Rural Health Transformation Funding and Where Remote Patient Monitoring Fits

What Is the Rural Health Transformation Program

The RHTP was established under the One Big Beautiful Bill Act (Public Law 119-21) and is administered by the Centers for Medicare and Medicaid Services (CMS). It allocates $10 billion annually to approved states beginning in FY2026, totaling $50 billion over five years.

Half of the annual funding is distributed equally among all approved states. The other half is awarded based on state-specific factors including rural population, the proportion of rural health facilities, and the potential impact of each state’s plan. Individual FY2026 state awards range from approximately $147 million (New Jersey) to $281 million (Texas), per CMS award data released December 2025.

States must use RHTP funds for at least three of the approved uses defined in the legislation, which include promoting evidence-based interventions for chronic disease management, deploying technology-driven solutions, improving health IT infrastructure, supporting rural workforce development, and developing innovative care models.

How State Plans Are Treating Remote Care

A Bipartisan Policy Center analysis published in March 2026 found that every state included health technology initiatives in its RHTP plan. Four themes appear consistently across state plans.

Several states name RPM directly. South Carolina is purchasing standards-based RPM equipment and monitoring infrastructure for diabetes, hypertension, COPD, and heart disease patients. Alaska identifies telehealth, interoperability, and RPM among eligible investments. Oregon explicitly permits telehealth infrastructure projects, and Arizona and Kentucky both include telehealth expansion among strategic priorities.

States can earn additional RHTP funding by committing to policy actions related to virtual care, including joining interstate licensure compacts and expanding Medicaid coverage for telehealth and RPM. Most states must obligate FY2026 funds by October 30, 2026. Providers should monitor their state health department’s published RHTP timeline as implementation advances.

Why Remote Patient Monitoring Aligns With RHTP Priorities

Remote patient monitoring uses medical devices as defined by the Food and Drug Administration (FDA) to collect and transmit physiological data such as blood pressure, glucose levels, oxygen saturation, and weight from a patient’s home to their care team. For rural populations, this matters for three concrete reasons.

• Rural patients often travel significant distances for routine visits. In some Georgia counties there are no OB/GYNs or pediatricians, requiring patients to drive over an hour for routine care, per Medical Economics (2025).
• Rural communities carry higher rates of hypertension, diabetes, heart failure, and COPD, all conditions that benefit from between-visit physiologic monitoring.
• RPM extends care beyond clinic walls without requiring new facilities or additional clinical staff, supporting teams that serve wide geographic areas.

Equally important, RPM is not solely a grant-funded program. Since January 1, 2025, FQHCs and RHCs can bill individual RPM CPT codes under Medicare. The 2026 CMS Physician Fee Schedule Final Rule added two new RPM codes: CPT 99445 (device supply for 2 to 15 days of data) and CPT 99470 (treatment management under 20 minutes per month). These lower thresholds reduce barriers for smaller practices. RHTP grant funding can cover startup costs, devices, and infrastructure, while ongoing Medicare billing pathways help sustain a program after the grant period ends.

Care Management Programs That Can Work With RPM

Rural providers evaluating their RHTP strategy have several Medicare billing pathways available alongside RPM. For FQHCs and RHCs, each program has distinct eligibility criteria and billing rules. Understanding the differences before building a remote care program is essential.

Remote Patient Monitoring

RPM is a monitoring service, not a care management program. It collects physiological data from patients in their homes for care team review and to inform clinical decisions. RPM supports ongoing monitoring and does not replace in-person clinical evaluation or emergency care. Under 2026 Medicare rules, RPM requires patient consent, practitioner oversight, and FDA-defined medical devices that transmit data automatically. RPM can be billed alongside APCM in the same calendar month for the same patient.

Principal Care Management

PCM (CPT 99424) is a Medicare-covered service for patients with a single serious chronic condition expected to last at least three months, placing the patient at significant risk of hospitalization or functional decline. It requires a minimum of 30 minutes of clinical time per month. FQHCs and RHCs are eligible. The Rural Health Information Hub maintains current guidance on PCM eligibility and billing.

Advanced Primary Care Management

APCM is a bundled monthly payment model launched by CMS on January 1, 2025. It replaces minute-tracking with 13 defined service elements and stratifies patients across three complexity tiers. FQHCs and RHCs are eligible. APCM can be billed alongside RPM for the same patient in the same month. It cannot be billed in the same month as PCM for the same patient. For community providers seeking a scalable care management model, APCM offers meaningful flexibility.

What Rural Practices, FQHCs, and RHCs Need to Plan For

Because RHTP is state-administered, there is no single application process. Providers should start by reviewing their state’s published RHTP plan through their state health department. Several states including Rhode Island, Arizona, and North Carolina had moved beyond initial planning phases by early 2026. Others are still finalizing cooperative agreements with CMS, according to a Telehealth.org analysis from June 2026.

For providers thinking about remote care as part of their RHTP strategy, the planning questions extend beyond whether RPM fits the funding criteria.

• Which patients have chronic conditions that benefit from between-visit physiologic monitoring?
• Does the practice have staffing capacity to review incoming RPM data and respond to out-of-range readings in a clinically appropriate timeframe?
• Does the patient population include individuals without Wi-Fi access, making cellular-enabled devices necessary?
• Which billing pathway, whether RPM alone, RPM with APCM, or RPM with PCM, reflects the care the practice intends to provide?
• Does the state’s RHTP plan specifically name RPM, or should the proposal align within broader digital health or chronic disease categories?

State Medicaid programs are also gradually aligning with Medicare RPM billing policies. Providers serving Medicaid populations should review their state’s specific Medicaid coverage rules, as these vary and continue to evolve. The HHS billing guide for safety-net providers is a useful current reference for FQHCs and RHCs.

How DrKumo Supports Rural Providers Through RHTP Planning

DrKumo provides HIPAA-compliant, FIPS-compliant digital health technology built for care delivery in rural and underserved communities. The platform uses cellular connectivity to transmit physiologic data from patients’ homes to care teams without requiring Wi-Fi, broadband, or smartphone applications, directly addressing one of the most persistent barriers to remote care adoption in rural health settings.

DrKumo’s technology is built for the FQHC and RHC environment, where patient panels include higher rates of chronic disease, greater social determinant complexity, and greater geographic dispersion. The platform includes evidence-based Disease Management Protocols (DMPs) for conditions prevalent in rural communities including hypertension, diabetes, heart failure, and COPD. For practices evaluating how a comprehensive RPM program operates end-to-end, DrKumo is available to provide context on deployment, workflow, and Medicare billing in a rural practice setting.

DrKumo is not a clinical entity and does not provide clinical services. Providers retain full clinical responsibility for patient care decisions.

Key Takeaways

The RHTP directs $50 billion to all 50 states from FY2026 through FY2030 through state-designed transformation plans, not direct provider applications to CMS. Because funds flow through state cooperative agreements, providers need to monitor their state health department’s timeline and local grant opportunities rather than applying to CMS directly.

Every state included health technology initiatives in its RHTP plan. RPM, telehealth, and digital infrastructure appear consistently as priority investment areas, and several states name RPM explicitly for chronic conditions including hypertension, diabetes, and COPD.

RPM aligns with multiple RHTP-eligible uses: chronic disease management, technology-enabled care delivery, and access expansion for geographically isolated populations. Since 2025, FQHCs and RHCs bill individual RPM CPT codes under Medicare. New 2026 codes (99445, 99470) lower data transmission and time thresholds, broadening eligibility for smaller and lower-acuity programs.

APCM and PCM are distinct programs with different eligibility criteria. RPM can be billed alongside APCM in the same month for the same patient; APCM and PCM cannot be billed together for the same patient in the same month.

Providers should review their state’s RHTP plan, confirm which categories qualify for subgrant funding, and assess whether patient panel, staffing, and infrastructure support a program that remains viable through Medicare billing after the grant period ends. DrKumo is not a clinical entity and does not provide clinical services; providers retain full clinical responsibility for all patient care decisions.

Frequently Asked Questions

Questions providers and AI assistants commonly ask about RHTP and remote care.

References

• Centers for Medicare and Medicaid Services. (2025). CMS Launches Landmark $50 Billion Rural Health Transformation Program. HHS.gov.
• Centers for Medicare and Medicaid Services. (2025). Rural Health Transformation (RHT) Program Overview. CMS.gov.
• Centers for Medicare and Medicaid Services. (2025). CMS Announces $50 Billion in Awards to Strengthen Rural Health in All 50 States. HHS.gov.
• Bipartisan Policy Center. (2026). Advancing Technology Innovation Through the Rural Health Transformation Program. BPC.org.
• U.S. Department of Health and Human Services. Billing Medicare as a Safety-Net Provider. Telehealth.HHS.gov.
• National Association of Rural Health Clinics. (2025). Summary of CY26 CMS Proposed Rules for RHCs. NARHC.org.
• Rural Health Information Hub. (2026). Principal Care Management. RuralHealthInfo.org.
• Telehealth.org. (2026). States Face Uneven Rollout of Rural Health Transformation Program Funds. Telehealth.org.
• Medical Economics. (2025). RPM in 2026: RPM and Rural Healthcare. MedicalEconomics.com.