Navigating the 2025 OIG Audit of Remote Patient Monitoring: What Providers Need to Know

The U.S. Department of Health and Human Services Office of Inspector General (OIG) has announced a comprehensive audit of Medicare Part B Remote Patient Monitoring (RPM) services throughout 2025. This audit aims to ensure that providers are furnishing and billing RPM services in compliance with Medicare requirements. With the rapid growth of RPM fueled by the COVID-19 pandemic and increasing adoption of digital health solutions, this scrutiny is unsurprising.

For independent physicians and healthcare organizations, this is a pivotal moment to review RPM programs, ensure compliance, and leverage CMS tools like #RemotePatientMonitoring (#RPM), #ChronicCareManagement (#CCM), and #RemoteTherapeuticMonitoring (#RTM) to enhance patient care and boost practice income.

Key Compliance Areas for RPM Programs:

1. Accurate Coding and Billing: Ensure your RPM coding aligns with CMS standards. Avoid upcoding, which can lead to audits and penalties, and downcoding, which can reduce reimbursements and still raise red flags.
2. Legitimate Vendor Partnerships: Vet RPM vendors thoroughly to avoid partnering with companies that engage in fraudulent billing practices.
3. Compliant RPM Devices: Use FDA-approved devices that support real-time data transmission, a requirement for Medicare billing.
4. Proper Communication Methods: Remember that CMS no longer permits text messaging as a billable form of interactive communication for RPM.
5. Single Practitioner Billing: Only one practitioner can bill RPM services for a patient within a 30-day period, even if multiple devices are used.

With CMS expanding RPM services to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in 2024, now is an opportune time to adopt and optimize RPM, CCM, and RTM services. Ensure compliance by partnering with RPM platforms that prioritize regulatory adherence and continuously update their systems to reflect evolving rules.

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