Medicaid Coverage of Remote Patient Monitoring: What To Know

On July 1, 2025, Arkansas will expand Medicaid coverage for maternal health services under the Healthy Moms, Healthy Babies Act. This expansion will notably include reimbursement for remote ultrasounds and remote patient monitoring (RPM) services like blood pressure and continuous glucose monitoring. In addition, pregnant women will be granted presumptive Medicaid eligibility, helping ensure faster access to critical care services during pregnancy. 

Arkansas' RPM Medicaid expansion is not unique. As the Center for Connected Health Policy (CCHP) noted in its fall 2024 "State Telehealth Laws and Reimbursement Policies Report," five states — Delaware, New Hampshire, New Jersey, Pennsylvania, and South Dakota — had added reimbursement for RPM during the prior year.  

These and other legislative changes reflect a broader trend: Medicaid coverage for RPM services is steadily expanding across the country. As technology becomes more central to healthcare delivery, improving outcomes, and reducing costs, state Medicaid programs are recognizing the clinical, operational, and financial benefits of RPM. 

Overview of State Medicaid Coverage of RPM 

While Medicaid is a federal program, it is administered at the state level, resulting in significant variation in RPM coverage policies. As of November 2024, the National Conference of State Legislatures notes that laws and regulations in at least 42 states allow for some form of Medicaid reimbursement of RPM services. 

States like California, Texas, New York, and Illinois, among others, have taken notable and more aggressive steps in this space. California covers both remote physiological monitoring (i.e., remote patient monitoring) and some remote therapeutic monitoring (RTM) codes. Texas Medicaid reimburses for RPM related to specific chronic conditions. New York offers RPM coverage for patients with certain chronic illnesses, including heart disease and diabetes, while Illinois places a special emphasis on maternal health within its RPM offerings. 

As is the nature of many Medicaid services, coverage details differ significantly among states. Some limit RPM reimbursement to patients with specific chronic conditions. Others cover services only for a specific duration of time. Payment amounts and billing codes can also vary, making it essential for providers to understand and remain informed about their specific state's policies, or work with an RPM vendor partner that largely does this work for them. 

Medicaid Remote Patient Monitoring State By State: Coverage Breakdown  

As of September 2024, the 42 state Medicaid programs offering some form of reimbursement for remote patient monitoring, according to the CCHP, are as follows:

Connecticut, Georgia, Montana, Nevada, New Mexico, Rhode Island, Tennessee, and Wyoming are the eight states that do not currently offer Medicaid reimbursement for remote patient monitoring. 

How Medicaid Coverage of RPM Improves Clinical Outcomes

Remote patient monitoring delivers measurable clinical and outcomes improvements, with Medicaid populations especially well-positioned to benefit. RPM enables continuous data collection and real-time alerts, allowing providers to identify and address issues before they escalate into emergencies. By enabling early detection and intervention, remote patient monitoring can significantly reduce hospitalizations and emergency room visits, leading to cost savings and lowering the risk of healthcare-associated infections. 

Managing chronic conditions becomes more effective with RPM. Conditions like heart disease, hypertension, diabetes, and asthma, which are prevalent among Medicaid populations, can be better controlled through regular monitoring, timely interventions, and ongoing patient education. For maternal health, access to RPM for management of gestational hypertension and gestational diabetes helps detect complications earlier, improving maternal and infant health and outcomes. 

RPM is also proven to enhance patient engagement. Patients who use RPM technologies often feel more involved in their care and supported by their care team, leading to better adherence to treatment plans and greater satisfaction with their providers and the healthcare system as a whole. A growing body of literature supports that RPM programs lead to reduced hospital readmissions, better medication adherence, and lower mortality rates for chronic conditions — important goals for all patient populations, including the millions of Medicaid beneficiaries. 

One study found that low-income Black and Hispanic stroke survivors were able to lower their blood pressure more when they used home monitoring plus had support from a nurse, compared to using home monitoring alone. This shows that remote patient monitoring, especially when combined with personal support, can make a big difference in improving the health of people on Medicaid and others in underserved communities 

Financial Value of Remote Patient Monitoring for Medicaid Providers  

Beyond clinical benefits, remote patient monitoring offers a significant financial opportunity for providers serving Medicaid populations. Depending on state rules, providers may be able to bill Medicaid for RPM patient setup, education, device supply, data monitoring, and clinical follow-up, thus generating recurring, scalable monthly revenue at a time when rising costs and tightening reimbursement make such income increasingly important. For instance, a mid-sized primary care practice enrolling 100 Medicaid patients into an RPM program could generate substantial additional revenue each month while simultaneously enhancing patient outcomes and reducing overall healthcare costs. 

Operational efficiency also improves when providers develop and offer RPM. By monitoring patients remotely, organizations can better allocate in-office visits and in-person services to those individuals requiring face-to-face care, which can help with efforts to better optimize scheduling and staffing.  

RPM also aligns well with value-based care initiatives. Providers can achieve better performance metrics in areas like Medicaid managed care programs and accountable care organizations (ACOs), potentially earning bonus payments or shared savings. 

Medicaid's Role in Advancing Remote Patient Monitoring  

Arkansas' upcoming expansion of Medicaid coverage for remote maternal health monitoring is part of a broader and encouraging national trend — and one that we hope continues. States across the country are increasingly recognizing the clinical and financial benefits of RPM for Medicaid populations, and Medicaid beneficiaries are reaping the health rewards. The growth of Medicaid coverage coincides with Medicare's established reimbursement for remote patient monitoring and broad telehealth coverage by many commercial payors, including RPM. 

For providers supporting patient populations eligible for remote patient monitoring, now is a great time to consider the implementation or expansion of RPM programs and the ability to leverage technology to deliver better ongoing care and build stronger, more sustainable operations. As coverage continues to grow, RPM will undoubtedly play an even bigger role in shaping the future of accessible, high-quality healthcare for all patients. 

Need help launching, expanding, or improving your RPM program? Prevounce is here to help. Contact us to learn how and get started.