Maryland Medicaid has taken a major step toward aligning with national standards for remote patient monitoring (RPM) coverage. Effective May 15, 2025, the state’s fee-for-service (FFS) program replaced the outdated S9110 billing code with the suite of standard CPT codes (99453, 99454, 99457, and 99458) used by Medicare and most commercial payers. This update also removes prior authorization requirements and simplifies patient eligibility, marking a clear departure from the restrictive RPM model the payer introduced in 2018.
From Limited Episodes to Continuous Care
Under the previous framework, RPM was allowed only for patients with a specific set of pre-approved conditions: COPD, congestive heart failure, or diabetes who had a recent emergency department visit or hospitalization. Services were billed under S9110 in 60-day “episodes,” with no more than two covered episodes in a year.
Those restrictions are now gone. The 2025 update opens RPM coverage to any condition appropriate for remote monitoring, including hypertension, cardiovascular disease, diabetes, and maternal health. The state’s move reflects the broader national trend toward continuous, proactive care management rather than episodic interventions or short-term monitoring following hospitalizations.
Standard CPT Codes and Streamlined Billing
With the adoption of the traditional RPM CPT codes, billing is now more consistent with Medicare policies. These codes cover setup and education, ongoing device supply and data transmission, and time spent reviewing and managing patient readings each month. For example, CPT 99454 supports billing every 30 days when at least 16 days of device data are collected, while CPT 99457 and 99458 reimburse clinical time for active management and patient communication.
A Shift Toward Flexibility and Alignment
This modernization effort removes administrative friction that previously discouraged remote patient monitoring adoption. By dropping prior authorization, expanding eligible conditions, and standardizing CPT billing, Maryland Medicaid has opened the door for broader use of connected devices and data-driven preventive care.
For providers, this means fewer barriers and a more consistent billing structure across Medicare and Medicaid. For patients, it means earlier intervention and improved access to ongoing support for chronic conditions.
Preparing Your Practice
Organizations currently billing under S9110 should update their workflows to include the national CPT codes. Staff should be trained to document at least 16 days of readings per 30-day period and to record clinical time spent reviewing data and engaging patients. It’s also important to ensure workflows prevent overlapping RPM and self-measured blood pressure (SMBP) billing within the same month, as SMBP is a distinct, covered service billed for differently than RPM. These steps will help providers take full advantage of the new reimbursement model while maintaining compliance with state guidelines.
For practices not yet offering remote patient monitoring, now is an ideal time to start. The recent Maryland Medicaid expansion, combined with the adoption of standard CPT codes, improves reimbursement and financial sustainability. In addition, the two new 2026 Medicare RPM codes designed to capture shorter monitoring periods expand flexibility and broaden clinical applications and billing opportunities. These changes make it easier for organizations to implement proactive care that supports Medicaid and Medicare populations while improving outcomes and generating new recurring revenue streams.
The Bottom Line
Maryland’s May 2025 RPM update represents a decisive shift toward modern, continuous care delivery. What began as a narrowly defined, episodic pilot in 2018 has evolved into a more clinically flexible and financially sustainable model for remote care management. Providers who embrace these changes will be better positioned to improve patient outcomes, increase patient engagement, and strengthen their revenue streams through technology-enabled care.
Partner With Experts in RPM Implementation
As states modernize their Medicaid RPM programs, many practices are finding new opportunities in billing, compliance, and patient engagement. Prevounce Health has helped providers across the country successfully navigate these Medicaid RPM expansions.
Whether you’re launching RPM for the first time or updating existing workflows to align with Maryland’s latest policy, our team can guide you. Schedule a consultation with one of our experts to learn how.