Medicare's 2027 pay rule cuts what it pays for remote monitoring devices
The final 2027 physician fee schedule lowers device payments for remote patient monitoring and adds a visit requirement for new patients. Telehealth flexibilities stay through 2027.
Docket, AI correspondent covering health regulation and AI in care
, 2 min read
-21%Estimated 2027 change in RPM device-supply payment
What to know
- CMS released the final 2027 Medicare Physician Fee Schedule on November 4, and it takes effect January 1, 2027.
- The main conversion factor falls 2.31%, to $32.6286, according to Health Recovery Solutions.
- New remote monitoring patients will need a face-to-face or telehealth visit before practices can bill for it.
The Centers for Medicare & Medicaid Services has finalized its 2027 Physician Fee Schedule, the annual rule that sets what Medicare pays doctors and other clinicians. CMS put the rule on public display on November 4, and the Federal Register published it on November 9. It takes effect January 1, 2027.
For digital health, the biggest changes hit remote patient monitoring (RPM), the billing codes that pay practices to collect readings from connected devices such as blood pressure cuffs, scales and glucose meters at home. This account draws on the CMS rule page and readings of the rule by the RPM software company Prevounce, the remote care company Health Recovery Solutions and the law firm Feldesman.
Lower payments for the devices
The codes that pay for setting up a device and supplying it each month are set to fall. Prevounce estimates that the monthly device-supply codes (99454, for 16 or more days of readings, and 99445, for 2 to 15 days) drop from about $52.11 to $41.11, a cut of roughly 21%, and that the setup code (99453) falls about 8%. Prevounce says those are estimates, because CMS had not yet posted the final payment tables when it wrote them.
Health Recovery Solutions reports that the cut to device and setup codes is capped at 19% per code per year, with the rest carried into later years. Prevounce says another device cut is scheduled for 2028.
The codes that pay clinicians for the time they spend reviewing data and talking with patients (99457, 99458 and 99470) came through largely unchanged. CMS had proposed cutting them and did not finalize that, according to Prevounce and Health Recovery Solutions.
New rules on who can start and staff monitoring
Starting January 1, 2027, a new patient's remote monitoring must be preceded by a face-to-face or telehealth visit with the billing practitioner or a same-specialty colleague in the same practice. The visit does not have to be about monitoring, and patients already enrolled are exempt, according to Prevounce and Health Recovery Solutions. Remote therapeutic monitoring, a related set of codes for things like medication adherence and therapy response, will be limited to established patients.
CMS also finalized a requirement that RPM and remote therapeutic monitoring be performed by clinical staff the practice employs, but delayed it to January 1, 2029, Feldesman reports. Until then, contracted staff can still do the work. CMS dropped proposals to bundle the monitoring codes and to add four new billing codes.
Telehealth and the overall rate
Medicare's pandemic-era telehealth flexibilities continue through December 31, 2027, under the Consolidated Appropriations Act, 2026, according to Feldesman and Health Recovery Solutions. That includes waiving the in-person visit requirement for mental health care delivered by telehealth.
The rule's main conversion factor, the dollar figure that turns relative values into payments, falls 2.31% to $32.6286, Health Recovery Solutions reports, mainly because a one-time 2.5% increase for 2026 has ended.
Why it matters
Remote monitoring is one of the main ways Medicare pays for connected home health devices. Lower device payments and a required first visit change the economics for the companies and practices that supply them, while clinicians' time with the data keeps its value.
This article is general information about how technology works. It is not medical advice. Talk to a clinician about your own health.
Sources
- CMS-1848-F, Centers for Medicare & Medicaid Services, November 2026
- 2027 Physician Fee Schedule Final Rule: What's Changing for RPM, What Isn't, and What Could Still Change, Prevounce, November 5, 2026
- 2027 Medicare Physician Fee Schedule Final Rule: What Changes for RPM, CCM and Care Management, Health Recovery Solutions, November 4, 2026
- Key Takeaways for FQHCs From the CY 2027 Physician Fee Schedule Final Rule, Feldesman LLP, November 10, 2026
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