Every July 1, a valuable, but often overlooked opportunity emerges for healthcare providers. It is the date when coverage begins for patients who enrolled in Medicare during the Medicare General Enrollment Period (January 1 – March 31). For providers, July 1 marks a chance to identify patients who are newly eligible for Medicare, and who may also qualify for remote patient monitoring (RPM) through Medicare.
Many of these newly enrolled Medicare patients are managing chronic conditions between in-person appointments. With Medicare they may now qualify for daily at-home remote patient monitoring. By offering RPM services to eligible patients, providers can enhance chronic care delivery, improve patient outcomes, and unlock new Medicare reimbursement opportunities.
What Is Remote Patient Monitoring Through Medicare?
Remote patient monitoring and Medicare complement care for senior patients managing chronic conditions. RPM programs use FDA-cleared medical devices to collect and transmit patient health data, such as blood pressure, weight, or blood glucose, from a patient’s home to their healthcare provider. RPM is a modern approach to chronic care that enhances engagement, helps detect early changes in condition, and reduces unnecessary hospitalizations.
Medicare reimburses for remote patient monitoring services when CMS guidelines are met. SOme of the requirements include:
- A chronic or acute condition
- At least 16 days of data collected in a 30-day period
- Use of medical-grade, FDA-cleared devices
- An established patient-provider relationship
Covered CPT codes include:
- 99453 (setup and patient education)
- 99454 (device supply with daily transmission)
- 99457 and 99458 (clinical monitoring and patient communication)
As of January 1, 2025, Medicare has taken a step in supporting sustainability of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). These community health centers can bill for RPM services using CPT codes or continue to use G0511. This offers is especially relevant for community health providers looking to increase Medicare reimbursement and strengthen value-based care metrics. This transition more accurately reflects the reality of the care coordination services provided MD Revolution supports this move enthusiastically
July 1: A Date for Expanding Medicare RPM
Why is July 1 important? Because it’s when Medicare coverage begins for individuals who enrolled during the General Enrollment Period (January 1 – March 31). This annual window captures thousands of older adults who delayed signing up when first eligible, many of whom are managing chronic conditions.
Some current patients may now be Medicare patients with chronic conditions who can benefit greatly from daily measurement of blood pressure or blood glucose with remote patient monitoring through Medicare. RPM devices and services offer reminders and confirmation that readings have been send to their care team, which is more than they were given in the traditional care model. Patients can feel supported knowing as they continue to age, they are being monitored.
July 1 signals a time to do the following:
- Review your patient list for individuals turning 65 this year.
- Identify patients who enrolled late and now activate July 1.
- Offer RPM to patients with chronic conditions newly covered by Medicare.
Chronic Conditions Are Prevalent in Medicare Beneficiaries
68 million people currently use Medicare. More than 95 percent of Medicare beneficiaries have at least one chronic condition, and almost half have four or more. The most common conditions include:
Using Medicare for remote patient monitoring is designed to regularly monitor these conditions with medical devices including, digital blood pressure monitors, connected scales, or glucometers that transmit data in real time.
Remote Patient Monitoring Through Medicare: Improve Outcomes
Remote patient monitoring reduces ER visits, hospital readmissions, and improves medication adherence. A 2023 study published in Telemedicine and e-Health found that RPM users had significantly fewer hospitalizations and lower costs compared to control groups.
For providers, it’s a scalable way to expand chronic care management without requiring more in-person visits. For patients, it offers daily oversight, peace of mind, and improved health literacy.
What Providers Can Do to Prepare for July 1
With Medicare coverage beginning for new enrollees on July 1, providers have a timely opportunity to expand their remote patient monitoring programs. Taking the following steps now can help you proactively identify eligible patients, ensure compliance with CMS guidelines, and build a sustainable care model that improves outcomes and captures Medicare reimbursement.
1. Identify Eligible Medicare Patients
Review your patient population—particularly those:
- Turning 65 this year
- Recently enrolled during the Medicare General Enrollment Period
- Previously uninsured or underinsured and now covered by Medicare
Focus on patients with chronic conditions, as they are most likely to benefit from RPM and qualify for coverage.
2. Screen for RPM-Appropriate Diagnoses
Pinpoint patients with chronic or acute conditions that are best managed through ongoing home monitoring, such as:
- Hypertension
- Type 2 diabetes
- Congestive heart failure
- COPD or asthma
- Obesity-related complications
These conditions align closely with Medicare’s supported use of RPM devices like connected blood pressure cuffs, glucometers, and scales.
3. Partner With a Compliant RPM Vendor
Implementing RPM internally can be complex. Consider working with an experienced RPM partner that provides:
- Cellular-enabled, FDA-cleared medical devices
- Automated data transmission and alerts
- EHR integration
- Support with documentation, logistics, and compliance
A strong partner will help reduce administrative burden, increase patient adherence, and ensure eligibility under Medicare’s guidelines.
4. Train Your Care Teams on RPM Protocols
Ensure your clinical and administrative staff are prepared to:
- Properly document patient consent and eligibility
- Monitor and respond to patient data
- Track time spent on care management activities
- Accurately code and bill for RPM using CPT 99453, 99454, 99457, 99458, and G0511 (for FQHCs and RHCs)
Proper training is essential not only for billing compliance but also for maximizing patient outcomes and maintaining program sustainability.
Remote Patient Monitoring and Medicare
Medicare and remote patient monitoring are increasingly working to improve outcomes, reduce costs, and modernize chronic care delivery. Your patients may now be eligible, and your practice may be leaving impact and financial gain on the table. Start identifying newly eligible Medicare patients today, and make remote monitoring part of your standard of care.
Ready to see how Tenovi devices work in the real world? Request a free demo and discover how simple connected care can be. Meet a better RPM experience for patients, physicians, and your team.
