Medicare Rule Would Cut Reimbursement for Remote Monitoring Vendors
A proposed federal rule limits payment for third-party health tech services, impacting rural patients and 230 industry groups who oppose the change.
By Alina Carter ·
The Centers for Medicare & Medicaid Services has proposed a rule that would stop paying doctors when remote patient monitoring is managed by outside technology companies. Under the current system, Medicare reimburses clinicians for initiating and overseeing these services, regardless of who processes the data. The new proposal restricts payment to cases where the provider’s own staff handle the monitoring at their facility.
This shift directly affects patients like Dianne Williams, a resident of rural Georgia. Williams uses a home blood pressure cuff that transmits data to CoachCare, a private vendor. She credits the service with helping her lose weight and lower her blood pressure through quarterly doctor visits and monthly calls from a nurse. Williams stated that having someone explain her progress and encourage her to change her diet and exercise habits was essential to her success.
The proposal responds to findings from the Department of Health and Human Services Office of Inspector General. Reports published in 2024 and 2025 identified concerns including fraud, insufficient data collection, and a lack of direct treatment from the prescribing clinician. CMS spokesperson Timothy Foster said the agency recognizes the role of technology in improving access but believes more safeguards are necessary to prevent fragmented care.
Critics argue the rule will disproportionately harm rural communities. Caroline Pearson, executive director of the Peterson Center on Healthcare, said the rule would virtually eliminate or dramatically reduce the use of remote monitoring for many Medicare patients. Most rural facilities lack the staff to run these programs in-house and rely on third-party vendors. Edward Vance, chief medical officer at Albany Area Primary Health Care, noted that his organization operates with shoestring budgets and cannot offer the service without outside help.
The rule applies specifically to traditional Medicare, not Medicare Advantage plans. However, experts warn that private insurers and Medicaid programs may follow suit, further limiting access. Andrew Van Ostrand, senior vice president at the Alliance for Connected Care, said the proposal took industry leaders by surprise. He noted that many vendors had already implemented changes based on the Inspector General’s recommendations.
A letter opposing the rule has been signed by more than 230 health tech vendors, healthcare systems, and advocacy groups. The letter was submitted as of September 14. In contrast, a few major industry players, including Humana, Blue Cross Blue Shield Association, and Sutter Health, largely support the proposed changes. Sutter Health offers its own internal remote monitoring program.
The use of remote monitoring has grown rapidly in recent years. The number of traditional Medicare patients enrolled in these programs increased tenfold between 2019 and 2023. Spending rose from just under $7 million to more than $194 million during that same period, according to a Peterson Center report from April 2025. The average duration of enrollment also grew from 1.7 months to 5.2 months.
Pearson argues that Medicare should limit the length of coverage unless providers prove ongoing need. She suggested a shift toward value-based reimbursement systems that pay based on health outcomes rather than volume of data reviewed. CMS has begun this transition with its ACCESS program, which launched in July and includes payments for both clinicians and vendors.
Van Ostrand pointed out that the proposed reimbursement cuts conflict with the Rural Health Transformation Program. This five-year, $50 billion initiative encourages states to adopt technology to improve rural healthcare. States have allocated at least $240 million from first-year funding specifically for remote monitoring, according to the Alliance for Connected Care.
The proposed rule is currently open for public comment. If finalized, it would require health systems to either hire more staff to manage data or stop using third-party platforms. Patients enrolled in traditional Medicare would be the primary group affected by the change in billing codes.
