Bar graph illustrating transition from fee-for-service alternatives Medicare, associated with decline, to CCM & RPM growth; highlights chronic care management reimbursement 2026 and includes medical and checklist icons.
Key Takeaways • CMS finalized a -2.5% efficiency adjustment to work Relative Value Units (RVUs) for non-time-based services in 2026, compressing reimbursement across thousands of procedure-based CPT codes. • 80%…
A person sits at a desk using two monitors; one displays a security alert, and the other shows health dashboard charts and statistics related to Medicare Fee-for-Service and 2026 RPM coverage.
Key Takeaways•UnitedHealthcare (UHC) announced plans to restrict RPM coverage to only two conditions: heart failure and hypertensive disorders of pregnancy, across its Medicare Advantage, commercial, and Medicaid plans.•The policy has…
Key Takeaways•RTM and RPM are distinct programs. They monitor different data types, can serve the same patient populations, but cannot be billed together for the same patient in the same…
A Venn diagram labeled GLP-1, CCM, and RPM overlaps at the center with "Chronic Care Trifecta." Blurred in the background, two people hold hands—highlighting the unified impact of RPM, CCM, and GLP-1 in chronic care.
Key Takeaways • The RPM + CCM + GLP-1 Trifecta bridges the “management gap” for Medicare patients, ensuring that high-cost medications are backed by continuous physiological data and clinical oversight.…
A healthcare professional discusses outcome-based chronic care with an older woman, showing her information on a clipboard in a bright, indoor setting.
Key Takeaways The ACCESS Model is a 10-year CMS initiative shifting chronic care from volume-based to outcomes-based reimbursement. CMS is introducing Outcome-Aligned Payments (OAPs) to reward measurable clinical improvements in…
Two healthcare professionals review data on a tablet next to a digital screen displaying Population Health Management insights, analytics icons, and APCM Required Element 9 details.
Key Takeaways APCM programs require population health reporting to meet CMS compliance standards. Population health analytics help identify high-risk patients earlier. Data-driven insights allow providers to close care gaps proactively.…
Wooden blocks with various healthcare, technology, and automotive icons are stacked in front of rising blue arrows and a red upward graph line, symbolizing growth in multiple sectors like BHI Integration and G0558 Reimbursement.
Key Takeaways APCM (Advanced Primary Care Management) includes 13 required service elements that practices must meet. Integrating Behavioral Health Integration (BHI) enhances holistic patient care. Care teams help patients navigate…
Major 2026 Updates to RPM, CCM, BHI, and APCM Remote Patient Monitoring (RPM) For Calendar Year (CY) 2026, CMS finalized important updates to the Remote Physiologic Monitoring (RPM) and Remote…
A hand places a wooden block with a medical cross above four blocks displaying sad, worried, neutral, and happy face icons, symbolizing Better Outcomes for CHF Patients through Remote Patient Monitoring.
The Centers for Medicare and Medicaid Services (CMS) is proposing key changes to the 2026 Medicare Physician Fee Schedule that could significantly increase the profitability of Advanced Primary Care Management…
A healthcare worker wearing scrubs and a headset communicates via video call at a desk with a laptop, paperwork, and eyeglasses, supporting Remote Patient Monitoring to ensure better outcomes for CHF patients.
Key Takeaways CHF patients benefit from ongoing monitoring rather than periodic office visits. RPM enables real-time tracking of weight, blood pressure, and symptoms. Care teams can intervene earlier to prevent…
