The Centers for Medicare and Medicaid Services (CMS) program's oversight of remote patient monitoring (RPM) in healthcare has been a topic of discussion since the Office of Inspector General (OIG) published a September 2024 report identifying widespread vulnerabilities and concerns about fraud. And nearly 1 year later — after a more recent analysis — the OIG urges CMS to review healthcare RPM claims more closely.
In its report, the OIG cites 2 measures the agency can use to identify potentially noncompliant providers:
- Billing for a high proportion of enrollees who have no prior history with the medical practice
- Billing for multiple monitoring devices a month for an enrollee
Here’s what your practice needs to know to prepare for increased scrutiny of RPM services.
By the numbers: Remote patient monitoring in healthcare
Given the amount Medicare and Medicare Advantage plans paid for healthcare RPM in 2024 ($536 million), it’s not surprising that the OIG has targeted the service for further review. This dollar amount represents a 31% increase from 2023, and Medicare has continually paid more for the service since it began widely covering it in 2019.
The number of Medicare enrollees receiving healthcare RPM has also skyrocketed over time. In 2024, nearly 1 million enrollees received RPM, a 27% increase from 2023. While many of these cases of RPM in healthcare are legitimate and warranted, the OIG suspects some may not be.
According to the most recent OIG analysis, medical practices billed RPM in healthcare for about 70 enrollees annually, adding about 5 new enrollees each year. However, its analysis found that some practices added at least 100 new enrollees in a single month, calling into question the validity of the services. One medical practice billed healthcare remote patient monitoring for nearly 3,400 new enrollees in a single month.
Remote patient monitoring in healthcare: Preparing for greater scrutiny
This recent OIG analysis indicates that CMS may be taking a closer look at healthcare RPM services, and medical practices should prepare for increased scrutiny.
As Dr. Soma Mandal, MD, explains: “As remote patient monitoring becomes an integral part of chronic disease management, it’s essential for practices to prioritize compliance and transparency. With increased CMS oversight, clear documentation and robust internal audits are more important than ever. By ensuring that remote patient monitoring services are clinically justified and well-documented, providers can continue to deliver high-quality, patient-centered care while maintaining the trust of payers and regulators.”
"By ensuring that remote patient monitoring services are clinically justified and well-documented, providers can continue to deliver high-quality, patient-centered care while maintaining the trust of payers and regulators."

Here are some ways to promote compliance and avoid becoming the target of an audit.
1. Audit your current healthcare remote patient monitoring billing
Your medical practice may be at risk if it bills healthcare remote patient monitoring:
- At an unusually high rate — particularly when there are sudden spikes in enrollment
- For multiple devices for the same patient in the same month
- For patients receiving the same service from multiple providers during the same month
- With a device supply only (CPT 99454) and no treatment management (99457/99458)
- Without a pre-existing provider–patient relationship
2. Focus on documentation improvement
Providers should be able to show who, what, when, why, and how for each healthcare remote patient monitoring service. If CMS or OIG pulled the chart, they should see a clear chain:
Patient need → device use → data transmission → provider review → care adjustment → billing code supported.
3. Demand more transparency from remote patient monitoring vendors
Providers who outsource healthcare RPM services may need to include audit clauses and data-sharing obligations regarding device supply/usage, consent management, and treatment management.
For example, providers may want to add the following language to their contracts. [Note: This is not legal advice, and practices should always consult with an attorney prior to contract execution.]
- Provider may review vendor’s healthcare remote patient monitoring activities and records on reasonable notice to confirm compliance with Medicare and other payer rules.
- Vendor will make available information about patient enrollment, device use, data transmission, and treatment management upon request.
- If issues are identified, vendor agrees to work with provider to correct them promptly at no additional cost.
- Vendor will notify provider immediately if it receives any government audit or inquiry related to healthcare remote patient monitoring services.
"Providers should be able to show who, what, when, why, and how for each healthcare remote patient monitoring service."
Looking ahead
In its 2026 CPT code update, the American Medical Association created 5 new codes to report healthcare remote monitoring services over short periods, 2 to 15 days within a 30-day period.
Additionally, there are 2 new codes for healthcare remote monitoring treatment management after 10 minutes of service per calendar month, down from the previous 20-minute threshold. All of these codes take effect January 1, 2026.
In its 2026 physician fee schedule final rule, CMS also proposes to cover 3 new remote patient monitoring codes.
When reporting remote patient monitoring in healthcare, clear and detailed documentation is critical. As CMS and the OIG continue to examine the service more closely, providers who demonstrate compliant, clinically meaningful RPM programs will stand out as trusted partners for payers — and may be better positioned for value-based care and chronic condition management initiatives.
Explore how Tebra streamlines RPM billing workflows, so your practice can confidently scale services while staying audit-ready for new 2026 CPT codes and increased CMS oversight. Book a free, personalized demo today.
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