CMS delays contractor-staffed remote monitoring ban to 2029
- CMS delayed to Jan. 1, 2029, its employed-staff requirement for RPM and RTM payment.
- From 2027, RTM services can be furnished only to established patients, CMS finalized.
- Practitioners billing RPM or RTM must furnish a separately reportable initiating visit.
- CMS cuts the non-QP conversion factor by 2.31% for CY 2027.
MARYLAND, UNITED STATES — Medicare practices that use contractors to deliver remote patient monitoring have two more years before that model stops being paid. The Centers for Medicare & Medicaid Services (CMS) has delayed until Jan. 1, 2029, its requirement that remote monitoring be performed by clinical staff employed by the billing practitioner.
The requirement covers remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services. Until it takes effect, practices can keep billing Medicare for monitoring that contractors perform.
Two more years to adapt
CMS set out the delay in its calendar year 2027 physician fee schedule final rule, released Nov. 4, AHA News reported.
The agency finalized the restriction itself but pushed back its start date, Fierce Healthcare reported. CMS said the delay gives “practices that rely on contractors two additional years to adapt.”
New rules start in 2027
Other remote monitoring changes go ahead as proposed. RTM services must be furnished only to established patients.
Practitioners billing for RPM or RTM services must also furnish a separately reportable initiating visit at the onset of the services.
Industry pushed back
Health tech companies, providers and lawmakers had urged CMS to reconsider the restriction on third-party vendors to preserve patients’ access to the services, Fierce Healthcare reported.
Many rural, small and independent practices, as well as urban and rural health systems, rely on specialized clinical and technology partners to make remote monitoring available to patients, it said.
Lower pay rates in 2027
The same rule decreases payments to physicians. CMS is reducing the conversion factor for qualifying alternative payment model participants by 1.83% and for other practitioners by 2.31% in 2027, compared with 2026.
For clinicians outside an advanced alternative payment model, the conversion factor drops from $33.40 to $32.63, Fierce Healthcare reported. The final cuts are steeper than the 1.68% (non-QP) and 1.19% (QP) cuts CMS proposed in July.
What it means for providers
For practices that outsource RPM staffing, the delay buys time to decide whether to hire monitoring staff, bring the service in-house or rework vendor contracts before 2029.
For vendors that supply clinical staff for remote monitoring, the rule sets a firm date. From 2029, Medicare will pay for RPM and RTM only when the billing practice’s own employees perform them.
Practices weighing remote patient monitoring partners or wider healthcare outsourcing can compare providers on OA’s list of the top healthcare outsourcing companies in the United States.
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