CMS proposes restrictions on remote patient monitoring billing for 2027

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule for the 2027 Physician Fee Schedule that would significantly alter reimbursement for remote patient monitoring (RPM) and remote therapeutic monitoring (RTM).

Key provisions in the proposal include a requirement that services only be billable when performed by clinical staff employed directly by the billing practice, effectively disqualifying work performed by contracted or outsourced staff. Additionally, the rule would require practitioners to conduct a separately reportable initiating visit before billing for RPM or RTM services.

The proposal also suggests lowering the value of several device supply codes by cross-walking them to self-measured blood pressure codes, citing a lack of sufficient pricing data. CMS has also requested information regarding the potential replacement of current RPM and RTM code sets with bundled monthly G-codes.

The announcement has met with broad opposition from provider groups, lawmakers, and insurers, all of whom have urged CMS to reconsider the proposed changes.