History of Remote Patient Monitoring: How It Began & Where It's Going

Updated: July 2026

It's no secret that technology has vastly improved healthcare. Over the past several years, we've seen telehealth essentially transform the delivery of care. From increased access and improved patient outcomes to reductions in care costs, telehealth technology like remote patient monitoring (RPM) is driving healthcare evolution, helping practitioners improve the ways in which we interact with patients every day. Thanks to the ingenuity and creativity of technology thought leaders and innovators, we can now reach more people than ever before, including previously hard-to-access rural patients, and do so more effectively and efficiently.

The Rapid Rise of Remote Patient Monitoring

RPM adoption has moved well past the early pandemic-era estimates. More than 23 million U.S. patients were already using RPM tools by 2020, and utilization has kept climbing steadily since. Market analysts now put the current global RPM market (devices and services combined) well into the tens of billions of dollars, with most forecasts projecting continued double-digit annual growth through the early 2030s as chronic disease burden rises and reimbursement continues to expand. (Market sizing varies significantly by research firm depending on scope — devices-only vs. services vs. combined market — so treat any single figure as directional rather than definitive.)

The concept of remote patient monitoring has taken hold, and it's obvious that it's here to stay, but how exactly did we get to this point so quickly? To many patients, it might seem like telehealth technology such as remote patient monitoring was only deployed in response to the 2020 COVID-19 pandemic. In reality, remote patient care has been in the making for nearly 150 years.

Technically, remote patient monitoring is just a single rung of the much broader telehealth ladder. RPM uses specific technology that can transmit data electronically via internet, Wi-Fi, and/or Bluetooth between patients and providers. As foreseen by a 1924 image from Radio News Magazine, our current technology has been following an almost prophetic path through history, working its way to this pivotal point in time where we can now see and treat our patients or consult with other experts from nearly anywhere and at any time.

Historical Timeline of Events Leading to Remote Patient Monitoring

So, how did RPM get here? Here are some of the most important developments and milestones from the past nearly 150 years — now updated through 2026.

• March 7, 1876 — Alexander Graham Bell is granted his first patent for the telephone. Little did he know that his invention would be a catalyst, laying the early groundwork for us to communicate with anyone, anywhere.

• Early 1900s — Lacking the infrastructure to bring about widespread telephone adoption, the use of radio communication is developed and expanded.

• 1948 — The concept of telehealth is officially put into action when physicians in West Chester, PA, send radiology images 24 miles over a telephone line for review and consultation with another physician in Philadelphia.

• 1959 — Doctors began to normalize and rely on the telehealth concept by transmitting neurological exams for consultation.

• 1960 — Psychiatrists begin transmitting psychiatric consultations via closed-circuit television.

• May 1961 — Remote patient monitoring is born when Alan Shepard, the first American in space, is monitored while in flight. NASA monitors his health from afar using early EKG technology, a thermometer, and a respiration sensor in his microphone. Not only can he talk to Earth, but he also transmits biologic data. Proceeding orbital flights are met with a few health technology hang-ups, but on the last two Mercury missions, blood pressure data is transmitted back to Earth seamlessly.

• 1967 — Health professionals start sending EKGs over telephone wires.

• 1970s — The first official remote patient monitoring program for Earthside patients is developed and deployed at the Papago Indian Reservation in Arizona. Riddled with complications, the program is discontinued in 1977 by program sponsors. However, the program isn't a total waste of resources: NASA is able to successfully use some of the gained knowledge in its space technology program.

• 1980 — Health professionals normalize transmitting x-ray images.

• 1982 — The first wearable biometric sports watch is introduced for use by athletes, using basic EKG technology incorporating a radio chest strap to measure heart rate and activity.

• January 1, 1983 — We celebrate the official birth of the internet.

• April 30, 1993 — The first official web browser is launched.

• 1999–2001 — Wireless internet is released to the public under the name Apple AirPort; Windows-based Wi-Fi follows shortly after, with a Wi-Fi router released in 2001.

• 2000 — While the short-range communication technology that would become known as Bluetooth traces back to the 1990s, the first official Bluetooth product is released this year.

• Early 2000s — Dial-up internet begins giving way to faster, more convenient broadband. By 2007, half of all internet users are connected via broadband.

• January 2015 — CMS introduced chronic care management (CCM) for patients with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.

• 2019 — CMS finalizes the original Medicare Physician Fee Schedule (PFS) codes for RPM (initially framed as "Chronic Care Remote Physiologic Monitoring," later clarified to apply to both chronic and acute conditions), introducing CPT codes 99453, 99454, and 99457. This made RPM one of the most lucrative Medicare care management programs — though adoption stays slow at first.

• January 2020 — Through the 2020 PFS final rule, CMS introduces RPM CPT code 99458 and shifts RPM treatment-management codes (99457/99458) from direct to general supervision, letting clinical staff — not just the billing practitioner — furnish these services. 

• March 2020 — The World Health Organization (WHO) officially characterized the rapidly spreading COVID-19 outbreak as a global pandemic. It's the "eureka" moment the healthcare industry needs to encourage widespread deployment of telehealth and a rapid rise in RPM usage. The federal government and private payers expand coverage of RPM, further fueling adoption; more than 23 million U.S. patients use RPM services and tools this year.

• January 2021 — Through the 2021 PFS final rule, CMS finalizes supervision rules letting auxiliary personnel (a broader category than "clinical staff," which can include contracted employees) furnish RPM services incident to the billing practitioner, removing a barrier that had blocked outside monitoring teams.

  Together, the 2020 and 2021 rules are widely credited as the changes that let third-party RPM platforms and remote clinical staff take on day-to-day monitoring work, helping RPM programs scale in the years that followed.

• 2022 — Despite growing recognition and appreciation for RPM, a Medical Group Management Association poll reveals that just 25% of practices offer it. A significant runway remains for practitioners to launch and grow RPM programs.

• November 2022  —  in the 2023 PFS final rule, in response to comments, CMS clarified that RTM or RPM services could be billed concurrently with chronic care management (CCM), transitional care management (TCM), principal care management (PCM), chronic pain management (CPM), or behavioral health integration (BHI).

• May 2023 — The COVID-19 Public Health Emergency officially ends, prompting CMS to re-evaluate which pandemic-era telehealth and remote monitoring flexibilities become permanent versus temporary.

• January 2024 — Through the 2024 PFS final rule, CMS extends RPM and RTM billing to federally qualified health centers (FQHCs) and rural health clinics (RHCs) under G0511, and adds codes for community health integration, principal illness navigation, and SDOH risk assessments. The AMA also approves new RPM/RTM codes for shorter time thresholds.

• January 2025 — Through the 2025 PFS final rule, CMS introduces advanced primary care management (APCM), allowing it to be billed alongside RPM and RTM when services are medically necessary.

• January 2026 — Through the 2026 PFS final rule, CMS lowers RPM/RTM time thresholds for the first time since the codes launched. Billing now works with as few as 2–15 days of device data (RPM CPT code 99445), plus a new 10-minute treatment-management code (RPM CPT code 99470). CMS also expands accepted communication methods to include audio-only calls, secure messaging, and AI-assisted prompts.

• July 14, 2026 — Through its 2027 PFS proposed rule, CMS releases what is described by industry observers as the most consequential RPM rulemaking since the codes were created in 2019, this time tightening rather than expanding access. Proposed changes limit RTM to established patients, require an initiating visit before RPM/RTM begins, and restrict billable services to practice-employed staff, excluding outsourced monitoring vendors.

(Exact code numbers, thresholds, and reimbursement rates change with each year's Physician Fee Schedule — always confirm current specifics against the CMS final rule or a qualified billing compliance source before using them operationally.) 

Future of Remote Patient Monitoring 

We have a good thing going with remote patient monitoring, and the entries in this timeline show technology and policy steadily pushing it forward, though "forward" doesn't always mean "looser." The 2026 rule expanded access with shorter time thresholds and more flexible communication modalities, while the 2027 proposed rule swings the other way, prioritizing program integrity and clinical accountability over growth for growth's sake. Whether that proposal survives the comment period in its current form, or gets softened, as stakeholders are actively pushing for, will shape a lot about how the RPM vendor and staffing landscape looks heading into 2027. What seems clear either way: CMS is no longer treating RPM as a niche pilot program. It's a mainstream part of Medicare payment policy that regulators are actively refining, which means practices and vendors alike should expect continued year-over-year rule changes rather than a settled, static program.

This post reflects publicly available reporting and CMS rulemaking as of mid-2026. Reimbursement rules and rates are subject to further change; this is not billing or legal advice — consult a qualified compliance specialist for program-specific decisions.

Frequently Asked Questions

When did Medicare start reimbursing for RPM?

Medicare has reimbursed RPM services since the 2019 Physician Fee Schedule, when CMS finalized the first dedicated RPM CPT codes. Reimbursement rules and codes have been updated in nearly every fee schedule since, and separate remote therapeutic monitoring (RTM) codes for non-physiologic data were added later.

How did the COVID-19 pandemic change RPM adoption?

The COVID-19 pandemic in 2020 is widely seen as the turning point that pushed RPM from a niche program into mainstream use, with the federal government and private payers expanding coverage and more than 23 million U.S. patients using RPM tools that year. Even so, a 2022 Medical Group Management Association poll found that only 25% of practices offered RPM, showing adoption still lagged behind the reimbursement infrastructure already in place.

Why was direct supervision a barrier to RPM adoption?

Direct supervision requires the billing practitioner to be physically present in the same office suite while auxiliary staff perform a service, which made it hard for practices to use remote monitoring staff or outside vendors. The 2020 Final Rule (effective January 1, 2020) permanently replaced this with general supervision for RPM treatment-management services, and the 2021 Final Rule extended general supervision to auxiliary personnel furnishing the device-related codes, meaning the billing practitioner only needs to be reachable, not on-site, which opened the door to remote and third-party staffing models.

When did RPM billing expand to community health centers and rural clinics?

CMS's 2024 Physician Fee Schedule extended RPM and RTM billing to Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) under HCPCS G0511, alongside new complementary care-management codes for community health integration and principal illness navigation. CMS’s 2025 Physician Fee Schedule further expanded RPM billing for FQHCs and RHCs by shifting to the standard set of CPT codes. This meaningfully widened which types of practices could bill for remote monitoring services.

What changed for RPM in the CY2026 Physician Fee Schedule?

The 2026 Physician Fee Schedule, finalized in October 2025, lowered RPM and RTM time thresholds for the first time since the codes were created, adding a shorter 2-15 day device-monitoring option and a 10-minute treatment-management alternative to the existing 20-minute requirement.

Is RPM covered by Medicare in 2026?

Yes, RPM remains covered under the 2026 Medicare Physician Fee Schedule, which also lowered the minimum monitoring period to as few as 2 days and added a 10-minute treatment-management option alongside the existing 20-minute code. Coverage details, thresholds, and rates are subject to change each year, so confirm specifics against the current CMS final rule. Private payers often have their own set of RPM coverage requirements and State Medicaid coverage may vary.

Disclaimer

Health economic and reimbursement information provided by Prevounce is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules, and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.

Prevounce encourages providers to submit accurate and appropriate claims for services. It is always the provider’s responsibility to determine medical necessity, the proper site for delivery of any services, and to submit appropriate codes, charges, and modifiers for services rendered. It is also always the provider’s responsibility to understand and comply with Medicare national coverage determinations (NCD), Medicare local coverage determinations (LCD), and any other coverage requirements established by relevant payers which can be updated frequently.

Prevounce recommends that you consult with your payers, reimbursement specialists, and/or legal counsel regarding coding, coverage, and reimbursement matters.

Payer policies will vary and should be verified prior to treatment for limitations on diagnosis, coding, or site of service requirements.