted
CMS cited HHS Office of Inspector General findings, including that 43% of Medicare enrollees who received RPM did not receive all three service components. Medicare RPM payments rose 31% to $536 million in 2024.
What to watch
The AMA's valuation committee is scheduled to review practice expense for all RPM codes in January 2027, which could move rates again. Pharmacies running or considering monitoring programs with prescriber partners should confirm who employs the clinical staff before 2029.
Sources: CMS, CY 2027 Medicare Physician Fee Schedule Final Rule (Nov. 4, 2026); Becker's Payer Issues; Becker's Spine Review; Applied Policy summary; CY 2026 PFS final rule summaries.