Remote Patient Monitoring Rule Is Due Nov. 1: What Home Care Teams Should Watch

Medicare's final physician fee schedule for 2027 is due by November 1, and one piece of it could change how a lot of older adults get checked on at home. CMS has proposed that Medicare stop paying for remote patient monitoring when a medical practice hands the monitoring work to an outside company. As KFF Health News reported via McKnight's Home Care this week, critics say the change could end these programs for many patients, especially in rural areas where clinics rely on vendors to run them.

What CMS proposed for remote patient monitoring

The proposal, released in July as part of the CY 2027 Physician Fee Schedule, has four main parts, according to a detailed explainer updated October 28. Clinical staff time would count toward the monitoring codes only if that person is a direct employee of the billing practice, though they could still work remotely. Monitoring would have to start with a face-to-face visit, in person or by telehealth, that actually covers the monitoring plan and consent. Remote therapeutic monitoring would be limited to established patients, and CMS wants to lower what it pays for setup and devices. Comments closed September 14, and the final rule is now under White House review. The federal review record shows the Alliance for Connected Care met with reviewers on October 19 to push back. The rule covers traditional Medicare only, but advocates warn that Medicare Advantage plans and Medicaid programs could follow.

Why this reaches home-based care

Home health and home care agencies don't bill these physician codes, so your claims don't change directly. Your clients might, though. The people using a blood pressure cuff, scale, or glucose meter that sends readings to a nurse are often the same people your aides and nurses see every week. Use has grown fast: the Peterson Center on Healthcare found traditional Medicare enrollment in these programs grew tenfold from 2019 to 2023, with spending rising from under $7 million to more than $194 million. If a primary care office or rural clinic shuts its program down, those daily readings and coaching calls go away, and the people in the home may be the first to notice that a client's numbers are slipping.

Questions worth asking your referral partners now

Ask the physician groups and clinics you work with whether their monitoring runs through an outside company and what they plan to do if the rule is finalized as proposed. Find out which of your clients are enrolled, so a program ending doesn't catch anyone by surprise. Make sure visit notes record vitals and changes plainly enough for a doctor's office to act on, and agree on who your team calls when something looks off. Teams using CareSync® can keep the home side of that picture clear by comparing planned visits with completed ones, so a referral partner gets a straight answer about what happened and when.

Nothing is final yet, and CMS could soften or change the proposal after more than 230 organizations signed a letter opposing it. Read the final rule when it posts before you change anything, and expect the real effects to show up in January, when practices decide whether to keep their monitoring programs or let them go.