How value-based providers can prepare for and leverage new opportunities.
The world of remote monitoring and chronic care management is continuing to evolve—and Medicare’s proposed policies for 2026 underscore that change. For providers working in remote patient monitoring (RPM), remote therapeutic monitoring (RTM), chronic care management (CCM) and value-based care, the upcoming changes from the Centers for Medicare & Medicaid Services (CMS) present both opportunities and challenges. At Telecare USA, we track these policy shifts closely so you can stay ahead of the curve, optimize reimbursement, and continue delivering high-quality outcomes for your patients.
In this blog, we’ll walk through the key 2026 changes most relevant to remote care, decode what they mean for your practice or program, and provide actionable take-aways so you’re ready when these changes go live.
1. What’s changing in 2026 for remote care & RPM/RTM
Here are some of the most significant proposed policy shifts for CY (Calendar Year) 2026 that affect remote care services:
a) Device supply / measurement-day thresholds
Historically, under RPM/RTM Medicare billing rules, patients had to have a minimum number of days of data transmitted (often 16+ days in a 30-day period) in order for device supply codes or monitoring to be billable. The proposed CY 2026 rule would relax that threshold—for example, allowing billing for 2-15 days of data transmission in a 30-day period for certain codes (respiratory, musculoskeletal, behavioral health) under the new paradigm. (Orrick)
b) Time-based management thresholds
Similarly, the time requirement for monitoring/management (e.g., 20+ minutes of management time per month) had excluded shorter, but still clinically meaningful, interactions. Under the proposed rule, payments could apply for 10-19 minutes of care/management time for some services.
c) Telehealth and supervision flexibilities
CMS is proposing to make more flexible the definition of “direct supervision” so that it can be achieved via real-time audio/video telecommunications for many services. This is important because it expands how remote teams can collaborate and supervise care. (Faegre Drinker)
d) Telehealth service list and frequency constraints
The proposed rule would simplify the process for adding services to the Medicare Telehealth Services List, and permanently remove frequency limitations for certain subsequent inpatient visits, nursing facility visits, and critical care consultations. (Prevounce Blog)
e) Emphasis on chronic disease prevention, behavioral health and digital tools
CMS’s policy direction for 2026 further emphasizes chronic disease management and behavioral health integration—suggesting that remote care services aligned to these themes (monitoring, coaching, digital therapeutics) are likely to receive more support. (Centers for Medicare & Medicaid Services)
2. Why this matters for Telecare USA and its clients
As a provider of RPM and remote care services (or as a partner advising such providers), these changes matter for several key reasons:
- Broader eligibility for remote monitoring: With fewer days required and shorter time thresholds, more patients may qualify for RPM/RTM. That opens the door to broader service populations — for example, patients with less intensive needs but still benefiting from monitoring/coaching.
- Operational flexibility: Shorter time thresholds mean that care teams can design workflows that are more efficient (e.g., 10-minute touchpoints instead of only >20-minute sessions) and still bill.
- Reduced friction for supervision: The ability to satisfy supervision requirements via real-time video means that remote teams, multi-site programs or providers working across geographies can scale more nimbly.
- Competitive advantage: Value-based care organizations and providers who adopt remote care early under the new rules will be better positioned to capture value, show outcomes, and differentiate themselves in the market.
- Risk mitigation: With CMS signaling expanded oversight (especially around fraud in RPM) and changing thresholds, practices that aren’t compliant or that rely on legacy workflows risk lost reimbursement or audit exposure. (Orrick)
3. Key considerations for implementing or scaling your RPM/RTM/CCM program
To make the most of the 2026 changes, here are some practical steps your organization should consider now.
Review your patient eligibility criteria
- Are there segments of your existing or prospective patients who previously did not meet the 16-day / 20-minute criteria but will qualify under the 2-15 day, 10-19 minute thresholds?
- Consider updating your screening workflows and enrollment scripts to include these newly eligible populations (e.g., less intensive monitoring, post-acute transitions, behavioral health cohorts).
- Align your care model for shorter intervals of monitoring or intervention — ensure your tech platform, staffing model and billing engine can support 10-minute interactions or 2-15 days of data.
Optimize your care team workflows
- Map out how your remote monitoring team will document and capture the required time (10-19 minutes) and data transmissions (2-15 days) so your billing aligns with the proposed rule.
- Ensure your device/data monitoring infrastructure is tuned to reliably capture days of data transmission, patient compliance metrics, escalation triggers, and documentation for monitoring time.
- Train staff on the new paradigm: shorter, more frequent engagements, and documentation that supports the new codes/time thresholds.
Review and update your billing and compliance processes
- Work with your billing department or partner to update code sets, eligible CPT/HCPCS codes (or proposed new codes) for devices and management time under the 2026 rules. (Note: Many of these are still proposed and comments are due, so stay current.) (HealthSnap)
- Check your audit and compliance framework: Given CMS’s heightened interest in oversight of RPM (especially transmission, device set-up, patient training, care management) you’ll want to document all required components (device supply, patient education, monitoring time, data review). (Orrick)
- Evaluate your contract terms, pricing models or value-based arrangements: As more patients qualify, and as codes/billing thresholds shift, your revenue model or shared-savings arrangement may need recalibration.
Communicate with your provider partners and patients
- Update provider partners (physicians, nurse practitioners, care managers) about the expanding eligibility and shorter thresholds so they understand who can enrol, understand the model and champion it.
- Educate patients (or prospective patients) about the monitoring program: highlight that it is now accessible to more people, with simpler thresholds and shorter but meaningful interactions—emphasizing convenience and improved outcomes.
- Monitor your enrollment pipeline and track MQLs/qualified patients under the updated criteria (for example: fewer days of data needed, shorter time in management, so earlier inclusion).
Stay alert to final rule changes and comment deadlines
- The CY 2026 proposed rule is still subject to change; finalization typically occurs later in the year and becomes effective Jan 1, 2026. (AAN)
- Stay on top of any CMS regulatory updates, codes that change, and CMS fact sheets.
- If you have strong views on how the thresholds or requirements should apply for your patient-population, consider submitting feedback during the comment period (especially if you are part of value-based networks, associations or provider groups).
4. The bottom line
For providers, care teams and organizations involved in remote monitoring and chronic care management, the proposed Medicare changes for 2026 open up meaningful new possibilities: more patients eligible for monitoring, shorter time commitments from your care teams, more flexibility in supervision and remote models. If implemented as proposed, these changes could accelerate adoption of remote care, improve patient access, and align well with value-based care imperatives around better outcomes at lower cost.
For Telecare USA and its clients/partners, this is an opportunity to take the lead—update your operational model, sharpen your enrollment strategy, align your technology and workflows, and position your organization to capitalize on these policy shifts early. Provider partners who move quickly will benefit from enhanced reimbursement opportunities, a broader patient base, and a stronger value-based care story.
5. Next steps
If you haven’t already, we recommend starting with:
- Audit your current RPM/RTM/CCM patient roster and identify who might newly qualify under the 2026 threshold changes.
- Convene your care team, operations and billing/finance stakeholders now to map the operational changes required (device monitoring days, care management time, documentation).
- Update your provider communication materials and patient-facing enrollment scripts to reflect the broader eligibility and changed thresholds.
- Monitor the final rule release (likely late 2025) and adjust your code sets, workflows or contracts accordingly.
- Measure and monitor your outcomes and economics for this expanded cohort—tracking both clinical outcomes and financial metrics will strengthen your value proposition to payors and value-based networks.
At Telecare USA, we are ready to partner with providers, health systems and value-based care organizations as these shifts take effect. If you’d like to discuss how we can help you optimize your remote care management strategy, please reach out.
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