What's Happening?
ATA Action, the advocacy affiliate of the American Telemedicine Association (ATA), has welcomed the Centers for Medicare & Medicaid Services' (CMS) decision to delay a proposed restriction on remote monitoring staffing. The rule, which would have required
remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services to be furnished only by clinical staff directly employed by the billing practice, will now take effect on January 1, 2029, instead of the previously proposed January 1, 2027. This two-year delay provides a reprieve for patients and practices that rely on clinical partners for remote monitoring. However, CMS did finalize other changes for remote monitoring services taking effect January 1, 2027, including limiting RTM to established patients and requiring a separately reportable initiating visit for RPM or RTM services. Additionally, the CY2027 conversion factor for Medicare Physician Fee Schedule (PFS) will see a decrease, adding financial pressure on practices.
Why It's Important?
The delay in the remote monitoring staffing restriction is crucial for maintaining patient access to virtual care, particularly for those in rural or underserved areas who benefit from remote monitoring programs. Without this delay, many practices relying on external clinical partners would have faced significant disruption, potentially leading to a reduction in available remote monitoring services. The ATA emphasizes that while the delay is positive, it is not a permanent solution, and the underlying policy issue remains. The financial pressures on practices are also highlighted by the decrease in the CY2027 conversion factor, which could impact the sustainability of virtual care services. The ongoing debate underscores the need for clear, long-term policies that balance program integrity with patient access and provider viability in the evolving landscape of telemedicine.
What's Next?
ATA Action plans to utilize the next two rulemaking cycles to advocate for targeted program-integrity safeguards that address fraud and abuse without hindering access to remote monitoring programs. The organization will also continue to press Congress to make Medicare telehealth permanent before the current flexibilities, extended through December 31, 2027, expire. If permanent solutions are not established, patients could face a 'telehealth cliff' at the end of 2027, losing access to critical virtual care services. The finalized changes for RTM and RPM, such as limiting RTM to established patients and requiring an initiating visit, will take effect on January 1, 2027, requiring practices to adjust their remote monitoring programs accordingly. The PFS final rule is scheduled for publication on November 9.
