Resources
for You and Your Team
The CY 2027 MPFS Proposed Rule is here: What’s at Stake for RPM, RTM, and Care Management?
The CY 2027 Physician Fee Schedule (PFS) proposed rule represents the most significant shift to remote monitoring since its inception. CMS proposes to dismantle the third-party clinical staffing model by mandating direct employment for RPM and RTM billing, introducing mandatory initiating visits, and slashing code valuations. Discover how these regulatory shifts affect your digital health operations and how to submit public comments before the September 14, 2026, deadline.
What Does the CY 2027 Medicare Physician Fee Schedule Proposed Rule Mean for Digital Health Companies?
CMS's 2027 Medicare Physician Fee Schedule proposed rule introduces sweeping changes for digital health, telehealth platforms, AI-enabled care, remote patient monitoring (RPM), remote therapeutic monitoring (RTM), software-based medical services, interoperability, and physician reimbursement. This comprehensive analysis explains the proposed BB/BC telehealth modifiers, the potential end of third-party RPM staffing models, CMS's new Software as a Medical Service (SaMS) framework, AI-focused requests for information, and the opportunities for digital health companies to influence the final rule before comments close on September 14, 2026.
Digital Mental Health Technology - The Quick Breakdown
In this rapid-fire breakdown, Nixon Law Group Senior Counsel Reema Taneja and Digital Health Expert Michael Schellhous cut through the noise to explain the critical shifts in Digital Mental Health Treatment (DMHT) codes.
They cover what the DMHT codes actually reimburse, how they fundamentally differ from Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM), and the strict FDA/CMS requirements your device must meet. They unpack the major hurdles—from the lack of a national payment amount (MAC contractor pricing) to provider uptake challenges—and advise founders on how to position their companies for success despite these limitations.
This video is an essential resource for founders looking to understand the pathway to reimbursement and influence the future of digital mental healthcare policy.
2026 Medicare Final Rule Part 1: Rapid-Fire Q&A on RPM and RTM Codes
The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule introduces some of the most consequential updates for Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) since their inception. In Part 1 of our rapid-fire video series, health law experts Carrie Nixon and Reema Taneja break down the most significant changes impacting digital health innovators and care management companies.
CMS Finalizes 2026 Remote Monitoring Reimbursement Updates: What Changed for RPM and RTM
CMS Finalizes Major 2026 RPM/RTM Rule: New Short-Duration Codes & OPPS Valuation Shift. The CY 2026 Medicare Physician Fee Schedule (MPFS) introduces unprecedented flexibility for digital health companies by finalizing new CPT codes for 2–15 day RPM/RTM monitoring (e.g., CPT 99445, 98984–98986) and 10-minute treatment management codes (e.g., 99470, 98979). Crucially, CMS is adopting Outpatient Prospective Payment System (OPPS) data for device supply code valuation, setting a precedent for valuing SaaS infrastructure costs. Learn how these changes—including the "sometimes therapy" designation for RTM—will reshape hybrid virtual care models, episodic monitoring, and reimbursement strategy going forward.