Marissa Plescia , 2025-04-17 23:05:00
The use of remote monitoring technologies has skyrocketed in recent years, and in a new report, the Peterson Center on Healthcare provided recommendations for policymakers on coverage and payment of these services.
The Peterson Center on Healthcare is a nonprofit organization focused on making healthcare more affordable. In 2023, the organization launched the Peterson Health Technology Institute (PHTI), an independent evaluator of digital health solutions. This report relies on the findings of three evaluations from PHTI on tools for diabetes, hypertension and musculoskeletal disorders, as well as an analysis of trends in Medicare and Medicaid billing.
Remote monitoring includes remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM). The former tracks patients’ physical data, like weight or blood glucose, while the latter tracks patients’ self-reported data, like pain or activity levels.
The report notes that Medicare billing for remote monitoring has surged in recent years. Federal spending in traditional Medicare on RPM rose from $6.8 million in 2019 to $194.5 million in 2023. Spending on RTM increased from $2.2 million in 2022 (when codes were released) to $10.4 million in 2023.
In addition, there’s been a steady rise in patients receiving long-term monitoring—even though studies show most benefits occur within the first few months. Some providers continue billing for remote monitoring services far after patients are likely to receive further benefits, the report found.
Based on these issues, the Peterson Center on Healthcare made the following three recommendations for policymakers on remote health technologies:
1. Coverage and reimbursement should be based on performance: Policymakers and payers should create “evidence-based, condition-specific remote monitoring duration limits and require an active redetermination of medical necessity to continue coverage for these services beyond those limits.” They should also link coverage to the clinical effectiveness of remote monitoring by condition.
2. Improve access and use of high-impact services: Policymakers and payers should eliminate the use of low-performing remote monitoring technologies and increase access to high-performing tools for those who need them.
“Today, there is very little penetration in use of RPM or RTM in rural areas, where high-impact remote services need to play a central role in care for rural populations given higher rates of chronic disease, provider shortages, and longer distances to care,” the report stated.
3. Advance data collection of remote monitoring services: Payers and policymakers need better data about how these technologies are performing, what digital solutions are being used, the conditions the technologies are being used to treat and other information. This will make it easier to make evidence-based coverage and reimbursement decisions for remote monitoring services.
“As we adopt exciting, new technologies that extend care beyond the walls of the doctor’s office, we need to design payment models that align with clinical benefits for patients,” said Caroline Pearson, executive director of the Peterson Center on Healthcare, in a statement. “That means ending ‘forever codes’ that incentivize long-term billing of ineffective care and instead designing payments that reimburse providers for the periods of time they should be actively monitoring and managing their patients’ diseases.”
Photo: SolStock, Getty Images