RPM Manual
The practical 2026 guide to device rules, day thresholds, management time, and audit defensibility for Remote Patient Monitoring.
Read the RPM Guide →The "Block Stretching" Trick: How Vendors Hide Low Compliance
Read the original: Block Stretching and RPM 99454
The Bottom Line
- The Definition: "Block Stretching" is when a vendor keeps a 30-day billing window open for 40, 50, or 60 days until the patient finally accumulates 16 days of data.
- The Illusion: Vendors use this to claim "100% billing success rates." They are not failing the month; they are just making the month longer.
- The Financial Loss: By stretching cycles, you might only bill 8 or 9 times a year per patient instead of 12. You lose 25-30% of your annual revenue.
- The Compliance Risk: CPT 99454 is defined as a 30-day period. Regularly billing "30-day" codes over 45-day spans creates a pattern of coding abuse.
The Hidden Cost of "Success"
Many practices stick with underperforming vendors because the vendor reports show a high "Success Rate" (e.g., "95% of submitted claims were paid!"). But this metric hides the frequency of submission. "Block Stretching" dilutes your annual revenue per patient (ARPP).
| Metric | Correct 30-Day Cycle | "Stretched" 45-Day Cycle |
|---|---|---|
| Billing Frequency | 12 times / year | 8 times / year |
| Revenue (at ~$50/mo) | $600 / patient | $400 / patient |
| Vendor Report Says: | "85% Compliance" | "100% Compliance" |
| Reality: | Honest Reporting | 33% Revenue Leakage |
Why Auditors Catch This
It is easy to spot in a data export. If your claims history shows Date of Service (DOS) spans that consistently drift (e.g., Jan 1, Feb 20, April 5), the auditor knows you aren't running a monthly program. You are running a "whenever we get the data" program, which does not meet the requirements of CPT 99453/99454.
Video Transcript
0:00 We talked about "Block Gapping," now let's talk about "Block Stretching." This is another trick vendors use to make their numbers look better than they actually are.
0:08 In a proper RPM program, the clock resets every 30 days. Day 1 to Day 30. If the patient doesn't get their 16 readings in that window, you don't bill. You start over.
0:18 But vendors hate not billing. So, instead of resetting the clock at 30 days, they just... keep it open. They stretch that "month" to 40 days, 45 days, or even 60 days, waiting until the patient finally crosses the finish line of 16 readings.
0:32 Then they submit the claim. They tell you, "Look! We have a 100% success rate on claims we submit!"
0:38 But here is the math they are hiding: If it takes 45 days to generate a 30-day bill, you are only billing 8 times a year instead of 12. You are losing 33% of your annual revenue per patient.
0:50 You are paying for a 100% success rate with a 33% pay cut. And, just like Gapping, it's not compliant with the 30-day definition of the CPT code.
Is your vendor hiding revenue leakage?
Use our Vendor P&L Analyzer to input your patient count and billing frequency. See exactly how much "Stretching" is costing you.
