{"id":32880,"date":"2026-10-19T13:00:47","date_gmt":"2026-10-19T07:30:47","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=32880"},"modified":"2026-10-16T18:22:30","modified_gmt":"2026-10-16T12:52:30","slug":"cy-2027-rpm-rtm-billing-changes","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/","title":{"rendered":"CY2027 Medicare RPM and RTM Changes: How Medical Practices Can Protect Reimbursement and Avoid Revenue Loss"},"content":{"rendered":"\r\n<p class=\"wp-block-paragraph\">The CY2027 RPM and RTM billing changes proposed by CMS would make remote monitoring harder to bill and worth noticeably less per patient. None of this is final. If CMS finalizes these provisions, they take effect January 1, 2027, and multi-site cardiology, primary care and endocrinology groups that run outsourced monitoring programs carry the largest exposure.<\/p>\r\n\r\n\r\n\r\n<p class=\"wp-block-paragraph\">Under the CY 2027 Medicare Physician Fee Schedule proposed rule released on July 14, 2026, groups would:<\/p>\r\n\r\n\r\n\r\n<ul class=\"wp-block-list\">\r\n<li>Need a separately reportable initiating visit before monitoring begins<\/li>\r\n\r\n\r\n\r\n<li>Bill clinical staff time only when that staff is directly employed by the billing practitioner or group<\/li>\r\n\r\n\r\n\r\n<li>Furnish RTM only to established patients<\/li>\r\n\r\n\r\n\r\n<li>See both device supply and treatment management codes revalued downward<\/li>\r\n<\/ul>\r\n\r\n\r\n\r\n<p class=\"wp-block-paragraph\">CMS is also asking for comments on replacing the 17 current RPM and RTM codes with four bundled HCPCS G-codes (CMS, CY 2027 PFS Proposed Rule Fact Sheet).<\/p>\r\n\r\n\r\n\r\n<div class=\"wp-block-yoast-seo-ai-summarize yoast-ai-summarize\">\r\n<h2>Key Takeaways<\/h2>\r\n\r\n<ul class=\"wp-block-list yoast-ai-summarize-list\">\r\n<li>The CY2027 RPM and RTM billing changes are proposed, not final; if finalized, they apply to Medicare Part B claims from January 1, 2027.<\/li>\r\n\r\n\r\n\r\n<li>RPM and RTM would require a separately reportable, face-to-face initiating visit (in person or telehealth) where the service is discussed and consent is obtained.<\/li>\r\n\r\n\r\n\r\n<li>Medicare would pay for RPM and RTM only when clinical staff are direct employees of the billing practitioner or group, ending payment for contracted vendor staff time.<\/li>\r\n\r\n\r\n\r\n<li>RTM would be limited to established patients, matching the rule that already applies to RPM.<\/li>\r\n\r\n\r\n\r\n<li>CMS proposes cutting practice expense values for set-up, device supply and treatment management codes, and is weighing four bundled G-codes.<\/li>\r\n\r\n\r\n\r\n<li>The proposed non-qualifying APM conversion factor of $32.84 is 1.68% lower than CY2026, compounding the remote monitoring cuts.<\/li>\r\n<\/ul>\r\n<\/div>\r\n\r\n<h2>Why Is CMS Changing RPM and RTM Billing?<\/h2>\r\n<p>Remote monitoring grew fast once Medicare started paying for it. RPM codes took effect in 2019 for physiologic data such as weight, blood pressure and pulse oximetry. RTM followed in 2022 for non-physiologic data, with device supply codes for the respiratory system, the musculoskeletal system and cognitive behavioral therapy. For CY2026, CMS added device supply codes for 2 to 15 days of monitoring and 10-minute treatment management codes, expanding the family to 17 codes.<\/p>\r\n<p>That growth drew the attention of the HHS Office of Inspector General. OIG&#8217;s 2024 report concluded that Medicare needed additional oversight of remote patient monitoring, noting that CMS lacked basic information about what data was being monitored and which devices were in use (HHS OIG, Additional Oversight of Remote Patient Monitoring in Medicare Is Needed, 2024). Its 2025 data snapshot flagged a series of billing patterns that CMS now cites directly (HHS OIG, Billing for Remote Patient Monitoring in Medicare, 2025):<\/p>\r\n<ul>\r\n<li>Medicare RPM payments kept rising from 2023 to 2024.<\/li>\r\n<li>Some billers added large numbers of patients in a single month, suggesting automated enrollment.<\/li>\r\n<li>Some billed RPM for patients they had no established relationship with.<\/li>\r\n<li>Some supplied devices but never performed treatment management on the data.<\/li>\r\n<li>Some billed for the same patients as another provider, or for multiple devices per patient.<\/li>\r\n<\/ul>\r\n<p>CMS also points to OIG&#8217;s finding that roughly 43% of Medicare enrollees receiving RPM did not receive all three components of the service: set-up and education, device supply, and treatment management. The CY2027 proposals are built to close each of those gaps, which is why they reach into staffing structure, enrollment workflow and valuation all at once.<\/p>\r\n<h2>What Is Changing in Medicare RPM and RTM Billing for CY2027?<\/h2>\r\n<p>CMS made four formal proposals and one comment solicitation. Each is described below against the rule that applies today.<\/p>\r\n<h3>A separately reportable initiating visit<\/h3>\r\n<p>Today, Medicare RPM requires an established patient but no specific visit tied to the start of monitoring. Under the proposal, the billing practitioner would have to furnish a separately reportable initiating visit for both RPM and RTM (CMS, CY 2027 PFS Proposed Rule Fact Sheet). Per the proposed rule as summarized by McDermott+, the visit must be face-to-face, either in person or by telehealth, and furnished by the billing practitioner.<\/p>\r\n<p>Visit codes that involve no face-to-face encounter with the billing practitioner, or that are not separately payable under Medicare, would not qualify. A visit where RPM or RTM is not actually discussed with the patient would not qualify either. The visit is where the practitioner assesses clinical appropriateness and obtains the beneficiary&#8217;s consent, and it can be billed separately from the monitoring services.<\/p>\r\n<p>This is stricter than chronic care management, where Medicare requires an initiating visit only for new patients or patients not seen within the prior year. As proposed, the RPM and RTM requirement applies at the onset of every monitoring episode. The proposed rule does not clearly spell out how patients already enrolled before January 1, 2027 would be treated, so that is one of the first details to check in the final rule.<\/p>\r\n<h3>Employed clinical staff only<\/h3>\r\n<p>Since 2020, CMS has allowed leased or contracted clinical staff to furnish RPM services under general supervision. That flexibility is what made turnkey vendor programs possible: the vendor supplies devices, a monitoring center, nurses who make the interactive calls, and the monthly time log.<\/p>\r\n<p>CMS now proposes to pay for RPM and RTM only when the clinical staff furnishing the service are direct employees of the billing practitioner or the practitioner&#8217;s group (CMS, CY 2027 PFS Proposed Rule Fact Sheet). Staff would still work under the billing practitioner&#8217;s general supervision and meet the other incident-to requirements in 42 CFR 410.26, and they would not need to be physically located in the office. CMS cites OIG findings about vendors cold-calling beneficiaries, staff with no relationship to the care team, and weak practitioner oversight.<\/p>\r\n<p>The proposal does not stop groups from buying software, platforms or technical services from vendors. What it removes is Medicare payment for clinical time performed by vendor personnel. Because most vendor contracts bundle devices, software and clinical staffing together, this is the provision with the largest operational and revenue impact for most groups.<\/p>\r\n<h3>RTM limited to established patients<\/h3>\r\n<p>RPM has required an established patient since CMS reinstated that rule after the COVID-19 public health emergency ended. CMS proposes extending the same requirement to RTM (CMS, CY 2027 PFS Proposed Rule Fact Sheet). Respiratory, musculoskeletal and cognitive behavioral therapy monitoring programs that enroll new patients at their first contact would need to change their intake sequence.<\/p>\r\n<h3>Lower values for set-up, device and management codes<\/h3>\r\n<p>CMS says remote monitoring devices appear to cost less than its original estimates and that reliable invoice data is scarce (CMS, CY 2027 PFS Proposed Rule Fact Sheet). The proposed revaluation, as detailed in the McDermott+ review of the rule, works through practice expense crosswalks:<\/p>\r\n<ul>\r\n<li>Set-up and education codes (99453 for RPM, 98975 for RTM) would take the practice expense inputs of 99473, the self-measured blood pressure education code.<\/li>\r\n<li>RPM device supply codes (99445 and 99454) would take the practice expense inputs of 99474, the self-measured blood pressure data code.<\/li>\r\n<li>RTM device supply codes (98976, 98977, 98978, 98984, 98985 and 98986) would take the practice expense inputs of 93270, a 24-hour external ECG event recording code.<\/li>\r\n<li>Treatment management codes (99470, 99457, 99458, 98979, 98980 and 98981) would lose their practice expense inputs entirely while keeping current work RVUs.<\/li>\r\n<\/ul>\r\n<p>The last point matters. Many groups assume only device payments are at risk. Under the proposal, treatment management codes billed in the office setting would also pay less, because the clinical staff portion of their practice expense would be removed.<\/p>\r\n<h3>Possible bundling into four G-codes<\/h3>\r\n<p>CMS is not formally proposing new codes, but it is soliciting comments on replacing the 17 RPM and RTM codes with four HCPCS G-codes: GRPM1 and GRTM1 for initial set-up and education, and GRPM2 and GRTM2 as bundled monthly codes. Each monthly code would combine device supply, a minimum number of days of data transmission, and at least 20 minutes of treatment management including at least one real-time interactive communication with the patient.<\/p>\r\n<p>Every element would have to be furnished in the calendar month to bill the code, and the established patient, initiating visit and staffing rules would carry over. If CMS adopts this structure, the current practice of billing device supply in months with little or no management time would end.<\/p>\r\n<h3>The conversion factor makes it worse<\/h3>\r\n<p>These changes arrive alongside a lower conversion factor. The proposed CY2027 non-qualifying APM conversion factor is $32.84, down 1.68% from $33.40, and the qualifying APM conversion factor is $33.17, down 1.19%, largely because the one-year 2.5% increase for CY2026 expires (CMS, CY 2027 PFS Proposed Rule Fact Sheet). Every RPM and RTM code would be hit by that reduction before any code-specific revaluation.<\/p>\r\n<table>\r\n<tbody>\r\n<tr>\r\n<td><strong>Requirement<\/strong><\/td>\r\n<td><strong>Current rule (CY2026)<\/strong><\/td>\r\n<td><strong>Proposed for CY2027<\/strong><\/td>\r\n<td><strong>What it means for revenue<\/strong><\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Initiating visit<\/td>\r\n<td>Not required for RPM or RTM<\/td>\r\n<td>Separately reportable, face-to-face visit by the billing practitioner (in person or telehealth) with service discussion and consent<\/td>\r\n<td>Enrollments without a qualifying visit fail the condition of payment<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Clinical staff<\/td>\r\n<td>Leased or contracted staff allowed under general supervision<\/td>\r\n<td>Direct employees of the billing practitioner or group only<\/td>\r\n<td>Vendor-performed management time becomes non-billable<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>RTM eligibility<\/td>\r\n<td>New or established patients<\/td>\r\n<td>Established patients only<\/td>\r\n<td>New-patient RTM enrollments become non-billable<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Set-up and device codes<\/td>\r\n<td>Valued on CMS&#8217;s original device cost inputs<\/td>\r\n<td>Practice expense crosswalked to 99473, 99474 and 93270<\/td>\r\n<td>Lower payment on every enrolled patient, every month<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Treatment management codes<\/td>\r\n<td>Include clinical staff practice expense<\/td>\r\n<td>Practice expense inputs removed; work RVUs kept<\/td>\r\n<td>Lower payment even for fully compliant in-house programs<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Code structure<\/td>\r\n<td>17 RPM and RTM CPT codes<\/td>\r\n<td>Comment solicitation on four bundled G-codes<\/td>\r\n<td>Possible new coding, charge master and scrubber changes<\/td>\r\n<\/tr>\r\n<tr>\r\n<td>Conversion factor<\/td>\r\n<td>$33.40 (non-qualifying APM)<\/td>\r\n<td>$32.84 proposed (-1.68%)<\/td>\r\n<td>Across-the-board reduction on top of the above<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<h2>Which Medical Groups Are Most Affected?<\/h2>\r\n<ul>\r\n<li><strong>Cardiology groups<\/strong> run some of the largest Medicare RPM programs, built on blood pressure and weight monitoring for hypertension and heart failure. Many launched with a turnkey vendor, which places them directly in the path of the staffing proposal.\u00a0Remote interrogation of implantable cardiac devices is billed under separate codes and is not part of this proposal, but groups should make sure device clinic staff and RPM staff are tracked separately so the staffing analysis is clean. MBC&#8217;s <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/cardiology-medical-billing-services.html\">cardiology billing services<\/a> team routinely sees both programs running side by side in multi-site cardiology groups.<\/li>\r\n<li><strong>Primary care and internal medicine groups<\/strong> often run RPM next to chronic care management for the same Medicare panel. When one contracted care team logs both CCM and RPM time, both revenue streams need review, even though the staffing proposal in this rule is written for RPM and RTM. Groups in Medicare Shared Savings Program ACOs should model the RPM changes together with the proposed E\/M complexity modifiers that would replace G2211, since both change per-patient revenue for the same population.<\/li>\r\n<li><strong>Endocrinology groups<\/strong> use RPM for blood glucose monitoring in diabetes management. Personal CGM codes sit outside the RPM family, but glucometer-based RPM programs, particularly those enrolled through vendor outreach, face the initiating visit and staffing requirements in full. MBC&#8217;s endocrinology billing services team can separate CGM, RPM and E\/M revenue so each is modeled on its own terms.<\/li>\r\n<li><strong>Pulmonology, orthopedic and rehabilitation groups<\/strong> that bill RTM for respiratory or musculoskeletal monitoring face the new established patient rule in addition to the initiating visit, staffing and revaluation proposals.<\/li>\r\n<\/ul>\r\n<p>The dividing line is simple. Groups that built remote monitoring in-house with their own nurses and medical assistants, and that enroll patients during a documented visit, face mainly a valuation cut. Groups running outsourced programs face a structural problem that requires a staffing decision before January.<\/p>\r\n<h2>Where Is RPM and RTM Revenue at Risk?<\/h2>\r\n<p>The exposure concentrates in four places.<\/p>\r\n<ul>\r\n<li><strong>Treatment management time performed by vendors:<\/strong>\u00a0Codes 99457, 99458 and 99470 pay for interactive management time. If vendor nurses perform that time, it would stop being billable on January 1, 2027 under the proposal, and groups would keep only the device and set-up revenue, which itself is being cut.<\/li>\r\n<li><strong>Enrollment without a qualifying visit:<\/strong>\u00a0Every new patient enrolled without a separately reportable, face-to-face initiating visit that documents the monitoring discussion and consent is a claim that fails a condition of payment. That risk shows up as denials in Q1 2027 or, worse, as overpayments found in a later audit.<\/li>\r\n<li><strong>Device and set-up payments:<\/strong>\u00a0The crosswalk to 99474 for RPM device supply is significant because 99474 has historically been valued well below 99454. This cut applies to every enrolled patient, every month, and no workflow change can offset it.<\/li>\r\n<li><strong>Code mapping and claim edits:<\/strong>\u00a0If CMS adopts G-codes, charge masters, EHR order sets, claim scrubbers and payer fee schedules all need updates before the first January claims. Medicare Advantage plans may move on their own timelines, which creates a period of mixed coding by payer.<\/li>\r\n<\/ul>\r\n<p>Here is how that exposure can look in a modeled example. These figures are illustrative assumptions, not CMS payment rates, and should be replaced with your own claims data.<\/p>\r\n<ul>\r\n<li>Assume a multi-site cardiology group with 600 Medicare RPM patients and blended revenue of $100 per patient per month: $45 from set-up and device supply and $55 from treatment management. Annual RPM revenue is $720,000.<\/li>\r\n<li><strong>Scenario 1, in-house staff:<\/strong> If device-related payment falls 60% and treatment management falls 30%, monthly revenue per patient drops to about $56.50. Annual revenue falls by roughly $313,000, or about 43%.<\/li>\r\n<li><strong>Scenario 2, vendor staff not replaced:<\/strong> Treatment management becomes non-billable and device payment falls 60%. Monthly revenue per patient drops to about $18. Annual revenue falls by roughly $590,000.<\/li>\r\n<\/ul>\r\n<p>The exact percentages will depend on the final valuations and your locality. The structure of the math will not: a vendor-staffed program carries roughly twice the exposure of an in-house program of the same size.<\/p>\r\n<h2>What Should Groups Review Before January 1, 2027?<\/h2>\r\n<p>The final rule will settle the details, but most of the preparation does not depend on them.<\/p>\r\n<ul>\r\n<li><strong>Map who performs monitoring time:<\/strong>\u00a0List every person who logs RPM or RTM time and whether they are W-2 employees of the billing entity, staff of an affiliated entity, or vendor personnel. PE-backed platforms and groups that employ staff through a management services organization need legal review, since direct employment by the billing practitioner or group may not extend to a sister entity.<\/li>\r\n<li><strong>Audit enrollment against visits:<\/strong>\u00a0For each active Medicare RPM and RTM patient, confirm whether monitoring started from a documented, face-to-face visit with the billing practitioner where the service and consent were discussed.<\/li>\r\n<li><strong>Check RTM patient status:<\/strong>\u00a0Identify RTM patients who were new to the group at enrollment.<\/li>\r\n<li><strong>Confirm all components are being delivered:<\/strong>\u00a0Run a report of patients billed for device supply without treatment management in the same month. This is the pattern OIG flagged, and it would not be billable under bundled G-codes.<\/li>\r\n<li><strong>Review vendor contracts:<\/strong>\u00a0Look for termination clauses, minimum enrollment commitments, device pricing and whether the clinical staffing piece can be separated from software and devices.<\/li>\r\n<li><strong>Model three scenarios:<\/strong>\u00a0Proposed rule finalized as written, finalized with G-code bundling, and finalized with the staffing provision delayed or changed. Build each at the code level from the last 12 months of claims.<\/li>\r\n<li><strong>Build documentation templates:<\/strong>\u00a0Add structured fields to visit notes for the RPM or RTM discussion, clinical rationale and consent so the initiating visit is easy to prove.<\/li>\r\n<li><strong>Prepare claim edits:<\/strong>\u00a0Plan scrubber rules that hold RPM and RTM claims lacking a linked initiating visit or an employed-staff attribution.<\/li>\r\n<li><strong>Plan Q1 2027 denial monitoring:<\/strong>\u00a0Track remote monitoring denials weekly for the first 90 days so documentation and coding gaps surface early.<\/li>\r\n<\/ul>\r\n<h2>How a Billing Partner Helps Protect Remote Monitoring Reimbursement<\/h2>\r\n<p>Most groups do not have a claims-level answer to the basic question: how much of our RPM and RTM revenue survives the proposed rule? A revenue cycle partner with remote monitoring experience can answer it from your own data.<\/p>\r\n<p>MBC&#8217;s remote patient monitoring billing services team starts with a 12-month claim audit that ties each RPM and RTM claim to its initiating encounter, the staff member who logged the time, the device supply period and whether all service components were billed. The output is a dollar figure for revenue at risk under each provision, broken out by location, ordering provider and payer.<\/p>\r\n<p>The operational work follows from that audit: building visit-linked enrollment workflows, setting up documentation templates that capture consent and service discussion, configuring claim edits for the new conditions of payment, and updating code mapping the week the final rule publishes.<\/p>\r\n<p>For groups considering bringing monitoring staff in-house, MBC models staffing cost against retained revenue so leadership can see whether the program still meets its margin target, or whether it should be scaled back to the patients with the strongest clinical case.<\/p>\r\n<h2>What Should Medical Groups Do Next?<\/h2>\r\n<p>The CY2027 RPM and RTM billing changes are still proposed, but CMS&#8217;s direction is clear. It wants remote monitoring tied to a real clinical relationship, started at a visit with the billing practitioner, performed by that group&#8217;s own employees, and paid at rates closer to actual device cost.<\/p>\r\n<p>Cardiology, primary care and endocrinology groups running vendor-staffed programs face the largest exposure, mostly through treatment management time that would become non-billable, while even fully in-house programs face lower values on every code. Groups that finish a staffing map, an enrollment audit and a three-scenario revenue model before the final rule publishes will be able to act within weeks instead of absorbing a quarter of denials.<\/p>\r\n<p>If you want a claims-level view of what your remote monitoring program would lose under the proposed rule, MBC offers an RPM and RTM billing review built from your last 12 months of claims. Call <a href=\"tel:888-357-3226\">888-357-3226<\/a>, email <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a>, or <a href=\"https:\/\/www.medicalbillersandcoders.com\/request-a-billing-quote.aspx?fromurl=mbcblog-cy-2027-rpm-rtm-billing-changes-oct-26\">request your review<\/a>.<\/p>\r\n<h2>FAQs:\u00a0<\/h2>\r\n\r\n<div class=\"schema-faq wp-block-yoast-faq-block\">\r\n<div id=\"faq-question-1792152033387\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">1. <strong>Are the CY2027 RPM and RTM changes final?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">No. As of October 16, 2026, they are proposed. The comment period closed September 14, 2026, and CMS typically publishes the final rule in early November, with changes effective January 1, 2027.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152065806\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">2. <strong>Does the RPM initiating visit have to be in person?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">No. It can be in person or by telehealth, but it must be face-to-face with the billing practitioner, separately payable, and include a discussion of the monitoring service and consent.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152079512\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">3. <strong>Which RPM and RTM codes would pay less?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">Set-up codes 99453 and 98975, RPM device codes 99445 and 99454, RTM device codes 98976 to 98978 and 98984 to 98986, and management codes 99457, 99458, 99470 and 98979 to 98981.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152092470\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">4. <strong>Will CMS replace RPM and RTM codes with G-codes in 2027?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">Not as proposed. CMS only requested comments on four bundled G-codes (GRPM1, GRPM2, GRTM1, GRTM2). The final rule could adopt them, defer them or drop them.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152155305\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">5. <strong>Do these changes apply to Medicare Advantage and commercial payers?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">The rule applies to Medicare Part B. Medicare Advantage and commercial plans set their own policies, though many follow CMS coding changes, so review each payer contract for 2027.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152166649\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">6. <strong>What is the difference between RPM and RTM?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">RPM tracks physiologic data like blood pressure, weight and glucose. RTM tracks therapy response, such as respiratory, musculoskeletal or CBT status.<\/p>\r\n<\/div>\r\n<div id=\"faq-question-1792152177886\" class=\"schema-faq-section\"><strong class=\"schema-faq-question\">7. <strong>Can you bill RPM and RTM at the same time?<\/strong><\/strong>\r\n<p class=\"schema-faq-answer\">No. Medicare doesn\u2019t allow both for the same patient in the same period. Either can be billed with CCM or PCM if time isn\u2019t counted twice.<\/p>\r\n<p><strong>Sources:<\/strong><\/p>\r\n<ul>\r\n<li><a href=\"https:\/\/www.cms.gov\/newsroom\/fact-sheets\/calendar-year-cy-2027-medicare-physician-fee-schedule-proposed-rule\">CMS: Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule Fact Sheet<\/a><\/li>\r\n<li><a href=\"https:\/\/www.federalregister.gov\/public-inspection\/2026-14327\/medicare-and-medicaid-programs-calendar-year-2027-payment-policies-under-the-physician-fee-schedule\">Federal Register: CY 2027 Payment Policies Under the Physician Fee Schedule (public inspection)<\/a><\/li>\r\n<li><a href=\"https:\/\/oig.hhs.gov\/reports\/all\/2024\/additional-oversight-of-remote-patient-monitoring-in-medicare-is-needed\/\">HHS OIG: Additional Oversight of Remote Patient Monitoring in Medicare Is Needed (2024)<\/a><\/li>\r\n<li><a href=\"https:\/\/oig.hhs.gov\/reports\/all\/2025\/billing-for-remote-patient-monitoring\/\">HHS OIG: Billing for Remote Patient Monitoring in Medicare (2025)<\/a><\/li>\r\n<li><a href=\"https:\/\/www.hrsonline.org\/resource\/hrs-publishes-cy2027-mpfs-proposed-rule\/\">Heart Rhythm Society: CY2027 MPFS Proposed Rule Summary<\/a><\/li>\r\n<\/ul>\r\n<p><strong>* Status as of October 16, 2026:<\/strong> Every CY2027 provision in this article is proposed, not final. The public comment period closed September 14, 2026. CMS typically publishes the PFS final rule in early November. Current CY2026 requirements stay in force through December 31, 2026, and this article will be updated when the final rule is released.<\/p>\r\n<\/div>\r\n<\/div>\r\n","protected":false},"excerpt":{"rendered":"<p>The CY2027 RPM and RTM billing changes proposed by CMS would make remote monitoring harder to bill and worth noticeably less per patient. None of this is final. If CMS finalizes these provisions, they take effect January 1, 2027, and multi-site cardiology, primary care and endocrinology groups that run outsourced monitoring programs carry the largest [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":32889,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[390,6595,6594,6604,6600,388,6596,6597,6601,6599,6603,6598,6602],"class_list":["post-32880","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medical-billing-services","tag-cardiology-billing-services","tag-cy-2027-physician-fee-schedule-proposed-rule","tag-cy2027-rpm-and-rtm-billing-changes","tag-endocrinology-billing-services","tag-medicare-remote-monitoring-codes","tag-orthopedic-billing","tag-remote-physiologic-monitoring-billing","tag-remote-therapeutic-monitoring-reimbursement","tag-rpm-billing-services","tag-rpm-compliance-2027","tag-rpm-g-codes","tag-rpm-initiating-visit-requirement","tag-rtm-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CY2027 RPM and RTM Billing Changes: Protect Reimbursement<\/title>\n<meta name=\"description\" content=\"Proposed CY2027 RPM and RTM billing changes add initiating visits, employed-staff limits and lower rates. 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The comment period closed September 14, 2026, and CMS typically publishes the final rule in early November, with changes effective January 1, 2027.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152065806\",\"position\":2,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152065806\",\"name\":\"2. Does the RPM initiating visit have to be in person?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"No. It can be in person or by telehealth, but it must be face-to-face with the billing practitioner, separately payable, and include a discussion of the monitoring service and consent.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152079512\",\"position\":3,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152079512\",\"name\":\"3. 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Medicare Advantage and commercial plans set their own policies, though many follow CMS coding changes, so review each payer contract for 2027.\",\"inLanguage\":\"en-US\"},\"inLanguage\":\"en-US\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152166649\",\"position\":6,\"url\":\"https:\\\/\\\/www.medicalbillersandcoders.com\\\/blog\\\/cy-2027-rpm-rtm-billing-changes\\\/#faq-question-1792152166649\",\"name\":\"6. What is the difference between RPM and RTM?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"RPM tracks physiologic data like blood pressure, weight and glucose. 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Dedicated to educating healthcare professionals on compliance, accuracy, and strategies to improve billing performance.","sameAs":["https:\/\/www.medicalbillersandcoders.com\/","https:\/\/www.linkedin.com\/in\/debbie-young-4544a631a\/"],"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/author\/debbie-young\/"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152033387","position":1,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152033387","name":"1. Are the CY2027 RPM and RTM changes final?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. As of October 16, 2026, they are proposed. The comment period closed September 14, 2026, and CMS typically publishes the final rule in early November, with changes effective January 1, 2027.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152065806","position":2,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152065806","name":"2. Does the RPM initiating visit have to be in person?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. It can be in person or by telehealth, but it must be face-to-face with the billing practitioner, separately payable, and include a discussion of the monitoring service and consent.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152079512","position":3,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152079512","name":"3. Which RPM and RTM codes would pay less?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Set-up codes 99453 and 98975, RPM device codes 99445 and 99454, RTM device codes 98976 to 98978 and 98984 to 98986, and management codes 99457, 99458, 99470 and 98979 to 98981.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152092470","position":4,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152092470","name":"4. Will CMS replace RPM and RTM codes with G-codes in 2027?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Not as proposed. CMS only requested comments on four bundled G-codes (GRPM1, GRPM2, GRTM1, GRTM2). The final rule could adopt them, defer them or drop them.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152155305","position":5,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152155305","name":"5. Do these changes apply to Medicare Advantage and commercial payers?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The rule applies to Medicare Part B. Medicare Advantage and commercial plans set their own policies, though many follow CMS coding changes, so review each payer contract for 2027.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152166649","position":6,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152166649","name":"6. What is the difference between RPM and RTM?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"RPM tracks physiologic data like blood pressure, weight and glucose. RTM tracks therapy response, such as respiratory, musculoskeletal or CBT status.","inLanguage":"en-US"},"inLanguage":"en-US"},{"@type":"Question","@id":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152177886","position":7,"url":"https:\/\/www.medicalbillersandcoders.com\/blog\/cy-2027-rpm-rtm-billing-changes\/#faq-question-1792152177886","name":"7. Can you bill RPM and RTM at the same time?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"No. Medicare doesn\u2019t allow both for the same patient in the same period. Either can be billed with CCM or PCM if time isn\u2019t counted twice.","inLanguage":"en-US"},"inLanguage":"en-US"}]}},"_links":{"self":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/32880","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/comments?post=32880"}],"version-history":[{"count":8,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/32880\/revisions"}],"predecessor-version":[{"id":32890,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/posts\/32880\/revisions\/32890"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media\/32889"}],"wp:attachment":[{"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/media?parent=32880"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/categories?post=32880"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.medicalbillersandcoders.com\/blog\/wp-json\/wp\/v2\/tags?post=32880"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}