Key Takeaways • APCM launched January 1, 2025, and its reimbursement rates increased by approximately 10% in 2026. Most practices still haven't enrolled a single patient. • The three most…
Key Takeaways•CMS's CY 2027 proposed rule would bar contracted and third-party clinical staff from billing RPM and RTM. Only direct employees of the billing practice would qualify.•This is a proposed…
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%…
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…
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.…
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…
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.…
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…
