RPM and Medicare in 2026: On patient health and financial sustainability

Physicians take a financial risk when they offer remote physiologic monitoring as a treatment — there’s a chance they may not get paid for it. The 2026 Medicare Physician Fee Schedule proposals on RPM reimbursement could change that. Lucienne Marie Ide, MD, PhD, is founder and CEO of Rimidi, a company that works with RPM, and the author of an analysis of the 2026 schedule. Here she the financial risk and why greater flexibility could create a more sustainable financial model for physicians.

Medical Economics: Will added flexibility become a characteristic that may be more appealing to physicians who have thought about implementing an RPM program, but haven't taken that step yet?

Lucienne Marie Ide, MD, PhD: As I've spoken with physicians about this, I do think there's an aspect where it gives them some downside risk protection. And what I mean by that is, the practice is providing these devices to the patients as part of the RPM program. And that's really what that 99454 code is reimbursing the practice for, giving a blood pressure cuff to the patient and having a system that transmits the data. In the current system. If that patient doesn't reach 16 days, the practice doesn't get reimbursed anything that month. And so having this flexibility where they could be reimbursed — the patient goes on vacation, they forget to take their blood pressure cuff with them. Things happen in life that get in the way of every single day, doing exactly what your physician asked you to do. And so I do think it makes the programs a bit more appealing to some physicians who worry that there's a real cost to those devices and they could end up losing money on the program. Everyone should be doing this because they believe it will benefit their patients, but it also has to be financially sustainable model.