A deep dive into CMS' limits on RPM payments
Last week, remote patient monitoring companies experienced extreme whiplash.
On Tuesday, the Centers for Medicare and Medicaid Services released its proposed Physician Fee Schedule for 2027, in which it nixed payment for vendors providing remote patient monitoring services. The news sent companies in the remote patient monitoring space reeling.
Early in the day on Wednesday, the Rural Patient Monitoring bill, which would increase rates for remote patient monitoring services for doctors practicing in the nation’s more bucolic zip codes, advanced out of the House Ways and Means Committee.
“I've been talking to people about ships passing in the night,” says Chris Adamec, VP at lobbying and consulting firm Sirona Strategies and Executive Director of the Alliance for Connected Care, which lobbies on remote patient monitoring policy.
What’s going on here
President Donald Trump’s administration wants to root out fraud, waste and abuse and also embrace tech-supported health care that can increase quality of care while reducing cost. That led to a proposed PFS that is only willing to pay for RPM that’s provided by a patient’s physician—not a third party. That’s a shock to the many companies that offer remote monitoring for health system patients. Still, the PFS was not a total loss. Read further down to see what else in the proposal points to opportunities not only for RPM, but tech-enabled care as a whole.
Episode 2 of Rounds is here!
Co-hosted by Christina Farr and Stephanie Davis, this episode dives into the biggest debates shaping digital health right now. Keaton Bedell, co-founder and CEO of Bridge, joins to unpack an exclusive data report on where virtual care is headed next, and Joe DeVivo, President, CEO, and Chairman of Butterfly Network, sits down to talk about the Midjourney partnership that's redefining the future of full-body imaging.
The industry perspective
The proposed PFS says the agency will only pay for RPM when furnished and directly overseen by a doctor or clinician who has a pre-established relationship with a patient. Many health systems work with a vendor to conduct their remote payment monitoring programs, says Adamec.
“I don't think that the providers that have chosen a vendor are going to decide to build it themselves if the vendor goes away,” says Adamec. “I think the patients are going to be cut off and not have access, and we're just going to go back to 1990s healthcare.”
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