Billing for Remote Patient Monitoring in Medicare

Why OIG Did This Review

• Remote patient monitoring is a technology-based health care service designed to allow for better management of health conditions, especially chronic conditions.
• Remote patient monitoring allows a patient to collect their own health data (e.g., their blood pressure or weight) using a connected medical device that automatically transmits these data to their provider. The provider then uses these data to treat or manage the patient’s condition.
• OIG previously found that the use of these services in Medicare has the potential to greatly expand in the future and that additional oversight of remote patient monitoring is needed.

What OIG Found

• The use of remote patient monitoring continued to grow in 2024, with Medicare payments exceeding $500 million.
• Monitoring billing can help safeguard the Medicare program and prevent fraud, waste, and abuse.
• We developed several measures to monitor billing for remote patient monitoring including:
  • billing for a high proportion of enrollees who have no prior history with the medical practice; and
  • billing for multiple monitoring devices a month for an enrollee.
• These measures can identify medical practices with billing for remote patient monitoring that warrant further scrutiny.
• Analyzing billing can help CMS, Medicare Advantage Organizations, and other entities ensure that enrollees receive the benefit of remote patient monitoring while, at the same time, minimizing program integrity risks.