JUDGMENT OF RECORD ·
Medicare is set to pull remote monitoring revenue back inside the practice. Its draft rule bars billing for vendor staff from Jan 1, and Congress has not stopped it.
On Oct 6, 32 House members asked CMS Administrator Oz to drop a draft rule that pays for remote monitoring only when clinical staff employed by the billing practice do the work. Contracted vendors would not qualify from Jan 1, 2027. CMS proposed it in the CY 2027 physician fee schedule on July 14 and drew over 43,000 comments. Medicare RPM spending rose 31% to $536M in 2024.
Practices moved toward in-house tools the next day. On Oct 7 Teladoc released SoloScribe, an ambient note tool, and said SoloVitals, which reads heart and breathing rates from a phone camera, ships in December. Solo runs in over 15,000 care sites. On Oct 6 Vitalize raised $31M to run hospital staffing.
The layer moving is regulation. If finalized, vendors that staff monitoring for practices lose the billing path, and the practice that employs the nurse keeps the fee. Profit Migration governs and stays Inactive, since revenue moves back to incumbents. Confidence is Medium: the text is primary, but the final rule can change.
- CONFIDENCE
- Medium
- HORIZON
- Through the CY 2027 final rule
- VS. PRIOR CALL
- New call
WHAT WOULD PROVE THIS WRONG
The final CY 2027 physician fee schedule lets practices bill RPM or RTM performed by contracted third-party staff, or delays the employment requirement past Jan 1, 2027.