Remote Patient Monitoring

POLICY

Remote patient monitoring services means the use of synchronous or asynchronous digital technologies that collect or monitor medical, patient–reported, and other forms of health care data for Program recipients at an originating site and electronically transmit that data to a distant site provider to enable the distant site provider to assess, diagnose, consult, treat, educate, provide care management, suggest self–management, or make recommendations regarding the Program recipient’s health care.

SOURCE: MD Health General Code 15-141.2; Code of Maryland Admin. Regs., Sec. 10.09.96.02(B)(14). (Accessed Aug. 2025).

RPM is a service which uses digital technologies to collect medical and other forms of health data from individuals and electronically transmits that information securely to health care providers for assessment, recommendations, and interventions.

Existing MD Medicaid guidance and regulation limits reimbursement for remote patient monitoring to certain chronic conditions.

SOURCE: Remote Patient Monitoring. MD Department of Health. (Accessed Aug. 2025).

SOURCE: MD Medicaid Synchronous Telehealth Policy Guide, p. 5. (May 15, 2025). (Accessed Aug. 2025).

Covered Services

Remote patient monitoring services include:

• Installation;
• Education for the participant in the use of the equipment; and
• Daily monitoring of vital signs and other medical statistics.

The remote patient monitoring provider shall establish an intervention process to address abnormal data measurements in an effort to prevent avoidable hospital utilization.

Physician, nurse practitioner, and physician assistant providers who establish remote patient monitoring programs shall be responsible for:

• Establishing criteria for reporting abnormal measurements;
• Informing the participant of abnormal results; and
• Monitoring results and improvements in patient’s ability to self-manage chronic conditions.

Medical interventions by a physician, nurse practitioner, or physician assistant based on abnormal results shall be reimbursed according to COMAR 10.09.02.07.

A home health agency shall:

• Have an order by a physician, physician assistant, certified nurse midwife, or certified nurse practitioner who has examined the patient and with whom the patient has an established, documented and ongoing relationship;
• Report abnormal measurements to the participant and to the ordering provider; and
• Send the ordering provider a weekly summary of monitoring results, including improvement in patient’s ability to self-manage chronic conditions.

SOURCE: Code of Maryland Admin Regs, Sec. 10.09.96.06. (Accessed Aug. 2025).

Several new codes for remote patient monitoring (RPM) and self-measured blood pressure (SMBP) have been included in the Maryland Department of Health’s (MDH) remote patient monitoring coverage policy. Providers should order RPM when it is medically necessary to improve chronic disease control and it is expected to reduce potentially preventable hospital utilization. Additionally, Medicaid has eliminated fee-for service prior authorization requirements. See transmittal for more information.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM: Self-Measured Blood Pressure (SMBP) Codes. May 27, 2025. (Accessed Aug. 2025).

Remote Ultrasound Procedures and Remote Fetal Nonstress Tests

The Maryland Medical Assistance Program shall provide, subject to the limitations of the State budget, comprehensive medical, dental, and other health care services, including services provided in accordance with § 15–141.5 regarding remote ultrasound procedures and remote fetal non stress tests using Current Procedural Terminology codes, for all eligible  pregnant women whose family income is at or below 250 percent of the poverty level for the duration of the pregnancy and for 1 year immediately following the end of the woman’s pregnancy, as permitted by the federal law.

The program shall provide reimbursement for a remote fetal non stress test in the same manner as an on-site fetal non stress test.

The Program shall issue guidance for program providers to carry out this section.

SOURCE: MD General Health Code 15-103 & 15.141.5. (Accessed Aug. 2025).

The purpose of this transmittal is to notify HealthChoice managed care organizations (MCOs), facilities, and providers that effective October 1, 2024, Maryland Medicaid will provide remote ultrasound procedures and remote fetal nonstress tests to eligible pregnant participants under certain circumstances as required by House Bill 1078–Maryland Medical Assistance Program – Remote Ultrasound Procedures and Remote Fetal Nonstress Tests.

Remote services are covered under the following conditions:

• If the patient is in a residence or another location outside the provider’s office
• The provider adheres to the same standard of care as for in-office services
• The provider is in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA), and
• The provider is enrolled with an active status as a Maryland Medical Assistance Program provider on the date the service is rendered and meets the requirements for participation outlined in COMAR 10.09.36.03.
• Reimbursement for a remote fetal nonstress test and remote ultrasound procedure is the same as an on-site test or procedure. Services must be identified and billed using the following place of service (POS) codes 10 or 12 to indicate remote delivery:

• • POS 10: Telehealth Provided in Patient’s Home. The location where health services and health related services are provided or received, through telecommunication technology. Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
  • POS 12: Home. Location, other than a hospital or other facility, where the patient receives care in a private residence.

SOURCE: MD Medicaid Provider Transmittal 59-25. Remote Ultrasound Procedures and Remote Fetal Nonstress Tests Effective October 1, 2024. Jan. 6, 2025. (Accessed Aug. 2025).

Maternal Health Self-Measured Blood Pressure Monitoring

Beginning on January 1, 2026, shall provide, subject to the limitations of the State budget, and as permitted by federal law, coverage for self–measured blood pressure monitoring for eligible program recipients in accordance with section 15-141.6 of this subtitle, including:

• The provision of validated home blood pressure monitors; and
• Reimbursement of health care provider and other staff time used for patient training, transmission of blood pressure data, interpretation of blood pressure readings and reporting, remote patient monitoring, and the delivery of co–interventions, including educational materials or classes.

“Self–measured blood pressure monitoring” means the regular measurement of blood pressure by the patient outside the clinical setting, either at home or elsewhere, requiring the use of a home blood pressure measurement device by the patient. “Validated home blood pressure monitor” means a blood pressure measurement device that has been validated for accuracy and is listed in the U.S. Blood Pressure Validated Device Listing.

SOURCE: MD Health General Code 15-101; 15-103; 15-141.6 as amended by HB 553/SB 94 (2025 Session). (Accessed Aug. 2025).

Self-Measured Blood Pressure Monitoring (SMBP)

SMBP is patient-led, and involves patients regularly measuring their blood pressure at home using a device, and providing data to healthcare providers, and should be billed using the codes indicated in the transmittal.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM: Self-Measured Blood Pressure (SMBP) Codes. May 27, 2025. (Accessed Aug. 2025).

CONDITIONS

Telehealth definition includes remote patient monitoring. The Program is required to reimburse a health care provider for the diagnosis, consultation, and treatment of a Program recipient for a health care service covered by the Program that can be appropriately provided through telehealth regardless of patient and provider location.

When appropriately provided through telehealth, the Program shall provide reimbursement in accordance on the same basis and the same rate as if the health care service were delivered by the health care provider in person. Reimbursement does not include:

• Clinic facility fees unless the health care service is provided by a health care provider not authorized to bill a professional fee separately for the health care service; or
• Any room and board fees.

The Department may adopt regulations to carry out this section.

SOURCE: MD Health General Code 15-141.2 (a-b, h), as amended by HB 1148/SB 582/SB 534 (2023 Session) & HB 869/SB 372 (2025 Session). (Accessed Aug. 2025).

Existing guidance states Medicaid recipients diagnosed with one of the following conditions qualify:

• Chronic Obstructive Pulmonary Disease
• Congestive Heart Failure
• Diabetes (Type 1 or 2)

The participant must be enrolled in Medicaid, consent to RPM, have an internet connection and capability to use monitoring tools and have one of the following scenarios within the most recent 12-month period:

• Two hospital admissions with the same qualifying medical condition as the primary diagnosis
• Two emergency room department visits with the same qualifying medical condition as the primary diagnosis
• One hospital admission and one emergency department visit with the same qualifying medical condition as the primary diagnosis.

SOURCE: MD Home Health Transmittal No. 64.  Jan. 10, 2018. MD General Provider Transmittal No. 85. Feb. 12, 2018, MD Remote Patient Monitoring Transmittal No. 1, Jan 10, 2018. (Accessed Aug. 2025).

A participant is eligible to receive remote patient monitoring services if:

• The participant is enrolled in the Maryland Medical Assistance Program on the date the service is rendered;
• The participant consents to remote patient monitoring services and has the capability to utilize the monitoring tools and take actions to improve self-management of the chronic disease;
• The participant has the internet connections necessary to host the equipment in the home;
• The participant is at risk for avoidable hospital utilization due to a poorly controlled chronic disease capable of being monitored via remote patient monitoring; and
• The provision of remote patient monitoring may reduce the risk of preventable hospital utilization and promote improvement in control of the chronic condition.

SOURCE: Code of Maryland Admin Regs., Sec. 10.09.96.05. (Accessed Aug. 2025).

An MCO shall provide its enrollees medically necessary remote patient monitoring services as described in COMAR 10.09.96.

SOURCE: Code of Maryland Admin Regs., Sec. 10.67.06.26-5. (Accessed Aug. 2025).

Medicaid has permanently expanded access to RPM services to include participants who qualify based on any conditions and medical histories capable of monitoring via RPM.

To receive RPM, the participants must be enrolled in Medicaid, consent to RPM, have the necessary internet connections, and be capable of using the monitoring tools in their homes.

See transmittal for more information.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM. May 27, 2025. (Accessed Aug. 2025).

Remote Ultrasound Procedures and Remote Fetal Nonstress Tests

The Maryland Medical Assistance Program shall provide remote ultrasound procedures and remote fetal non stress tests coverage using Current Procedural Terminology codes, for all eligible pregnant women whose family income is at or below 250 percent of the poverty level for the duration of the pregnancy and for 1 year immediately following the end of the woman’s pregnancy, as permitted by the federal law, if the patient is in a residence or a location other than the office of the patient’s provider.

The covered Current Procedural Terminology (CPT) codes that were expanded to permit remote testing are listed in the transmittal. For additional information, go to the Professional Services Provider Manual and Fee Schedule at: https://mmcp.health.maryland.gov/Pages/Provider-Information.aspx.

SOURCE: MD General Health Code 15-103, 15.141.5 & MD Medicaid Provider Transmittal 59-25. Remote Ultrasound Procedures and Remote Fetal Nonstress Tests Effective October 1, 2024. Jan. 6, 2025. (Accessed Aug. 2025).

Maternal Health Self-Measured Blood Pressure Monitoring

Beginning on January 1, 2026, shall provide, subject to the limitations of the State budget, and as permitted by federal law, coverage for self–measured blood pressure monitoring for eligible program recipients in accordance with section 15-141.6 of this subtitle.

In this section, “eligible Program recipient” means a Program recipient who:

1. Is pregnant;
2. Is postpartum; or
3. Has been diagnosed with:
   1. Chronic kidney disease;
   2. Diabetes;
   3. Heart disease; or
   4. A cardiometabolic disease.

SOURCE: MD Health General Code 15-103; 15-141.6 as amended by HB 553/SB 94 (2025 Session). (Accessed Aug. 2025).

Self-Measured Blood Pressure Monitoring (SMBP)

To receive SMBP, the participants must;

• be enrolled in Medicaid
• consent to SMBP
• have the necessary internet connections, and
• be capable of using the monitoring tools in their homes. Referrals for SMBP may cover an episode of monitoring in a single year period.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM: Self-Measured Blood Pressure (SMBP) Codes. May 27, 2025. (Accessed Aug. 2025).

PROVIDER LIMITATIONS

The Department may specify in regulation the types of health care providers eligible to receive reimbursement for health care services provided to Program recipients via telehealth. If the Department specifies by regulation the types of health care providers eligible to receive reimbursement for health care services provided to Program recipients under this subsection, the regulations shall include all types of health care providers that appropriately provide telehealth services.

The Program is not required to reimburse a health care provider for a health care service delivered in person or through telehealth that is:

• Not a covered health care service under the Program; or
• Delivered by an out–of–network provider unless the health care service is a self–referred service authorized under the Program.

SOURCE: MD General Health Code 15-141.2(g-h). (Accessed Aug. 2025).

Eligible Providers:

• Home Health Agencies
• Hospitals
• Clinics
• Federally Qualified Health Centers
• Managed Care Organizations
• Health Professionals (Physicians, Nurses, Physician Assistants)

SOURCE: Remote Patient Monitoring. MD Department of Health. (Accessed Aug. 2025).

Remote patient monitoring is not a substitute for delivery of care. Provider shall see patients in person periodically for follow-up care.  To provide remote patient monitoring, the provider shall be enrolled with an active status as a Maryland Medical Assistance Program provider on the date the service is rendered and be a:

• Physician;
• Physician assistant;
• Certified nurse practitioner; or
• Home health agency when remote patient monitoring services are prescribed by a physician; and
• Meet the requirements for participation in the Medical Assistance Program as set forth in COMAR 10.09.36.03.

Medical Record Documentation. A remote patient monitoring provider shall:

• Maintain documentation using either electronic or paper medical records;
• Retain remote patient monitoring records according to the provisions of Health-General Article, §4-403, Annotated Code of Maryland;
• Submit the preauthorization on a form developed by the Department; and
• Include the participant’s consent to participate in remote patient monitoring.

SOURCE: Code of Maryland Admin Regs, Sec. 10.09.96.04. (Accessed Aug. 2025).

Home health agencies may only be reimbursed for remote patient monitoring when the service is ordered by a physician.

SOURCE: Code of Maryland Admin Regs, Sec. 10.09.96.07. (Accessed Aug. 2025).

Physicians or home health agencies can provide RPM. RPM may be billed using revenue code 0581 for home health agencies. See transmittal for HCPCS codes that apply to all other professionals.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM: Self-Measured Blood Pressure (SMBP) Codes. May 27, 2025. (Accessed Aug. 2025).

Remote Ultrasound Procedures and Remote Fetal Nonstress Tests 

The provider shall the same standard of care that the provider would follow when providing services on-site.

The program shall require that a provider offering a remote ultrasound procedure or remote fetal non stress test use digital technology to collect any health data from the patient and electronically transmit the information in a secure manner to a health care provider in a different location for interpretation and recommendations that is compliant with the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and approved by the Federal Food and Drug Administration.

SOURCE: MD General Health Code 15-103 & 15.141.5; MD Medicaid Provider Transmittal 59-25. Remote Ultrasound Procedures and Remote Fetal Nonstress Tests Effective October 1, 2024. Jan. 6, 2025. (Accessed Aug. 2025).

OTHER RESTRICTIONS

The Department may preauthorize services when the provider submits to the Department adequate documentation demonstrating the:

• Participant’s condition meets the criteria listed in Regulation .05 of this chapter; and
• Participant has not already been preauthorized for two episodes during the past rolling calendar year.

The RPM reimbursement rate is an all-inclusive rate of $125 per 30 days of monitoring which covers equipment installation, participant education for using the equipment, and daily monitoring of the information transmitted for abnormal data measurements.

Reimbursement does not include RPM equipment, upgrades to RPM equipment or internet service for participants.

The Program does not cover more than:

• 2 months of remote patient monitoring services per episode; and
• Two episodes per year per participant.

SOURCE: MD Home Health Transmittal No. 64.  Jan. 10, 2018, Code of Maryland Admin Regs, Sec. 10.09.96.06, Sec. 10.09.96.07, Sec. 10.09.96.08. (Accessed Aug. 2025).

HCPCS code S9110 is no longer reimbursable for RPM.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM. May 27, 2025. (Accessed Aug. 2025).

Remote Ultrasound Procedures and Remote Fetal Nonstress Tests

A remote fetal nonstress test must use FDA monitoring solutions for use of the capture and documentation of the following:

• Fetal Heart Rate
• Maternal Heart Rate
• Uterine Activity

SOURCE: MD General Health Code 15-103, 15.141.5 & MD Medicaid Provider Transmittal 59-25. Remote Ultrasound Procedures and Remote Fetal Nonstress Tests Effective October 1, 2024. Jan. 6, 2025. (Accessed Aug. 2025).

Self-Measured Blood Pressure Monitoring (SMBP)

Eligible participants may only receive one unit of SMBP in a given 30-day period.

The SMBP rate does not include:

• SMBP equipment
• Upgrades to SMBP equipment; or
• Internet service for participants

See transmittal for more information.

SOURCE: MD Medicaid Provider Transmittal 78-25. Update to Reimbursement for RPM: Self-Measured Blood Pressure (SMBP) Codes. May 27, 2025. (Accessed Aug. 2025).