Medicare’s newly proposed 2026 Physician Fee Schedule (PFS) delivers a long-awaited win for digital health: CMS will now reimburse for partial-month RPM / RTM data, and less than 20 minutes of associated care management time. This finally acknowledges the value of patient data monitoring, even when patients transmit less than 16 days of data per month. And it also finally values efficient care coaching that may take less than 20 minutes.Below, we break down the most important developments:
Until now, CMS only reimbursed patient data submissions when 16+ days of data were transmitted in a 30-day period—leaving providers uncompensated for shorter but still meaningful monitoring.Now proposed for payment:
This recognizes that patient adherence isn't binary. Partial data still offers clinical value, and CMS is finally adjusting policy to match that reality.
CMS is also introducing new treatment management codes for 10–19 minutes of remote clinician/staff time, expanding access to partial service reimbursement:
This allows providers' staff to be compensated for shorter patient engagements and follow-ups between visits—a particularly valuable change when working with high-risk or nonadherent populations who may require more frequent but briefer touches.
CMS is explicitly soliciting feedback on these valuation differences, asking stakeholders to submit evidence around:
CMS also plans to resurvey RPM codes in 2028 and place RTM codes on a New Technology review path with reassessment slated for 2030—signaling an openness to continued adjustment.
These updates are more than administrative tweaks. They represent: i) a philosophical shift toward meeting patients and providers where they are, and ii) expanded revenue opportunities for clinicians offering tech-enabled chronic care.Want to capitalize on these new codes and unlock more reimbursed care for your patients? Let’s talk.
