CMS has finalized the 2026 Medicare Physician Fee Schedule (PFS), and this year’s rule delivers some of the most substantial improvements to Remote Care Management since the programs were created. The updates sharpen the structure of Chronic Care Management (CCM), expand flexibility in Remote Patient Monitoring (RPM), and accelerate the shift toward comprehensive, proactive, team-based care.
For organizations running care management programs—or planning to in 2026—the signal is unmistakable: Medicare is doubling down on longitudinal, technology-enabled support as a core component of value-based care.
For the first time in five years, CMS approved an increase to the Medicare payment calculation. The change amounts to roughly 2.5% higher reimbursement, translating to an additional $1–$2 per patient interaction across many care management services.
It’s a modest but important correction. Practices managing large or growing risk-bearing populations will feel the impact quickly—improving sustainability and freeing up resources to expand preventive, high-touch programs. These adjustments move reimbursement closer to the real clinical effort required to support patients with chronic, complex, or unstable conditions.
RPM remains central to CMS’s long-term vision of continuous, real-world patient support. The 2026 rule introduces structural refinements that make the program more inclusive and easier to operationalize at scale.
CMS introduced a complementary RPM device code split:
Historically, RPM device billing required at least 16 days of readings, limiting which patients could be meaningfully included. The new 2–15-day code removes that barrier and expands the clinical scenarios where RPM is appropriate—post-acute monitoring, condition-specific intermittent tracking, and patients who struggle with daily device use.
This is a major unlock for reach, flexibility, and operational scalability.
CMS also finalized a new 10-minute RPM management code (CPT 99470).
This creates a billing mechanism for meaningful—but shorter—interventions that today often go unreimbursed.
It supports more frequent check-ins, accelerates early detection of deterioration, and helps teams intervene before small issues escalate into costly utilization.
The CCM framework stays intact, but CMS tightened the guidance around documentation, supervision, and time tracking. The intent is consistency: CMS wants clearer expectations for how longitudinal care is delivered across different care settings and care teams.
For practices already running structured CCM workflows, the updates will feel like reinforcement—not reinvention.
CMS is continuing to build APCM into a foundational pillar of its long-term preventive care strategy. In 2026, three new APCM add-on codes were finalized, each supporting areas that historically saw underinvestment:
APCM is becoming the connective tissue that links CCM, RPM, behavioral health integration, and whole-person primary care into a coherent reimbursement structure. Expect this framework to grow significantly over the next several years.
Across the board, CMS is reinforcing the same message: proactive, continuous care is essential infrastructure, not an optional service. The 2026 rule:
Practices with mature workflows will adjust smoothly, while those considering remote care management will find 2026 the clearest and most favorable entry point to date.
Welby will deploy full support for every 2026 CCM, RPM, and APCM change before the Calendar Year 2026 cycle begins. That includes:
Our platform and automation infrastructure are built for this exact type of regulatory evolution—ensuring partners never scramble to adapt when CMS moves the goalposts.
Remote care workflows should elevate clinicians, not burden them. The 2026 PFS is a step forward, and Welby is positioned to help practices realize its full potential.
If you want help planning, optimizing, or scaling your care management programs under the new rule, we’re here. The practices that lean in now will be the ones leading the next chapter of proactive, continuous, patient-centric care.
Let’s build the future of care management—together.
