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CMS is proposing a remote patient monitoring ban on Medicare payment for services delivered by third-party vendors, marking a significant shift in how the agency intends to regulate this growing category of billed services.
What the Remote Patient Monitoring Ban Would Require
The proposed rule, released July 14 as part of the 2027 physician fee schedule, would allow payment for remote physiologic monitoring and remote therapeutic monitoring only when clinical staff employed by the billing practice furnish the services, not contracted third-party companies. Staff would not need to be on-site, but the billing relationship would have to run through the practice itself.
Why CMS Is Proposing This Change
CMS said outsourcing remote patient monitoring to a third party “can fragment care, lead to insufficient involvement and oversight of the billing practitioner, or result in services that do not actually represent or facilitate all required aspects” of the services, framing the rationale behind this remote patient monitoring ban around care coordination and oversight concerns.
Evidence Behind the Remote Patient Monitoring Ban
The agency cited its Office of Inspector General findings, including a 2024 report that found 43% of Medicare enrollees who got remote patient monitoring in 2022 missed at least one required service component, and a 2025 report showing remote patient monitoring payments jumped 31% from $408 million in 2023 to $536 million in 2024.
Rapid Spending Growth Raises Scrutiny
That sharp rise in payments, combined with documented gaps in service delivery, appears to be a central driver behind CMS’s push for a remote patient monitoring ban targeting third-party vendor arrangements specifically, rather than the RPM billing codes themselves.
Additional Requirements Tied to the Remote Patient Monitoring Ban
The proposal would also require that remote patient monitoring services go only to established patients, mandate a separately reportable initiating visit before billing, and seek comment on bundling codes. These additional provisions suggest CMS is pursuing a broader tightening of RPM billing requirements beyond just the third-party vendor restriction.
Industry Pushback on the Proposal
Some industry groups oppose the change. Christopher Adamec, executive director of the Alliance for Connected Care, told TechTarget the proposal “ends RPM, both high quality and low quality,” warning it could cut off access for beneficiaries who rely on vendor-run programs, particularly at smaller and rural organizations.
What Comes Next for the Remote Patient Monitoring Ban
CMS is accepting comments on the proposed rule through Sept. 14, with most provisions set to take effect Jan. 1, 2027. This timeline gives affected vendors, practices, and patient advocacy groups a defined window to weigh in before the remote patient monitoring ban and related requirements are finalized.
What Providers Should Consider
Practices currently relying on third-party vendors for remote patient monitoring services should begin evaluating whether they have the internal clinical staffing capacity to bring these services in-house before the January 2027 effective date. Smaller and rural organizations that have depended on vendor-run RPM programs, as highlighted by industry critics, may face the most significant operational adjustments if this remote patient monitoring ban is finalized as proposed.
What This Means for the Future of RPM Billing
If finalized, this remote patient monitoring ban would represent one of the more significant structural changes to how remote monitoring services are billed under Medicare, shifting the model away from outsourced vendor arrangements toward direct practice-based delivery. Given the sharp growth in RPM payments documented by OIG, the proposal reflects a broader pattern of CMS scrutinizing rapidly expanding billing categories for potential oversight gaps, a dynamic that may extend to other emerging virtual care service lines in future rulemaking cycles.
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