By: Chaunte’ Causey, Communications Manager, PCC
A newly released report from the Peterson Center on Healthcare titled Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment (April 2025) offers key insights into how Remote Patient Monitoring (RPM) can improve care for Medicare and Medicaid populations—while also lowering costs and shaping future policy.
This in-depth report evaluates how remote monitoring technologies are being used, which conditions benefit most from their application, and how coverage and reimbursement policies might be better aligned with clinical evidence.
What is Remote Patient Monitoring?
According to the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network (MLN) Telehealth and Remote Patient Monitoring Fact Sheet, updated in April 2025, RPM allows patients to use connected medical devices at home to collect and transmit their health data to providers. RPM includes two categories:
Remote Physiological Monitoring: Captures data like blood pressure, weight, or blood glucose levels.
Remote Therapeutic Monitoring (RTM): Tracks non-physiological data such as medication adherence and physical therapy progress.
Medicare began reimbursing for RPM services in 2019, adding RTM coverage in 2022. Both sets of services involve three billing components: device supply, patient education/setup, and provider time spent reviewing data and managing care.
Coverage Across Payers
Most state Medicaid programs have followed Medicare’s lead, with 41 states offering some form of RPM reimbursement, according to research by the Center for Connected Health Policy (CCHP). However, coverage among private insurers remains inconsistent and often narrower in scope.
Key Clinical Insights from the Peterson Report
The report draws on evaluations by the Peterson Health Technology Institute (PHTI) to assess the clinical effectiveness of RPM and RTM for managing conditions like hypertension, diabetes, and musculoskeletal disorders. Here are some of the findings:
Hypertension is the leading diagnosis for RPM users, representing 57% of Medicare beneficiaries with an RPM episode. The average episode lasts 6.6 months, aligning with evidence that RPM is most useful during active medication management periods.
Musculoskeletal disorders are the top diagnosis for RTM users, accounting for nearly 60% of episodes. The average RTM episode lasts 1.7 months, reflecting a typical course of physical therapy.
RPM for hypertension helps providers quickly adjust medications and achieve faster improvements in blood pressure.
RTM during physical therapy results in greater pain and functional improvements compared to in-person treatment alone.
RPM for diabetes is most impactful for patients with high HbA1c levels or those undergoing care plan transitions.
Utilization is growing rapidly:
In 2023, 451,000 Medicare patients used RPM, compared to just 44,500 in 2019.
The average duration of RPM use in Medicare rose from 1.7 to 5.2 months between 2019 and 2023.
However, only 1% of Medicare beneficiaries use RPM services, and fewer than 0.2% used RTM in 2023.
Recommendations for Policymakers
The report outlines several policy suggestions to strengthen RPM use:
Align coverage with evidence-based practices: Data shows that current RPM usage patterns—such as six-month monitoring for hypertension—already reflect where the clinical benefit is strongest.
Improve access to high-impact tools: Most RPM users are in urban areas, while rural populations—who often face higher rates of chronic disease—remain underserved. The report suggests CMS reconsider how geographic reimbursement variations may unintentionally limit rural access.
Enhance data collection: Medicare does not currently require RPM billing claims to identify the condition being treated or the device being used, limiting the ability to track outcomes and effectiveness.
Moving Forward
As RPM and RTM services become more common, the focus must remain on improving both access and data collection. The authors caution that adding unnecessary billing complexities or limitations could deter provider participation and restrict patients from receiving the benefits of remote care technologies.
For organizations like Palmetto Care Connections, which are committed to expanding digital health tools across rural South Carolina, these findings reinforce the importance of improving broadband access and supporting digital health training in medically underserved areas.
Sources:
Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment, Peterson Center on Healthcare, April 2025
Telehealth and Remote Patient Monitoring Fact Sheet, Medicare Learning Network (CMS), April 2025
Center for Connected Health Policy (CCHP) Policy Finder – https://www.cchpca.org
To read the full Peterson report, visit:
https://petersonhealthtechnologyinstitute.org/reports/evolving-remote-monitoring
To explore Medicaid and Medicare RPM policy by state, visit CCHP’s Policy Finder:
https://www.cchpca.org/policy-trends
By: Chaunte’ Causey, Communications Manager, PCC
