Medicare Proposal Would Limit Remote Monitoring Reimbursements
The Centers for Medicare & Medicaid Services plan to stop paying for third-party monitoring, a change that could affect rural patients and increase administrative burdens.
By Jillian Foster ·
Only 1% of patients enrolled in traditional Medicare currently use remote physiologic monitoring, yet spending on these programs has grown from just under $7 million in 2019 to more than $194 million in 2023, according to an April 2025 report from the Peterson Center on Healthcare. The Centers for Medicare & Medicaid Services has proposed a rule that would halt Medicare reimbursements for providers who use health technology companies to administer remote monitoring for their patients.
Under the proposed rule, Medicare would pay clinicians only when the service is provided by someone at the facility where they work. This change would prevent the use of outside vendors for data collection and patient coaching. The proposal is a response to reports from the Department of Health and Human Services’ Office of Inspector General, an independent federal oversight agency. The 2024 and 2025 reports raised concerns about fraud, a lack of data collection, and patients not receiving treatment from the clinician who prescribed the device.
Caroline Pearson, executive director of the Peterson Center on Healthcare, said the rule would virtually eliminate or dramatically reduce the use of remote monitoring services for many Medicare patients. She noted that rural communities would likely be among the hardest hit because it is often difficult for patients in those areas to travel to in-person appointments. Most rural healthcare facilities that offer these programs use third-party vendors because they lack the capacity to launch and oversee their own operations.
Timothy Foster, a spokesperson for CMS, stated that the agency recognizes the important role that technology-enabled care can play in improving access to care, including in rural communities. However, he said more safeguards are needed. The proposed rule notes that outside vendors may have little to no established relationship with patients and their clinicians, which can fragment care. It also suggests that clinicians may not be involved enough to warrant being paid by Medicare.
Andrew Van Ostrand, senior vice president at the Alliance for Connected Care, said the proposal took the industry by surprise. He noted that many vendors have already made changes inspired by recommendations from the HHS Office of Inspector General. Van Ostrand argued that the proposed changes, including a cut in reimbursement rates, are misaligned with the Rural Health Transformation Program. This five-year, $50 billion initiative encourages states to adopt tech solutions to improve rural healthcare.
According to an Alliance for Connected Care report, states have earmarked at least $240 million from their first-year rural health funding for remote monitoring. More than 230 health tech vendors, healthcare systems, and patient and medical advocacy groups had signed a letter opposing the rule change as of Sept. 14. The proposed rule would apply only to patients enrolled in traditional Medicare, not those with privately run Medicare Advantage plans. However, experts warned that other insurers could adopt similar changes.
Dianne Williams, a patient in rural Georgia, relies on a blood pressure cuff that transmits data to her care team. She said the services encourage her to take her medication and inspired her to change her diet and exercise. Edward Vance, chief medical officer of Albany Area Primary Health Care, said his health system could not offer remote monitoring without an outside vendor. He noted that many community health centers operate with shoestring budgets and run at a borderline understaffed situation.
From 2019 to 2023, the average duration of remote physiologic monitoring for traditional Medicare patients increased from 1.7 months to 5.2 months. Pearson said Medicare should limit how long patients can be prescribed remote monitoring unless there is proof treatment is still needed. She added that the agency should require clinicians to report more data, including outcomes. Some large health systems, including Humana, Blue Cross Blue Shield Association, and Sutter Health, largely support the proposed rule.
