On July 14, 2026, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2027 Physician Fee Schedule proposed rule, which includes several proposed changes to how Medicare pays for Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services. One day later, the House Ways and Means Committee advanced separate legislation aimed at expanding RPM access in rural and underserved communities.
Neither has been finalized. Below is what each one actually says, with direct links to the source documents.
What CMS Proposed for RPM and RTM
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Issued Jul 14, 2026 CY 2027 Physician Fee Schedule Proposed Rule — CMS-1848-P, open for public comment | ||||
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The CY 2027 PFS proposed rule covers a wide range of Medicare Part B payment policy. Its “Remote Monitoring” section describes four changes CMS is proposing for RPM and RTM billing, plus one item it is only seeking comment on.
“For CY 2027, we are proposing to require that RTM services be furnished only to established patients, that practitioners reporting RPM or RTM services must furnish a separately reportable initiating visit in association with the onset of RPM or RTM services, and only to allow payment for RPM or RTM services when performed by clinical staff employed by the practice and not when those services are delivered by contractors. We also are proposing updates to how these services are valued under the PFS as we understand the devices may be available at a reduced cost compared to our initial estimates.”
A possible shift to four new G-codes
CMS is also seeking public comment on a more structural option: consolidating the current RPM and RTM CPT code family into four new HCPCS G-codes — two for RPM and two for RTM — covering initial device setup/education and monthly monitoring and management. In its own words:
“We also considered, and are seeking comments on, bundling the RPM and RTM CPT codes and creating four new HCPCS G-Codes to describe remote monitoring services. This approach would address recommendations from recent OIG reports that we do not believe can be fully resolved with the current coding structure of the remote monitoring code family.”
This is a comment solicitation, not a finalized proposal — CMS has not proposed to adopt the G-codes and is asking for feedback before deciding whether to pursue them.
What the House Ways and Means Committee Advanced
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Passed Committee 39–0 H.R. 3108 — the Rural Patient Monitoring Access Act (RPM Access Act) | ||||
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The Committee’s own July 16, 2026 release describes H.R. 3108 this way:
“Remote patient monitoring (RPM) empowers patients to take charge of their health by using innovative technology to stay connected with their health care provider, and advances care coordination to better treat patients with complex chronic diseases… RPM bridges care gaps for rural patients who face disproportionately higher rates of chronic disease and related mortality. Current Medicare payment rules arbitrarily decrease RPM reimbursement for services provided in certain rural areas. This bill establishes a national floor for RPM reimbursement, eliminates negative payment adjustments to remote monitoring services in rural areas, strengthens quality of remote monitoring by clarifying technology and response requirements, and bolsters clinical evidence of RPM by requiring a report on hospital admissions and inpatient days for patients furnished RPM.”
Figures the Committee cites in its own bill materials in support of H.R. 3108:
| 50%Reduction in heart attack/stroke rates for patients with uncontrolled hypertension using RPM | 27%Reduction in hospital admissions associated with RPM use | 52%Lower Medicare spending in one RPM program for heart failure patients |
H.R. 3108 passed the Ways and Means Committee 39–0. It still needs a vote by the full House, action by the Senate (or reconciliation with S. 1535), and the President’s signature before it could become law.
Same Week, Different Directions
| Date | Event | Source |
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| Jul 14, 2026 | CMS issues the CY 2027 PFS proposed rule, including proposed RPM/RTM billing restrictions | CMS.gov |
| Jul 15, 2026 | House Ways and Means Committee marks up and passes H.R. 3108, the RPM Access Act, 39–0 | Ways and Means Committee |
| Jul 16, 2026 | CMS rule published in the Federal Register; Committee publishes its markup summary | Federal Register / Ways and Means |
| Jul 21, 2026 | ATA Action issues a statement addressing both developments | ATA Action |
What ATA Action Said
ATA Action, the American Telemedicine Association’s affiliated advocacy organization, issued a statement on July 21, 2026 addressing both developments. ATA Action CEO Kyle Zebley described the sequence of events as creating what the organization called a “sharp dichotomy” between CMS’s proposed restrictions and the Committee’s action to expand RPM access.
Zebley said the organization is “eager to work with CMS within the PFS process to address concerning patient access” and operational issues raised by the proposed rule, while welcoming Congress’s bipartisan support for the separate rural monitoring legislation.
The statement also noted that pandemic-era Medicare telehealth flexibilities are scheduled to expire December 31, 2027, absent further Congressional action, and said ATA Action would continue engaging with CMS during the rulemaking process.
What Happens Next
CMS proposed rule: Public comments are accepted through September 14, 2026, at regulations.gov (file code CMS-1848-P). A final rule is expected later in 2026; most PFS provisions would take effect January 1, 2027, if finalized as proposed.
H.R. 3108: Passed committee; requires a full House floor vote, Senate action, and presidential signature to become law. None of its provisions are currently in effect.
Considerations for RPM/RTM Programs
Because both proposals are still pending, neither changes current Medicare billing requirements today. Organizations that operate or are evaluating RPM programs may want to track a few specific items as each moves forward:
- Staffing model. The CMS proposal, if finalized, would limit billable RPM/RTM services to clinical staff directly employed by the billing practice, which would affect models built around contracted or outsourced monitoring staff.
- Initiating visit workflow. A separately reportable initiating visit would add a documented, billable step at the start of monitoring services.
- Rural reimbursement floor. If H.R. 3108 becomes law, it would apply specifically to RPM reimbursement in rural and underserved areas. It addresses payment levels, not the staffing or visit requirements proposed separately by CMS.
- Comment period. September 14, 2026 is the formal deadline for submitting comments on the CMS proposed rule directly to CMS.
Key Takeaways
On July 14, 2026, CMS issued the CY 2027 Physician Fee Schedule proposed rule (CMS-1848-P), which proposes restricting RPM and RTM billing to clinical staff employed by the billing practice, extending the established-patient requirement to RTM, adding a separately reportable initiating visit, and revaluing RPM/RTM codes. CMS is also seeking comment on consolidating current codes into four new HCPCS G-codes. The public comment period closes September 14, 2026.
One day later, on July 15, 2026, the House Ways and Means Committee passed H.R. 3108, the Rural Patient Monitoring Access Act, 39–0. The bill would establish a national reimbursement floor for RPM and eliminate negative payment adjustments in certain rural areas, but it still requires a full House vote, Senate action, and presidential signature before becoming law.
ATA Action issued a statement on July 21, 2026 noting the timing of both developments and its intention to engage with CMS during the rulemaking process. Neither the CMS proposal nor H.R. 3108 is currently in effect.
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Frequently Asked Questions
Has the CMS CY 2027 Physician Fee Schedule proposed rule been finalized?
No. CMS issued it as a proposed rule on July 14, 2026. It is open for public comment through September 14, 2026. A final rule has not been issued, and current RPM/RTM billing rules remain in effect until CMS finalizes and implements new requirements.
What would CMS’s proposed rule change about who can bill for RPM and RTM?
As proposed, RPM and RTM services would only be payable when performed by clinical staff employed by the billing practice, not when delivered by contracted third-party monitoring companies. The proposal would also extend the established-patient requirement to RTM and add a separately reportable initiating visit for both RPM and RTM.
Is CMS definitely creating four new G-codes for RPM and RTM?
Not yet. CMS is soliciting public comment on bundling the current RPM and RTM CPT codes into four new HCPCS G-codes. This is a comment request, not a finalized proposal, and CMS has not committed to adopting it.
What is H.R. 3108?
H.R. 3108, the Rural Patient Monitoring Access Act, is a bipartisan bill that would establish a national reimbursement floor for RPM and eliminate negative payment adjustments applied to remote monitoring services in certain rural areas. It was introduced April 30, 2025, and passed the House Ways and Means Committee 39–0 on July 15, 2026.
Has H.R. 3108 become law?
No. It has passed committee markup only. It still requires passage by the full House, action by the Senate (or reconciliation with companion bill S. 1535), and the President’s signature before any of its provisions take effect.
Do the CMS proposal and H.R. 3108 conflict with each other?
They address different aspects of RPM policy. CMS’s proposal concerns billing conditions — staffing, patient relationship requirements, initiating visits, and code structure. H.R. 3108 concerns reimbursement rates in rural areas. Both are pending, and neither is finalized.
References
- Centers for Medicare & Medicaid Services. (2026, July 14). Calendar Year (CY) 2027 Medicare Physician Fee Schedule Proposed Rule [Fact sheet]. CMS.gov.
- Centers for Medicare & Medicaid Services. (2026). CMS-1848-P. CMS.gov.
- Federal Register. (2026, July 16). Medicare and Medicaid Programs; CY 2027 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies. 91 FR 43842.
- Congress.gov. (2025). H.R.3108 – Rural Patient Monitoring Access Act, 119th Congress. Library of Congress.
- U.S. House Committee on Ways and Means. (2026, July 16). Ways & Means Committee Approves Legislation to Expand Access to Care for Rural Patients & Seniors, Improve Health Care Price Transparency, & Hold Health Care Empires Accountable. Waysandmeans.house.gov.
- ATA Action. (2026, July 21). ATA Action Sounds Alarm as CMS’ PFS Proposed Rule Threatens to Reverse Bipartisan Congressional Gains on Remote Patient Monitoring. AmericanTelemed.org.
