RPM Changes 2026: What Primary Care Physicians Need to Know — with Medical Office Force by Your Side
At Medical Office Force, we don’t just follow CMS updates; we live and breathe them, translating regulatory changes into real-world solutions for primary care practices across the country. With the 2026 Medicare Fee Schedule (PFS) proposing key updates, especially around Remote Patient Monitoring (RPM), it’s time for primary care physicians to lean in, prepare, and seize the opportunities ahead.
And MOF is here to help you do just that efficiently, confidently, and profitably.
Why These CMS Updates Matter
If you’ve been offering RPM, Chronic Care Management (CCM), or any form of office-based care, these changes directly impact how you’ll be reimbursed and how your team operates daily. But don’t worry, we’ve broken down the most critical updates so your practice can be ready to thrive, not just survive.
1. New RPM Codes = More Billing Flexibility
What’s changing?
1. A new RPM device code for 2–15 days of monitoring (currently, 99454 requires 16 days).
2. A new code for 10–20 minutes of clinical RPM time, ideal when the time falls short of the full 99457 20-minute threshold.
What does this mean for you? You’ll finally be able to bill for the real care you’re already delivering, those quick follow-ups, episodic checks, or short-term device monitoring after discharge.
What you can do now:
1. Review your current RPM caseload: Who might benefit from short-term monitoring?
2.Audit your care team’s time logs; many short but valuable touchpoints go unbilled.
3.Talk to your EHR or billing provider (or call us!) about getting ready for these new codes.
How MOF helps: We’ve already helped dozens of practices prepare for these coding shifts by streamlining documentation and automating time tracking for maximum RPM reimbursement.
2. CCM Isn’t Changing, But That’s No Reason to Cost
CCM codes like 99490 and 99439 aren’t going anywhere in 2026. But here’s the thing: many practices think they’re doing CCM right, but they’re still leaving money on the table.
What you can do now:
1. Tighten your documentation: Does it fully reflect the time and complexity involved?
2. Educate patients: Many don’t realize how valuable this monthly touchpoint is.
3. Check your billing logs: Are you capturing every minute you’re allowed?
MOF Tip: We often find that practices under-document time or skip secondary codes like 99439. Our team can run a free consultation to make sure you’re maximizing what’s already on the books.
3. Office-Based Providers Get a Reimbursement Boost
In a welcome move, CMS plans to increase reimbursement by +4% for services delivered in non-facility settings, a win for independent primary care physicians.
What this means: If you own or lease your office space and deliver care outside of a hospital or facility, you’ll see improved margins on certain services.
How to prepare:
1. Consider bringing in more diagnostics (like EKGs, echos) in-house.
2. Evaluate your service mix. Are there underutilized procedures you can expand?
3. Think ahead about marketing your “convenient, full-service” primary care.
Let MOF guide you: From analyzing service profitability to helping you negotiate with payers, we’ve supported independent clinics across the U.S. as they grow their in-house offerings.
4. Time-Based Coding Is the Future, Track Everything
CMS isn’t making major E/M changes for 2026, but the focus on time-based coding and chronic condition care continues.
Why this matters: RPM, CCM, and E/M visits may overlap, and when they do, you need to track and report accurately.
Action steps:
1. Start tracking all care team time now (yes, even the 5-minute calls!).
2. Retrain your staff on the difference between 99457 vs 99458, and how time stacks across codes.
3. Use care coordination codes wherever they apply (e.g., TCM, PCM, BHI).
MOF makes this easy: Our proprietary documentation templates and workflows guide your team on what to record, when, and how, helping you stay compliant and profitable.
5. Speak Up, CMS Wants to Hear From You
The proposed rule is open for comment until September 12, 2025. This is your chance to influence how final rules take shape.
Primary care physicians can advocate for:
1. Better pay for the care you’re already delivering
2. Less documentation hassle
3. Support for chronic care that’s actually sustainable
How to take action:
1. Join efforts through AAFP, ACP, or your local medical society.
2. Follow CMS newsletters and updates, or just subscribe to MOF’s curated update list.
3. Prepare your internal team to pivot billing practices early in 2026.
These updates prove one thing: CMS is finally catching up to the realities of primary care. But with change comes complexity, and you’ve got enough on your plate already.
At Medical Office Force, we’re here to walk alongside you, not just as a service provider, but as your compliance partner, your billing expert, and your behind-the-scenes team.
So, what’s next? Let’s talk. Whether you want a free audit, a walkthrough of the new codes, or just a conversation about how your practice can adapt, we’re ready when you are.
Contact MOF today and let’s build a smarter future for your practice.