In 2019, the Center for Medicare and Medicaid Services (CMS) launched its Remote Patient Monitoring (RPM) program, to reimburse providers for using digital technology to monitor patients between visits. The program covers collecting and transmitting patient clinical data. It also supports a clinician’s time to review the data and intervene if it indicates a harmful clinical change.
Medicare, the first to cover RPM more than twenty years ago, continues to expand the program, supporting more billing opportunities for providers.
For example, the number of RPM services billed to Medicare significantly increased between 2019 and 2021. Claims grew from fewer than 134,000 to 2.4 million. Medicare payments for the four most common RPM billing codes increased from $5.5 million to $101.4 million in that same period. Over those three years, the number of providers billing consistently for RPM increased over eightfold from 400 to 3,700.
When analyzing which providers use RPM and how they use the time-based codes, primary care providers focused on hypertension or diabetes management led the way. Also, 69% of monthly reimbursement for patient monitoring was for 20 minutes, and 31% was used for monitoring beyond 20 minutes.
Here, we highlight Medicare’s trajectory of RPM reimbursement, provide an overview of current billing guidelines, and point to possible future changes.
The timeline shown below highlights essential changes over the past 20 years as Medicare evolved and expanded its RPM coverage.
This trajectory speaks to CMS’s commitment to RPM and acknowledges its value in treating chronic and acute conditions.
2002: CMS introduced CPT code 99091 RPM services, but it was bundled with other services and lacked separate payment. The American Medical Association stated, “For many years, the AMA has recognized that telehealth and remote patient monitoring offer promise to improve patient care and increase efficiencies in care delivery. But these clinical services did not have a clear path to payment.”
2018: The Current Procedural Terminology (CPT®) Editorial Panel reviewed suggestions for adding chronic care remote physiologic monitoring and internet consultations. The 2018 Medicare Physician Fee Schedule unbundled CPT code 99091 for remote patient monitoring, allowing physicians to be paid for non-face-to-face patient care activities.
2019: CMS launched the RPM program, providing four CPT codes that allowed physicians and other qualified healthcare professionals to provide services not covered at the time. The new codes covered the following:
2021: CMS expanded Medicare coverage for RPM to include auxiliary personnel who could provide specific RPM services under the general supervision of the billing physician or practitioner, including initial set-up and patient education.
2024: The 2024 Medicare Physician Fee Schedule expanded the HCPCS code G0511 for general care management to include Remote Physiologic (or Patient) Monitoring (RPM) and Remote Therapeutic Management (RTM) services. Additionally, Rural Health Clinics and Federally Qualified Health Centers can bill for multiple instances of the G0511 code. This enables rural providers to combine RPM and Chronic Care Management, creating more comprehensive chronic disease management.
2025: In its 2025 Final Rule, CMS switched course to allow Rural Health Clinics and Federally Qualified Health Centers to use standard fee-for-service billing codes, as shown below. HCPCS code G0511 will no longer be used.
Participating fee-for-service providers can bill for RPM services under four CPT codes, split into time- and device-based categories. These codes cover the initial device set-up and education, as well as capturing daily readings and time-based codes for review, analysis, and decision-making based on patient data.
*The reimbursement rates listed are from the 2025 Physician Fee Schedule. They are based on a national average and may vary by location. See the 2025 Medicare Physician Fee Schedule Final Rule for up-to-date rates.
Medicare has several types of requirements for RPM reimbursement, including:
One of Medicare’s RPM requirements is that patients are told what cost-sharing the service entails. As with all Medicare services, patients are responsible for applicable coinsurance, deductibles, and copays.
Since Remote Patient Monitoring is covered under Medicare Part B, patients are responsible for 20% coinsurance.
RPM coverage is expanding across all payer categories. As of April 2024, 32 state Medicaid programs and a growing number of commercial payors covered RPM in addition to Medicare coverage.
The CPT Editorial Panel approves new changes to CPT codes and what they cover. They are considering some changes that could further expand coverage, including:
In addition to these considerations, various provider and patient groups advocate eliminating copays for Medicare beneficiaries under the RPM program. However, this change would not be under the purview of Medicare or CMS and would require congressional action.
ThoroughCare is a comprehensive software platform that supports end-to-end RPM workflow. Our platform offers a structured approach to Medicare care management programs while enabling flexibility to meet individual patient needs. This includes:
Yes, Medicare has covered Remote Patient Monitoring since 2002. Starting in 2019, Medicare launched an RPM care management program with four CPT codes that reimburse providers for time- and device-based billing.
There are several Medicare reimbursement requirements around patient eligibility and consent, who can deliver the service, patient cost-sharing, as well as minimum device readings and time spent by clinicians and auxiliary staff each month.