Remote Patient Monitoring — Overdue or Overused?

This editorial examines the rapid expansion and reimbursement of remote patient monitoring (RPM) services, accelerated by Covid-19 and legislative support. RPM has broadened from device-based cardiac surveillance to widespread chronic condition management through home-based technologies measuring blood pressure, glucose, oxygen saturation, and more. The 2019 and 2020 CMS rule updates introduced new billing codes and expanded coverage, including acute conditions like Covid-19. However, RPM’s surge raises concerns about cost, evidence, and equity. Devices often lack clinical effectiveness data, and CMS offers minimal specifications for coverage, creating potential for overuse under fee-for-service incentives. A graph model projects Medicare costs could reach $18.5 billion annually with just 50% uptake among patients with ≥6 chronic conditions. The authors advocate for rigorous research to guide RPM deployment, transparent standards from FDA and CMS, and lessons from countries like Germany that link reimbursement to demonstrated clinical value. While RPM holds promise, its scale must be matched by evidence-based policy and patient-centered design.

This editorial examines the rapid expansion and reimbursement of remote patient monitoring (RPM) services, accelerated by Covid-19 and legislative support. RPM has broadened from device-based cardiac surveillance to widespread chronic condition management through home-based technologies measuring blood pressure, glucose, oxygen saturation, and more. The 2019 and 2020 CMS rule updates introduced new billing codes and expanded coverage, including acute conditions like Covid-19. However, RPM’s surge raises concerns about cost, evidence, and equity. Devices often lack clinical effectiveness data, and CMS offers minimal specifications for coverage, creating potential for overuse under fee-for-service incentives. A graph model projects Medicare costs could reach $18.5 billion annually with just 50% uptake among patients with ≥6 chronic conditions. The authors advocate for rigorous research to guide RPM deployment, transparent standards from FDA and CMS, and lessons from countries like Germany that link reimbursement to demonstrated clinical value. While RPM holds promise, its scale must be matched by evidence-based policy and patient-centered design.