CMS Delays Medicare Third-Party RPM Payment Ban to 2029
CMS finalized a two-year delay, to January 1, 2029, of a proposal ending Medicare payment for remote patient monitoring services provided by third-party vendors contracting with healthcare providers, according to Healthcare Dive. The original start date was January 1, 2027. CMS cited HHS Office of Inspector General findings that third-party contracting has led to fraud and improper billing, since billing providers may lack oversight of care delivered by outside vendors. Under the finalized policy, Medicare will eventually pay only for RPM services provided by clinical staff employed by the practice treating the patient. CMS also finalized a separate change limiting payment for monitoring of non-physiologic metrics, such as medication adherence and pain levels, to established patients. Virtual care lobbying groups including ATA Action and the Connected Health Initiative said they will use the two-year window to push CMS for program-integrity safeguards that preserve RPM access.