CMS Proposes 2026 Telehealth and RPM Coverage Updates

CMS Proposes 2026 Telehealth and RPM Coverage Expansion

LOS ANGELES, CA — January 15, 2025 — The Centers for Medicare and Medicaid Services has released a proposed rule for calendar year 2026 that includes significant expansions to telehealth and Remote Patient Monitoring coverage under Medicare. The proposed changes would broaden the pool of eligible patients, add qualifying conditions, and extend flexibility provisions that were introduced during the public health emergency.

Key Proposed Changes for RPM and CCM

The proposed rule addresses several areas directly relevant to remote monitoring programs. Geographic restrictions for telehealth originating sites would be further relaxed, making it easier for patients in both rural and urban settings to receive RPM and CCM services. The proposal also revisits device eligibility criteria, potentially allowing a wider range of FDA-cleared monitoring devices to qualify for RPM billing under CPT codes 99453 through 99458.

New qualifying conditions under consideration include expanded coverage for metabolic syndrome monitoring, post-surgical recovery tracking, and fall risk assessment through contactless monitoring technologies. These additions would open RPM enrollment to patient populations that currently fall outside traditional eligibility requirements.

What Providers Should Prepare For

The comment period for the proposed rule runs through spring 2025, with a final rule expected before the end of the year. Providers and technology platforms should begin preparing for several operational changes. Multi-program enrollment criteria may shift, allowing patients to be simultaneously enrolled in RPM and CCM with fewer documentation barriers. Compliance requirements for data transmission and device setup are also expected to be updated.

"These proposed changes reflect what the industry has been demonstrating for years — that remote monitoring reduces hospitalizations and improves outcomes across a much broader set of conditions than the original guidelines anticipated," said Cosmo Cochrane, Co-Founder of CCN Health. "We have been building our platform to support exactly this kind of expansion, with multi-program enrollment and flexible device configurations already in place."

CCN Health currently supports five Medicare programs — RPM, CCM, PCM, BHI, and RTM — and is positioned to incorporate any new qualifying conditions or eligibility changes into its platform workflows as the final rule takes effect.

Availability

CCN Health will publish updated compliance guidance and platform configurations as the final rule is released. Current customers will receive program-specific impact assessments through their account teams.

About CCN Health

CCN Health is a remote patient monitoring and chronic care management platform serving senior living, skilled nursing, and physician practice markets. The platform integrates with leading EHR systems to deliver automated data exchange across five Medicare programs: RPM, CCM, PCM, BHI, and RTM.