Medicaid remote monitoring lets patients send health readings from home to their care team, paid for through a state Medicaid program. Most states now cover it in some form. The rules, though, change from one state to the next.
The evidence has also become more specific. Two real-world studies of Texas Medicaid patients tracked daily blood pressure and blood glucose readings over five months. Patients who took readings consistently saw their numbers improve. Many patients struggled to keep up, and the studies show where programs lose them.
This guide covers how remote patient monitoring (RPM) works under Medicaid and how state rules differ. It also reviews what the Texas studies and patient interviews found, and closes with lessons care teams can use.
What Is Medicaid Remote Monitoring?
Medicaid remote monitoring is remote patient monitoring covered by a state Medicaid program. A patient uses a connected device at home, such as a blood pressure monitor, glucometer, weight scale, or pulse oximeter. Each reading transmits to the care team. Clinicians review the data, respond to readings outside set ranges, and adjust treatment between visits.
Remote monitoring works alongside office visits. It does not replace them. What it adds is a record of the weeks between appointments, when patients manage their conditions on their own.
The biggest difference from Medicare is who sets the rules. Medicare uses one national framework. Under Medicaid, each state decides whether to cover RPM, which patients qualify, who can bill, and how much it pays.
Where Medicaid Coverage for Remote Monitoring Stands in 2026
The Center for Connected Health Policy (CCHP) found that 41 state Medicaid programs reimburse for RPM in its Fall 2025 report. CCHP reviewed state policies between late May and early September 2025, so some states may have changed since.
That count includes a range of coverage. Five states limit RPM payment to communication technology-based services (CTBS) codes. They are Hawaii, Iowa, Massachusetts, New Hampshire, and New Jersey. CCHP counts Alaska because its manual lists self-monitoring, though anecdotal reports suggest the service is not actually paid. CCHP’s research also focuses mainly on fee-for-service Medicaid, so managed care plans may set different terms.
For the current list of states, see our guide to state coverage.
How State Medicaid Rules for Remote Monitoring Differ
Two states can both cover RPM and still run very different programs. CCHP’s Fall 2025 report shows the main places where rules split.
Eligible Conditions
Some states name specific conditions or patient histories. Louisiana passed a law requiring Medicaid to cover RPM for beneficiaries with certain chronic conditions. These include sickle cell disease, asthma, diabetes, cancer, and heart disease. Those patients also need at least two hospitalizations and a provider recommendation. Maryland went the other way and opened RPM to patients with any condition.
Approvals and Orders
Approval rules vary widely. Maryland eliminated prior authorization for RPM. Alabama made provider orders valid for one calendar year and added initial and annual home assessments. In the Texas studies covered below, monitoring needed Medicaid approval and physician reauthorization every 60 days.
Who Can Bill
Provider rules decide which practices can offer monitoring at all. Texas added federally qualified health centers (FQHCs) and rural health clinics as eligible home telemonitoring providers. New York expanded RPM payment to outpatient settings, including some FQHCs.
Patient Age
California removed its requirement that Medicaid RPM patients be 21 or older.
Codes and Payment
Medicaid coverage of RPM does not always mean payment for the same codes Medicare uses. States choose their own code sets and rates, and those change over time.
Maternal Health Is a Growing Focus
Medicaid covers many pregnancies, and several states are adding remote monitoring for pregnant and postpartum patients. Virginia passed a bill clarifying that RPM for high-risk pregnant patients covers conditions such as maternal diabetes and hypertension. Arkansas now requires coverage of self-measured blood pressure monitoring for pregnant and postpartum women, including the device, training, and data transmission. Texas passed a law directing the state to study home telemonitoring before expanding it, with high-risk pregnancy among the conditions under review.
For blood pressure programs, this is an area to watch.
What Texas Medicaid Studies Show
Researchers at Texas A&M University published two studies on Texas Medicaid patients. Both used 2016 to 2018 data from a telemonitoring company serving those patients. One covered hypertension. The other covered diabetes. Both programs followed the same model.
A physician referred the patient, and Texas Medicaid approved the service. A technician then set up the equipment at home and trained the patient. Each patient chose a daily time to take a reading. If no reading arrived, staff called the patient. If a reading fell outside the physician’s range, a nurse called the patient and escalated concerns to the physician. Physicians received weekly summary reports.
Hypertension Results
The hypertension study followed 823 patients with an average age of 73.2. The equipment paired a Bluetooth monitor with a separate transmission unit. Patients did not need internet service or a smartphone.
Researchers defined adherence as sending readings on at least 80% of days. Of the 823 patients, 57.7% met that bar. Reminder calls raised the overall daily transmission rate from 59.7% to 77.2%.
Blood pressure improved in both groups. Adherent patients lowered systolic pressure by an average of 2.2 mm Hg and diastolic pressure by 0.7 mm Hg. Nonadherent patients lowered systolic pressure by 1.6 mm Hg. The gains were larger for patients who started high. Among adherent patients who averaged above 140/90 in the first month, systolic pressure fell by 14.8 mm Hg. That group was small, at seven patients.
For more on blood pressure programs, see our guide to hypertension RPM.
Diabetes Results
The diabetes study followed 382 patients with an average age of 70.5. Just under half (48.7%) tested on at least 80% of days. Reminder calls raised the daily transmission rate from 64.3% to 75.6%.
Consistent testing lined up with better numbers. Adherent patients lowered their average blood glucose from 147.2 mg/dL to 138.2 mg/dL over five months. Their day-to-day variability also improved. Nonadherent patients showed no significant change.
For more on glucose programs, see our guide to diabetes RPM.
What the Studies Could Not Show
Retention was a challenge in both programs. In the hypertension program, only 39% of enrolled patients sent readings across a continuous 180 days. In the diabetes program, 22% stayed enrolled 180 days or longer. Neither study explains why patients dropped off.
The authors also note clear limits. Both studies covered Texas Medicaid only, and neither had a control group. The diabetes study had no A1C or medication data. Both programs asked for one reading a day. That is more often than home blood pressure guidance calls for and less often than general glucose guidance suggests.
What Medicaid Patients Say About Remote Monitoring
Numbers show what happened. Interviews can show why. A qualitative study in the Journal of Patient Experience took that approach. Researchers interviewed 17 Medicaid patients enrolled in a remote monitoring program for diabetes or hypertension.
Three main themes came up. The first was the experience of enrolling, which patients described in both positive and negative terms. The second was how they used the program day to day, including text messages, monitoring routines, and the technology itself. The third covered wider factors that shaped how well they managed their conditions.
The authors concluded that RPM programs could be an effective way to support diabetes and hypertension management. They also noted two limits. The sample was small, and Medicaid program design varies by state.
6 Lessons for Medicaid Remote Monitoring Programs
The Texas studies and the patient interviews point to several practical steps.
1. Support Patients Through the First Month
Both Texas studies treated the first 30 days as a startup period, when patients were still learning the equipment. Build that time into onboarding. Check in early, confirm readings are arriving, and fix problems while the routine is still new.
2. Identify Adherence Problems Early
In the hypertension study, 75% of nonadherent patients were already falling short in their first month of monitoring. Their adherence then dropped further over time. A patient who misses often in month one needs more than a reminder call.
3. Follow Up on Missed Readings the Same Day
A missed reading tends to lead to another. In the hypertension study, adherent patients sent a reading on only 67.1% of the days after a miss, compared with 91.3% overall. Adherence was also lowest on weekends, especially Sundays. Same-day follow-up and weekend coverage close those gaps.
4. Remove Technology Barriers
The diabetes study authors named transmission problems as a challenge that reminder calls did not fully solve. Devices that work without a smartphone, an app, or home Wi-Fi take several failure points out of the process.
5. Keep Supplies on Hand
Glucometers use a test strip and lancet with every reading. When a patient runs out, testing stops for a reason that has nothing to do with motivation. Supply planning is part of patient adherence.
6. Plan for the Staff Workload
Support takes people. In the hypertension study, 823 patients generated roughly 350 reminder calls a day. Programs should plan staffing and workflows that surface exceptions, so nurses spend time on the patients who need it.
Frequently Asked Questions About Medicaid Remote Monitoring
The questions below cover Medicaid remote monitoring coverage, how state rules differ, and what research shows. They also cover what patients need at home.
1) Does Medicaid cover remote patient monitoring?
In most states, yes. CCHP’s Fall 2025 report found that 41 state Medicaid programs reimburse for RPM. Five of those limit payment to CTBS codes, and each state sets its own rules.
2) Which conditions does Medicaid remote monitoring cover?
It depends on the state. Some states name specific chronic conditions, while Maryland now allows RPM for any condition. Several states are adding coverage for high-risk pregnancy and postpartum blood pressure.
3) Does remote monitoring improve outcomes for Medicaid patients?
Texas Medicaid studies found improvement in patients who took readings consistently. Adherent hypertension patients lowered systolic pressure by 2.2 mm Hg on average, and adherent diabetes patients lowered average glucose by 9 mg/dL. Neither study had a control group.
4) How many Medicaid patients keep up with daily readings?
In the Texas studies, 57.7% of hypertension patients and 48.7% of diabetes patients sent readings on at least 80% of days. Reminder calls raised daily transmission rates in both programs.
5) Do patients need a smartphone or Wi-Fi for remote monitoring?
Not with cellular devices. Tenovi devices send readings over cellular networks, either on their own or through the Tenovi Cellular Gateway. Patients do not need an app, a smartphone, or a Wi-Fi password.
6) Is Medicaid remote monitoring the same as Medicare RPM?
No. Medicare sets national rules. Each state Medicaid program decides its own coverage, eligible conditions, billing providers, codes, and payment.
Understanding Medicaid Remote Monitoring
Medicaid remote monitoring gives patients a way to share readings from home and gives care teams something to act on between visits. Forty-one state Medicaid programs reimburse for it. Coverage still differs by state in conditions, approvals, eligible providers, and codes, and maternal health is a growing area.
The Texas Medicaid studies show both the results and the work involved. Patients who took readings consistently lowered their blood pressure or blood glucose. Reminder calls raised transmission rates, but many patients still struggled, and many did not reach six months. Patient interviews add that enrollment and daily use shape how people experience these programs.
The practical lessons are consistent. Support patients early. Spot adherence problems in the first month. Follow up the same day, remove technology barriers, and plan for the staff time it takes.
Tenovi provides cellular-connected remote monitoring infrastructure for RPM companies, health systems, payers, and other organizations serving Medicaid patients. Our FDA-cleared devices send readings automatically, with no syncing, no apps, and no Wi-Fi. We handle fulfillment, provisioning, and support, including glucometer supply replenishment, all through one API. Contact us for a free demo and consultation.
This material is provided for general informational and educational purposes only and does not constitute legal, compliance, billing, coding, or reimbursement advice. CPT® codes, descriptions, and Medicare payment rates referenced here are drawn from publicly available sources, are subject to change, and may vary by payer, locality, and patient circumstances. Tenovi makes no representation or guarantee regarding coverage, payment, or the appropriateness of any code for a particular patient or service, and any presented are illustrative only. Providers are solely responsible for independently determining medical necessity and applicable coding, coverage, documentation, and billing requirements and for submitting accurate claims. Consult applicable payer guidance and qualified billing, coding, compliance, or legal professionals before making billing decisions. CPT® is a registered trademark of the American Medical Association.
