Two things happened four days apart in July 2026, and they point in opposite directions. On July 14, the Centers for Medicare and Medicaid Services (CMS) released a proposed 2027 Physician Fee Schedule that would restrict how remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) get delivered and paid. On July 16, the House Ways and Means Committee passed the Rural Patient Monitoring Access Act (H.R. 3108) by a vote of 39 to 0, a bill built to expand RPM access in rural and underserved areas. Neither is final. Here is what each one actually does, and what to watch while both are still in motion.
What CMS Proposed on July 14
We covered the full proposed 2027 Physician Fee Schedule in detail when CMS released it. The provisions most relevant here: RPM and RTM would be limited to established patients, the billing provider’s own clinical staff, not outside contractors, would be required to perform monitoring, a separately billed initiating visit would be required to start a program, and CMS proposes consolidating condition-specific RPM and RTM codes into four Healthcare Common Procedure Coding System (HCPCS) codes at lower valuations.
It is a proposal, not a final rule. The comment period runs through September 14, 2026, and any changes CMS finalizes would take effect January 1, 2027.
What the RPM Access Act Would Do
The Rural Patient Monitoring Access Act (H.R. 3108) sets a national minimum RPM reimbursement rate, ending reduced payment adjustments for rural areas so rural practices are not paid less for the same service. It requires RPM providers to respond to data anomalies and transmit patient data to the electronic health record, and it mandates a congressional report on hospital admissions and cost savings tied to RPM.
The bill was introduced by Rep. David Kustoff (R-TN), with Reps. Troy Balderson (R-OH), Donald Davis (D-NC), and Mark Pocan (D-WI). A Senate companion, S.1535, comes from Sen. Marsha Blackburn (R-TN) and Sen. Mark Warner (D-VA). On introducing the bill, Kustoff put it plainly:
“The RPM Access Act is important legislation that will help doctors and nurses monitor patients remotely. I urge my colleagues to support this bill to help provide Americans with good-quality healthcare no matter their location.”Rep. David Kustoff (R-TN)
The 39-0 committee vote on July 16 sends the bill to the full House. It still needs a House floor vote, Senate passage, and a presidential signature before it becomes law.
The Contradiction ATA Action Is Flagging
The timing has not gone unnoticed. Kyle Zebley, CEO of the American Telemedicine Association and executive director of its advocacy arm ATA Action, pointed out that Congress advanced legislation to expand rural RPM access just two days after CMS proposed cutting it, calling it a “sharp dichotomy.” One branch of government is moving to protect and expand remote monitoring. Another is proposing to narrow it. Here is how the two tracks compare directly:
| CMS’s Proposed 2027 Fee Schedule | RPM Access Act (H.R. 3108) | |
|---|---|---|
| Status | Proposed rule, comment period through September 14, 2026 | Passed committee 39-0 on July 16, 2026, needs a full House and Senate vote |
| Patient eligibility | Would limit RPM and RTM to established patients | No new eligibility restriction |
| Staffing and quality | Would require the billing provider’s own clinical staff, not outside contractors, to perform monitoring | Requires response to data anomalies and EHR data transmission |
| Reimbursement direction | Proposes lower valuations and code consolidation | Sets a national minimum rate, raising the floor for rural reimbursement |
| Oversight | None specified | Mandates a report on hospital admissions and cost savings tied to RPM |
What This Means for Your Program Right Now
Nothing here is settled. The fee schedule is a proposal with a comment period still open, and H.R. 3108 is a bill that passed one committee in one chamber. Restructuring a program around either outcome today would be premature.
One provision is worth watching closely regardless of which way this goes: the proposed requirement that the billing provider’s own clinical staff, not outside contractors, perform monitoring. The exact language CMS finalizes here matters a great deal for any practice using a staffing model where care navigators operate as an extension of the provider team. That is the provision to flag for your compliance review once the final rule lands, not the one to assume will resolve in your favor.
On the reimbursement side, the direction is more straightforward to plan around. If H.R. 3108 becomes law, rural practices get a reimbursement floor equal to the national rate. If CMS finalizes the proposed valuations, reimbursement moves the other way. Either way, the anomaly-response and EHR-transmission standard the bill would require is already standard practice for a well-run RPM program, worth confirming your documentation already meets it before either track resolves.
Frequently Asked Questions
Is the RPM Access Act law yet?
No. H.R. 3108 passed the House Ways and Means Committee 39-0 on July 16, 2026. It still needs a vote by the full House, passage of the Senate companion bill (S.1535), and a presidential signature before it takes effect.
Does the RPM Access Act change the 2027 Physician Fee Schedule?
Not directly. They move through separate processes, one is a bill in Congress and the other is a CMS regulatory proposal, and they are not currently reconciled. It is possible for H.R. 3108 to become law while CMS’s proposed restrictions also move forward, unless Congress or CMS acts to align them.
What does CMS’s 2027 Physician Fee Schedule propose for RPM?
Limiting RPM and RTM to established patients, requiring the billing provider’s own clinical staff to perform monitoring, requiring a separately billed initiating visit, and consolidating billing codes at lower valuations. It is a proposal, with a comment period open through September 14, 2026.
What should a practice do while both are pending?
Keep documentation and staffing practices audit-ready under either outcome, and treat the clinical-staffing provision in the CMS proposal as the one to review with counsel once a final rule is issued. There is no need to restructure a program based on a bill or a proposal that has not been finalized.
Tracking policy changes while running a remote care program takes bandwidth most commercial teams do not have to spare. Our team reads every proposed rule and tracks legislation like H.R. 3108 as it moves, so your program is never caught flat-footed by a final rule.