Recent news updates convey a consensus that CMS is increasing support for CCM (Chronic Care Management) and RPM (Remote Patient Monitoring) through higher payments, flexible billing, expanded telehealth, and streamlined compliance requirements for 2026.

Specifically, expected changes to CCM and RPM reimbursement and regulations for 2026 will include several updates focused on increased reimbursement rates, expanded telehealth policy, and new billing codes.​

Key Payment Updates

Starting in 2026, CMS is increasing the Physician Fee Schedule (PFS) conversion factor by 2.5%, with a further increase of 1.24% for providers participating in Alternative Payment Models (APM), and 0.74% for non-APM providers. The total reimbursement increase will therefore be 3.77% for APM participants and 3.26% for non-APM participants. These updates are in direct response to persistent advocacy by physician groups who have noted that prior cuts threatened chronic disease management programs and patient access.​

New and Revised Billing Codes

CMS is proposing significant flexibility in RPM billing. The prior requirement of 16 days of device use per month (CPT 99454) is being replaced by a structure allowing reimbursement for 2–15 days (using a new CPT code 99445) and 16–30 days, both at the same rate. A new RPM management code is also being introduced: CPT 99470, which covers 10–20 minutes of treatment management, enabling providers to bill for shorter patient interactions at an appropriate rate. Additionally, the value for existing 20-minute codes (99457/99458) will remain stable, as recommended cuts were rejected.​

CCM Code and Service Updates

Chronic Care Management will benefit from the reimbursement increases and may also see expanded qualifying services as part of broader telehealth policy. The telehealth parity supports CCM and RPM team-based care, including mental health counseling and chronic disease management via virtual platforms.​

Telehealth and Regulatory Expansion

Telehealth reimbursement parity is extended to certain visits, with updated originating site rules allowing patients to access telehealth from more locations—including homes, rural centers, and senior living facilities. These adjustments are intended to support practice operational efficiency and broaden patient access, especially for chronic disease populations.​

Compliance and Documentation Changes

Regulatory changes require accurate, standardized documentation and quality reporting for both CCM and RPM, to qualify for enhanced reimbursement and avoid payment denials. Quality reporting requirements will be streamlined but will require regular audits and compliance checks to ensure coding accuracy.​

Industry Responses and Implications

Leading sources, including the American Medical Association and Becker’s Hospital Review, have noted that these reimbursement and regulatory changes are positive, but caution about the need for investment in compliance infrastructure and ongoing education for billing teams. These changes follow five years of Medicare cuts, and are widely seen as a turning point in CMS’s support for value-based care through chronic disease management programs.​

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References​

These sources represent a consensus that CMS is increasing support for CCM and RPM through higher payments, flexible billing, expanded telehealth, and streamlined compliance requirements for 2026.