AMA Rule Changes for 2026

The American Medical Association’s (AMA) recent decision to remove the requirement for remote physiologic monitoring (RPM) providers to collect data at least 16 days out of a 30-day period is a significant milestone RPM programs. This policy change, slated for implementation in early 2026, will enable healthcare organizations to offer shorter-term and less frequent RPM services, paving the way for more inclusive and sustainable RPM programs.

Since CMS began reimbursing for RPM services in 2019, healthcare providers have faced challenges due to rigid requirements. Currently, Medicare reimbursement for RPM services is capped at approximately $170 per patient per month, with limited coverage of devices and data types that qualify. The strict 16-day data collection requirement further restricted many organizations, particularly those aiming to offer RPM services to patients with varying needs or conditions that don’t require daily monitoring.

This latest CPT panel ruling, made at the AMA’s September meeting, is a welcome surprise for advocates who had previously pushed for a more flexible approach. In May, telehealth leaders had proposed adding “supply of device” codes to allow reimbursement for programs that monitor patients less frequently than 16 days per month. Although the proposal was initially declined, the AMA’s eventual reversal indicates a responsiveness to industry concerns, possibly recognizing that the 16-day rule was arbitrary and didn’t account for certain clinical needs.

The original 16-day rule didn’t account for cases where fewer monitoring days would still provide meaningful insights. Removing this requirement now allows healthcare organizations to serve a broader range of patients, including those who only require periodic monitoring or those in rural or underserved areas who may not have consistent access to monitoring technology.

The easing of RPM reimbursement restrictions aligns with recent CMS efforts to expand remote monitoring codes. CMS has introduced codes for remote therapeutic monitoring (RTM) alongside the original RPM codes, acknowledging a growing need for remote solutions that can manage not just physical metrics like heart rate or glucose levels but also therapeutic outcomes such as pain or medication adherence. 

This change is expected to significantly impact RPM adoption, especially as health systems strive to address chronic diseases and complex care needs outside of hospital settings. It could also encourage the development of RPM solutions focused on preventative care and early intervention, expanding the reach of telehealth services in line with healthcare trends that emphasize continuity of care and patient-centered models.

The AMA’s decision offers a clear pathway for more flexible RPM and RTM options. It also highlights the momentum for expanding access to telehealth and remote care technologies. As providers prepare for the 2026 implementation, this ruling could prompt further advocacy for telehealth reimbursement reforms, ensuring RPM and RTM services are both financially viable and accessible to more patients.