Remote monitoring code changes could make it into CY2026 fee schedule, at the earliest

The American Medical Association’s coding panel, which is responsible for creating medical billing codes, is set to meet September 19-21 in Albuquerque where it will consider yet another proposal to lower the requirements for providers to get paid for remote monitoring. Remote monitoring was scarcely mentioned in the Center for Medicare and Medicaid Services’ (CMS) proposed CY2025 physician fee schedule, out last week, which dashed any hope for payment changes by 2025. If the latest remote monitoring code change application goes through at the September coding meeting, the earliest the industry could see significant remote monitoring changes is in 2026, barring legislation.

The Commonwealth Fund has published the results of a study seeking to understand why more primary care practitioners (PCPs) are not participating in value-based payment (VBP) models. After conducting focus groups with PCPs who have not participated in VBP models and interviews with primary care executives and association leaders, the report offers some recommendations about how to improve PCP participation. The report notes that during the past 14 years, CMS and states have tried several VBP models for primary care, but most PCPs still do not participate in VBP models, and the reasons are largely unknown.