Operational guidance and analysis for APCM, RPM, RTM, and value-based care execution.
Before outsourcing remote patient monitoring, ask vendors how they staff the work, document care, contact patients, control record access, and manage financial incentives.
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Your clinical team can run RPM and APCM without an outsourced clinical vendor. FairPath brings the readings, care plans, communication, and program requirements together.
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A physician or other QHP bills Medicare RPM and remains accountable for the claim. Eligible clinical staff may perform qualifying treatment-management work under current supervision and incident-to rules, while CMS has only proposed a direct-employee restriction for 2027.
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You do not need to hand your RPM program to a third-party vendor that takes a percentage of collections. Start small, keep clinical control, and use FairPath as the operating layer for eligibility, enrollment, devices, documentation, code readiness, and billing records.
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CMS proposes limiting billable RPM and RTM clinical-staff work to direct employees of the billing practice beginning in 2027. Practices that own the clinical work, documentation, patient relationship, and program economics are best positioned for what comes next.
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FairPath helps practices using Tebra/Kareo reduce duplicate documentation work, connect care-management workflows, and save time on RPM, CCM, APCM, billing, and report follow-up.
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For years, Physician Fee Schedule (PFS) rates were set using data from office-based practices. Starting in 2026, CMS will now use auditable cost data from Hospital Outpatient Departments (OPPS) to set the rates for some PFS technical services, explicitly in...
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If you manage an RPM program, you already know about the 16-day rule. What you may not know is that the workaround some billing teams use to deal with non-compliant patients - pausing the billing cycle until the patient starts transmitting again - creat...
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CMS has fused APCM eligibility, practitioner attribution, and continuity into a single monthly operating system. Billing without that coherence now creates denial and audit exposure. If you are treating these as three separate checkboxes, you are already be...
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With 10 days left in the year, practices were bracing for a major UnitedHealthcare shift: a new RPM medical policy that would sharply narrow coverage to two indications and label most other RPM use as "unproven." Then UHC said it is postponing implementatio...
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If you manage a Remote Physiological Monitoring (RPM) program, CPT code 99454 is likely your biggest source of revenue and, also likely, your biggest headache. The 16-day requirement - the patient must transmit data on at least 16 separate days within a 3...
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CMS permanently adopted virtual direct supervision for services furnished after December 31, 2025. That sounds like a green light for remote care management, but it is narrower than most practices think. It changes where the supervisor can be, not what can...
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If your RPM, CCM, or RTM vendor is charging a percentage of collections, you may have a federal fraud-and-abuse problem that neither of you is talking about. It is the most common vendor pricing model in remote care, and it is structurally the hardest to de...
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Independent pharmacies are being told they need to "diversify revenue." The default answer from industry consultants is telepharmacy - remote dispensing to underserved areas. That is a real business, but it is not the same business as clinical services re...
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Eating disorders are not just a behavioral health problem. They are a chronic medical condition that requires ongoing primary care coordination, medical monitoring, medication review, nutrition support, family communication, and escalation planning. If your...
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Anthem has quietly made an important update to its clinical policy CG-MED-91 , effective December 18, 2025. The change aligns Anthem with CMS’s 2026 Physician Fee Schedule and formally recognizes the new “short-cycle” Remote Physiologic Monitoring (RPM) and Remote Therapeutic Mo…
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If you run an independent practice, rapid RPM growth probably still feels like a win.
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If you manage a Remote Physiological Monitoring (RPM) program, CPT code 99454 is likely your biggest source of revenue and, also likely, your biggest headache. This code, which reimburses for the supply of the device and data transmission, has long carried a notorious "all-or-no…
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Beginning January 1, 2026, UnitedHealthcare (UHC) will dramatically narrow coverage for Remote Physiologic Monitoring (RPM) across its commercial, Medicare Advantage, and exchange plans.
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If you are billing RPM for Diabetes, Hypertension, or COPD under UHC, your claims will likely be denied starting January 1st.
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