---
title: Medicare Wants to Stop Paying for Home Monitoring That Practices Contract Out
description: CMS has proposed that from January 2027 only staff employed by a doctor's practice could provide remote patient monitoring. Comments close September 14, 2026.
author: Darie Nani (Editor-in-Chief)
date: 2026-08-07T10:23:41.977Z
updated: 2026-08-07T10:23:41.989Z
canonical: https://richhealthmagazine.com/article/medicare-remote-monitoring-2027-contract-out
image: https://cdn.nanimediahouse.com/medicare-remote-monitoring-home-112951.webp
categories: Everyday Wellness
content_type: News
region: United States
publication: Rich Health Magazine
schema_type: Article
---

The Centers for Medicare and Medicaid Services, the federal agency that runs Medicare, has [proposed a rule](https://www.federalregister.gov/documents/2026/07/16/2026-14327/medicare-and-medicaid-programs-cy-2027-payment-policies-under-the-physician-fee-schedule-and-other) that would stop Medicare paying for home monitoring of things like blood pressure, weight and blood oxygen when a doctor’s practice hires an outside company to run it. Nothing has changed yet. The proposal is open for public comment on the federal docket until September 14, 2026, and if the agency finalizes it, the change would take effect on January 1, 2027.

Two kinds of service are covered. Remote physiologic monitoring is what CMS calls the tracking of “parameters such as weight, blood pressure, and pulse oximetry to monitor a patient’s condition and inform their management”. Remote therapeutic monitoring follows whether a patient is sticking to an at-home treatment plan, in categories covering the respiratory system, cognitive behavioral therapy and the musculoskeletal system. Practices sometimes run this monitoring with their own staff and sometimes contract it out.

## Only Staff Employed by the Practice Could Do the Monitoring

Under the proposal, Medicare would pay for either service only when the clinical staff doing the work are direct employees of the billing practitioner or that practitioner’s practice. CMS writes that, if finalized, “beginning January 1, 2027, the RPM and RTM codes could not be billed in cases where the service is not performed by clinical staff of the billing practitioner and will not allow contracting out to third-party companies”.

The agency is clear about what that does not mean. Staff would not have to sit in the practice’s office, and the patient would not have to be on site. They would still work under the billing practitioner’s general supervision and meet the existing rules for care provided incident to a doctor’s own services. What would change is who employs the person doing the monitoring, not where that person sits.

## CMS Points to Cold Calls and Fragmented Care

CMS says it drew on recent oversight findings. It describes monitoring being “outsourced to third-party companies that provide services via telephone and online contact only, using staff who have little to no established relationship with the beneficiary or other members of the care team”. It cites findings that some companies have been “cold calling” beneficiaries “to solicit them for remote monitoring services they may not need”, and says arrangements like these can fragment care and leave the practitioner without enough oversight of it.

Behind that sits a 2024 [report from the HHS Office of Inspector General](https://oig.hhs.gov/reports/all/2024/additional-oversight-of-remote-patient-monitoring-in-medicare-is-needed/), which CMS quotes in the rule. Investigators found that about 43 percent of enrollees who received remote patient monitoring did not get all three parts of it: the education and setup, the device itself, and the ongoing treatment management. OIG said that raises questions about whether the monitoring is being used as intended. The same report found Medicare lacks basic information for oversight, including who ordered a patient’s monitoring in the first place.

## A Visit With the Doctor Would Have to Start the Monitoring

CMS is also proposing that a practitioner could not simply add monitoring to a patient’s chart. There would have to be a separate, billable visit at the start, in person or by telehealth, and the monitoring would have to actually come up in it. A visit where it is never discussed could not count. The agency says the point is to make sure someone decides the monitoring is clinically appropriate for that patient, and to create the moment when the patient’s consent is taken.

Alongside that, remote therapeutic monitoring would be limited to patients the practitioner already has a relationship with, which is a condition remote physiologic monitoring already carries. CMS reasons that a practitioner who already knows the patient will have had the chance to take a history and examine them.

## A Company That Sells Monitoring Wants CMS to Reconsider

ChartSpan, which describes itself as one of the nation’s largest care management and remote monitoring organizations, leads a group called the Save Remote Patient Monitoring Coalition that is urging CMS to drop the employment restriction. It proposes an alternative it calls a Registered RPM Organization framework, under which outside monitoring companies would enroll with CMS, meet accreditation standards, be named on every claim they support, submit to outlier-focused auditing and report standardized results each year. The coalition says the model follows frameworks CMS already uses, including accreditation for suppliers of durable medical equipment, and argues that most primary care and rural practices cannot staff continuous monitoring in-house.

## Comments Close on September 14 and Nothing Is Decided

CMS has asked specifically for comment on how often third-party billing happens now, and on how the restriction would affect access to remote monitoring if it goes ahead. After reading the comments the agency can finalize the proposal as written, change it, or drop it. Until a final rule is issued, existing arrangements continue as they are, including a practice’s use of an outside monitoring company.

## FAQ

**Q: What is remote patient monitoring?**
Remote physiologic monitoring is the tracking of measurements such as weight, blood pressure and pulse oximetry to follow a patient's condition and guide their care. Remote therapeutic monitoring tracks whether a patient is following an at-home treatment plan, in categories that include respiratory, cognitive behavioral and musculoskeletal therapy.

**Q: Has my Medicare coverage for home monitoring already changed?**
No. This is a proposed rule, open for public comment until September 14, 2026. If CMS finalizes it, the changes would take effect on January 1, 2027. Nothing about current billing has changed.

**Q: If it is finalized, could my doctor's practice still offer remote monitoring?**
Yes. The proposal would not end remote monitoring. It would require the clinical staff doing it to be direct employees of the billing practitioner's own practice rather than a separate company the practice has hired, and CMS says those staff would not need to be physically in the office.