CMS Proposes Ban on Outsourced Remote Patient Monitoring for Medicare
CMS released the CY 2027 Physician Fee Schedule proposed rule restricting remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) under Medicare. The proposal would prohibit outsourcing of RPM/RTM services and revise reimbursement methodology, reversing 2026 expansions that lowered data-transmission thresholds and added new billing codes. The proposed changes would take effect January 1, 2027 if finalized. State Medicaid agencies that follow Medicare payment policies or allow RPM under managed care contracts may face operational and reimbursement changes if states align telehealth coverage with Medicare rules.
Medicaid managed care plans that reimburse RPM based on Medicare fee schedules or cover RPM for chronic conditions would need to assess contract language, payment rates, and vendor relationships if states adopt similar restrictions.
Managed Care
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