RPM Manual
The practical 2026 guide to device rules, day thresholds, management time, and audit defensibility for Remote Patient Monitoring.
Read the RPM Guide →UHC Postpones RPM Rollback: Why the PDF Still Says "Jan 1"
The Bottom Line
- The Status: UnitedHealthcare has verbally confirmed they are postponing the drastic RPM coverage cuts originally slated for January 1, 2026.
- The Confusion: The official policy documents (PDFs) on their portal have not been updated yet and still show the old effective date.
- The Strategy: Do not discharge patients yet. However, document the specific "Network Bulletin" announcement number in your internal compliance logs to defend against automated denials in Q1.
- The Risk: Automated claims systems may still deny based on the old logic until their software is patched. Be ready to appeal.
Read the full breakdown in our in depth article.
Your "Defense Pack" for Q1 2026 Claims
When a major payer like UHC announces a delay but fails to update their published PDFs in time, automated claim denials often skyrocket. Their adjudication software may still be programmed with the "Jan 1" rules engine.
If you receive denials for RPM (99454/99457) on UHC patients in January or February, do not assume the coverage is gone. Use this "Defense Pack" data in your appeal:
Appeal Language Template
Reference ID: UHC Network Bulletin Update (December Cycle)
Argument: "This claim was denied based on policy regarding RPM indications. However, UnitedHealthcare publicly announced a postponement of this coverage policy update prior to the effective date. The denial is based on obsolete logic that contradicts the verbal confirmation provided by Provider Relations."
Note: Keep a record of the date and time you verified this with your specific network representative.
Why This Happened
Payers often release "pre-payment" policy updates months in advance. When provider pushback is significant (as it was here), the "business decision" to delay often happens faster than the "IT decision" to update the claims engine or the "marketing decision" to update the website PDF. You are currently operating in that gap.
Video Transcript
0:00 Important update regarding the UnitedHealthcare (UHC) RPM rollback that was scheduled for 2026. We are hearing from multiple sources that they are postponing this cut.
0:10 However, here is the dangerous part: If you go to their website right now and download the policy PDF, it still says "Effective Jan 1." They have not updated the document yet.
0:18 This creates a massive confusion gap. Your billing team looks at the PDF and says, "We have to stop." But the reps on the phone are saying, "No, it's delayed."
0:25 Here is my advice: Do not mass-discharge your UHC patients yet. If you offboard them now, and the policy is delayed, re-onboarding them is a nightmare of consent forms and device setups.
0:35 Instead, hold steady. Keep monitoring. But be prepared for Q1 denials. Their software might still reject claims because the computer thinks the rule changed, even if the executives said wait. You need to be ready to appeal with the announcement number.
0:48 We will keep you posted as soon as the physical PDF is updated.
Need to diversify your payer mix?
If UHC volatility is hurting your forecast, look at APCM. It's a cleaner, more stable revenue model for 2026.
