A telemedicine advocacy group is warning that proposed Medicare payment changes for 2027 could restrict access to remote patient monitoring and reduce reimbursement for the services.
ATA Action said the Centers for Medicare & Medicaid Services proposal would tighten billing requirements for remote physiologic monitoring and remote therapeutic monitoring while changing how the services are valued and paid.
The proposal would limit remote therapeutic monitoring billing to patients who have an established relationship with the billing practitioner, according to ATA Action. It also would require a separately reportable visit connected to the start of monitoring services and prohibit the use of third-party remote monitoring companies.
ATA Action said CMS also is considering consolidating existing billing codes into four new codes covering initial setup and monthly monitoring or management. The organization said two codes would apply to remote physiologic monitoring and two to remote therapeutic monitoring.
Kyle Zebley, CEO of the American Telemedicine Association and executive director of ATA Action, said the proposed rule would scale back remote monitoring services and cut reimbursement. He said the organization shares CMS' goal of reducing fraud, waste and abuse but believes that effort should not come at the expense of patients and health care providers.
The group contrasted the July 14 CMS proposal with action two days later by the House Ways and Means Committee. Zebley said the committee approved legislation with bipartisan support that would expand and protect access to care in rural and underserved communities, including remote monitoring services.
ATA Action said it plans to seek changes to the proposed remote monitoring provisions and advocate for what it considers fair reimbursement. The organization also urged Congress to extend or make permanent pandemic-era Medicare telehealth policies before they expire Dec. 31, 2027.
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