Remote Patient Monitoring

POLICY

“Remote patient monitoring services” means using digital technologies to collect medical and other forms of health data from a patient and then electronically transmitting that information securely to healthcare providers in a different location for interpretation and recommendation.

A health insurance entity may consider any remote patient monitoring service a covered medical service if the same service is covered by Medicare. The appropriate parties may negotiate the rate for these services in the manner in which is deemed appropriate by the parties.

SOURCE: TN Code Annotated, Sec. 56-7-1011, (Accessed Jan. 2026).

No later than December 31, 2024, the bureau of TennCare shall amend existing rules, or promulgate new rules, on fee-for-service and medicaid managed care plans regarding reimbursement to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests utilizing established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient’s provider and the same standard of care is met.

SOURCE: TN Code Annotated, Sec. 71-5-168, (Accessed Jan. 2026).

CONDITIONS

No Reference Found

PROVIDER LIMITATIONS

No Reference Found

OTHER RESTRICTIONS

Reimbursement of expenses for covered remote patient monitoring services must be established through negotiations conducted by the health insurance entity with the healthcare services provider, healthcare system, or practice group in the same manner as the health insurance entity establishes reimbursement of expenses for covered healthcare services that are delivered by in-person means.

Remote patient monitoring services are subject to utilization review under the Health Care Service Utilization Review Act, compiled in chapter 6, part 7 of this title.

This section does not apply to a health incentive program operated by a health insurance entity that utilized an electronic device for physiological monitoring.

SOURCE: TN Code Annotated, Sec. 56-7-1011, (Accessed Jan. 2026).

When amending or promulgating rules pursuant to subsection (b), the bureau shall ensure that:

• A remote ultrasound procedure or remote fetal nonstress test is only reimbursable when the provider uses digital technology:
  • To collect medical and other forms of health data from a patient and electronically transmit that information securely to a healthcare provider who is in a separate location for the purpose of interpretation and making recommendations;
  • That is compliant with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) (42 U.S.C. § 1320d et seq.); and
  • That is approved by the federal food and drug administration; and

A fetal nonstress test is only reimbursable with a place of service modifier for at-home monitoring with remote monitoring solutions that are cleared by the federal food and drug administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.

SOURCE: TN Code Annotated, Sec. 71-5-168, (Accessed Jan. 2026).