Remote Monitoring Services Under the 2027 PFS Proposed Rule: Epstein Becker Green Submits Comments to CMS

On behalf of one or more health care practices that furnish device-enabled remote monitoring services to Medicare beneficiaries, Epstein Becker Green (EBG) submitted comments on September 14, 2026, to the Centers for Medicare and Medicaid Services (CMS) related to the 2027 Physician Fee Schedule Proposed Rule (“Proposed Rule”).

These comments oppose restrictions the practices believe would reduce patient access and care quality and recommend evidence-based oversight alternatives instead.

In the Proposed Rule, CMS announced potentially sweeping changes to Medicare payment rules for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM). The practices assert that, if finalized, these rules would negatively impact the future of both RPM and RTM. EBG submitted comments (“Comments”) on five specific proposed restrictions.

• Employment Mandate. CMS proposes requiring that clinical staff be direct W-2 employees of the billing practice, abandoning a 25-year auxiliary-personnel framework and the remote-monitoring policy it confirmed in 2020. As reflected in the Comments, this requirement would eliminate participation by small, rural, and independent practices that use contracted staff under practitioner supervision, consolidating access in large health systems and conflicting with state licensing laws.
• Established-Patient Limits. CMS proposes restricting monitoring to patients with prior relationships to the billing provider. As reflected in the Comments, this restriction would delay treatment for post-operative patients referred from surgeons, often “new” to the billing practitioner at the moment monitoring need arises, and during the clinically decisive early-recovery window.
• Initiating-Visit Requirement. CMS proposes requiring a separately reportable visit for every patient before monitoring begins. The Comments recommend that CMS instead mirror its chronic care management policy, requiring initiating visits only for new patients and those not recently seen, and confirm that therapy evaluation codes qualify. The Comments further recommend that CMS place telehealth flexibility on a footing that survives the December 31, 2027, sunset of therapist telehealth authority.
• Device Revaluation. CMS proposes pricing therapeutic rehabilitation platforms, which include motorized hardware, integrated sensors, patient software, and clinician dashboards, using the same values as blood-pressure cuffs and event recorders. The Comments propose that CMS distinguish device classes and set inputs from invoice-level cost data, rather than commodity pricing.
• Code Restructuring. CMS proposes bundled monthly G-codes requiring every service component in every calendar month. This proposal would repeal the episodic flexibility the agency finalized last year. The Comments propose that any restructuring retain a separately billable device-supply component and episodic pathways and proceed only through a future proposal with published values.

The Comments note that the integrity concerns CMS identified in its Department of Health and Human Services Office of Inspector General (HHS-OIG) reports centered on documentation, transparency, and ordering-provider identification—all addressable through oversight guardrails. An employment mandate does not solve those problems; it simply reduces access where it matters most and burdens compliant practices.

CMS has posted all comments received, which presently exceed 44,000, on its website at https://www.regulations.gov/document/CMS-2026-2377-0002.

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The Health Law Advisor blog is currently edited by Emily Chi Fogler.