Ask most clinic owners what their home exercise program completion rate is and you get a shrug, or a number that came from a feeling rather than a report.
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Most clinics evaluating remote therapeutic monitoring ask what the software does. Fewer ask what the people do, which is strange, because the people are what Medicare is paying for.
Every conversation I have had about the CY2027 proposed rule ends at the same place. If Medicare stops paying for outsourced monitoring, what does that actually do to the money? Here is how to answer it for your own practice, using arithmetic rather than a vendor's projection.
If you've been following the CMS proposed rule on remote therapeutic monitoring, you know the core worry. If it's finalized as written, Medicare would stop paying for monitoring done by an outside vendor's employees.
If you run remote therapeutic monitoring in your practice, or you've thought about starting, you've probably heard CMS proposed a change in July that could affect how Medicare pays for it.
Every RTM demo looks the same. A clean dashboard. Adherence graphs trending up. A patient list color coded green and yellow and red. A billing summary showing what the practice could have collected last month if it had been running this all along.
The CY2027 proposed rule turns on three pieces of regulatory language that most clinic owners have never had to think about. If the outsourcing provision is finalized, they become the vocabulary that decides whether your RTM claims get paid.
Most of the attention on the CY2027 proposed rule has gone to the outsourcing provision, which is understandable because it is dramatic. I think a quieter change will disqualify more claims.
Comments on the CY2027 Physician Fee Schedule close at 11:59pm Eastern on September 14. After that the record is closed and CMS writes the final rule, expected around November 1.
Opportunity Calculator
Enter your clinic's numbers to get a projection of revenue and profit generated using Remote Therapeutic Monitoring.
*Projection based on a Physical Therapy Assistant (PTA) doing the monitoring service.