Smart Meter calls on RPM industry to fight proposed 2027 Physician Fee Schedule changes

Smart Meter, a provider of cellular-connected remote patient monitoring (RPM) solutions, is calling on RPM vendors, health care providers and industry partners to mobilize against provisions in the Centers for Medicare & Medicaid Services' (CMS) proposed Calendar Year 2027 Physician Fee Schedule that the company says could sharply curtail access to remote monitoring for millions of Medicare beneficiaries.

The proposed rule, issued July 14, includes several changes that Smart Meter and other industry stakeholders believe would undermine the growth and viability of RPM programs nationwide. Among the most consequential proposals is a prohibition on Medicare reimbursement for RPM and remote therapeutic monitoring (RTM) services furnished by third-party clinical staff who are not direct employees of the billing practitioner or practice. The rule would also reduce practice expense valuations for device supply and treatment management codes. If finalized, the changes would take effect Jan. 1, 2027.

"These proposed changes threaten to dismantle the operating model that has allowed RPM to scale and reach patients who need it most, particularly in rural and under-resourced communities," Casey Pittock, CEO of Smart Meter, said in a statement. "CMS has raised legitimate program-integrity concerns, and we take those seriously. But we believe the agency is proposing a solution that goes far beyond addressing a small number of bad actors and risks eliminating a care model with a genuine, measurable track record of reducing healthcare costs and keeping patients out of the emergency department and out of the hospital."

Mobilizing the industry, funding independent research

Smart Meter said it is working with policy advocacy organizations and its existing base of health care provider and vendor customers to urgently fund independent third-party research examining RPM's clinical efficacy and its measurable impact on reducing emergency department utilization and overall system costs. The company said much of the existing evidence supporting RPM's value has been generated by industry participants themselves or is drawn from a limited body of independent, peer-reviewed studies — a gap CMS has cited in support of its proposed changes.

"If CMS's central question is whether RPM actually reduces avoidable utilization and saves the system money, then the right response is to go get rigorous, independent answers — not to unwind a benefit before that evidence is fully built out," Pittock said. "We're asking other vendors, health systems and provider groups to join us in funding that work so the final rule is shaped by data, not assumptions."

Call to action

With the CMS public comment period closing Sept. 14, Smart Meter is urging the RPM community to act. The company is asking stakeholders to submit public comments to CMS outlining how the proposed rule would affect patients, providers and RPM programs, and to contact Smart Meter directly to join its coalition on research, comment strategy or broader advocacy.

"This is a moment for the RPM industry to speak with one voice," Pittock said. "Every provider and vendor who has seen firsthand what remote monitoring does for their patients has a stake in this outcome, and a comment period only works if people actually use it."

The push comes as CMS has spent recent years both expanding and tightening the rules around remote monitoring. Two new billing codes took effect this year intended to give practices more flexibility in how they bill for measurement days and monitoring time, reflecting the program's continued growth since RPM codes were introduced in 2019. At the same time, the proposed 2027 changes follow warnings raised in an HHS Office of Inspector General report that flagged program-integrity concerns tied to how some RPM services are staffed and documented — concerns that CMS now appears to be addressing directly through the employment and payment restrictions in the proposed rule.

The tension between those two forces — a payment model regulators have steadily built out to encourage adoption, and a compliance apparatus increasingly focused on how third-party staffing models deliver those services — is likely to shape how CMS approaches remote monitoring policy well beyond this rulemaking cycle. Vendors that rely heavily on outsourced or contracted clinical staff to review patient data may face the most direct exposure if the employment restriction is finalized as proposed, while practices that keep monitoring functions in-house could be comparatively insulated. Industry groups have signaled they intend to press CMS during the comment period to narrow the rule's scope to target documented abuses rather than the broader third-party staffing arrangements many RPM programs depend on to operate at scale.