Key Takeaways

• Nsight Health has been named No. 78 on the 2026 Inc. 5000, the annual ranking of the fastest growing private companies in America (3,476% Verified 3-Year Growth), placing the company in the top 2 percent of all honorees nationwide.
• The national ranking follows a No. 12 finish on the 2026 Inc. 5000 Regionals: Southeast list earlier this year, earned with 683% verified two year revenue growth.
• Growth has been driven by measurable clinical outcomes across hypertension, diabetes, heart failure, and COPD, delivered by a U.S.-based clinical team employed by Nsight Health.
• An independent Optum actuarial analysis found directionally favorable first year medical savings of approximately $2,467 to $3,012 per member per year across three high cost chronic disease cohorts.
• Nsight Health delivers four care management programs under one clinical infrastructure: RPM, CCM, BHI, and PCM, serving 150,000+ patients, 2,000+ providers, and 560+ clinics nationwide.

Nsight Health has been named No. 78 on the 2026 Inc. 5000, Inc.'s annual ranking of the fastest growing private companies in America. Out of 5,000 honorees drawn from every industry in the country, Nsight Health placed in the top 2 percent nationally, a recognition based on one thing only: verified revenue growth.

The announcement, made by Inc. on August 11, 2026, caps a remarkable trajectory for the Miami based remote care company. In the spring, Nsight Health was ranked No. 12 on the 2026 Inc. 5000 Regionals: Southeast list with 683 percent verified two year revenue growth. Today, the company stands among the fastest growing private companies in the entire United States with a Inc. 5000 verified 3-Year Growth rate of 3,476%.

"This ranking belongs to our clinical team and to the providers and patients who trust us every day," said Michael Ciullo, Founder and CEO of Nsight Health. "We did not get here by outspending anyone. We got here because patients get healthier on our programs, and when patients get better, providers stay and growth follows."

What the Inc. 5000 Ranking Means

The Inc. 5000 is widely regarded as the most prestigious ranking of America's fastest growing private companies. Past honorees include Microsoft, Meta, Oracle, and Patagonia. Companies on the 2026 list are ranked by percentage revenue growth from 2022 to 2025, must be privately held, for profit, U.S. based, and independent, and must pass Inc.'s editorial review. There are no judging panels and no subjective categories. The list measures verified growth, nothing else.

Together, the 2026 honorees generated combined 2025 revenue of approximately $385 billion and created more than 627,000 jobs over the past three years, according to Inc. Honorees will be celebrated at the Inc. 5000 Conference and Gala in Dallas this October, and the top 500 will appear in the Fall issue of Inc. magazine.

For a self funded, founder led healthcare company competing against venture backed organizations, a top 100 national finish is a statement about what disciplined, outcomes first execution can produce.

Growth Built on Clinical Outcomes

Nsight Health's growth has never been driven by marketing spend alone. It has been driven by clinical results that providers can see in their own patient populations. Across more than 150,000 patients supported and 40 million+ vitals monitored, Nsight Health's remote care programs have produced measurable improvements across the highest cost chronic conditions in American healthcare.

*Clinical outcomes reflect internal, aggregate observations from Nsight Health's remote care programs, reviewed by Nsight Health's clinical leadership. They have not been independently validated through peer reviewed clinical trials. Individual results vary and nothing here is medical advice.

Every one of those readings is reviewed by a U.S.-based clinical team employed by Nsight Health, working 24/7/365. Nsight runs the clinical program so provider practices can extend care between visits without adding staff, technology, or workflow burden.

An Independent Economic Signal, Validated by Optum

Clinical improvement is the foundation. The economic evidence is beginning to follow. In 2026, Nsight Health engaged Optum to conduct a retrospective, propensity score matched, difference in difference analysis comparing Nsight patients against matched Medicare fee for service controls over a 12 month follow up period.

Across three high cost chronic disease cohorts, Nsight patients demonstrated lower growth in total medical spending during their first year of care. Estimated total medical savings were approximately $2,467 per member per year for hypertension with complications, approximately $3,012 for diabetes, and approximately $2,483 for chronic kidney disease, before considering program costs. All six economic comparisons in the study favored Nsight. The findings were directionally favorable but did not reach conventional statistical significance, and they should be read as an early but meaningful economic signal rather than definitive proof of savings.

What Provider Partners Are Saying

Rankings measure growth. Partners explain it. Here is what practices across primary care, nephrology, and cardiology say about working with Nsight Health.

"We have seen significant revenue increase for not much extra work on providers. By far, Nsight Health is the best CCM/RPM team we have had in over 20 years of practice."
Emylee Cooper, Practice Administrator and Biller, Drs. Branton and Jarrah PA

"What stood out most was Nsight's commitment to being a true extension of our care team. They did not just provide a technology solution. They provided a clinical partnership that helped us enhance outcomes, improve the patient experience, and create additional value for our practice."
Sarah Dorsey, Office Manager, 287 Family Medicine

"Their reliable RPM/CCM services, combined with outstanding customer support, make them a trusted and highly recommended partner in chronic disease management."
Ron Reynolds, Practice Manager, CSRA Renal

"Nsight has been a true partner to our cardiology team, responsive, proactive, and easy to work with. Communication is clear, follow through is consistent, and we always feel supported. We trust Nsight and would confidently recommend them to other practices."
Kristie Boschee, Office Administrator, Cabrillo Cardiology

What Patients Are Saying

Behind the ranking are the daily interactions between patients and the nurses who monitor them. These reflections come from public patient reviews of Nsight Health, shared here with identifying details removed.

"It is comforting to know blood pressure readings are transmitted on a daily basis and reviewed every day. If they see a variance from your normal range, they call and check on you. They work closely with your physician and are available 24/7 if you have a medical question or problem. I have been very pleased and wholeheartedly recommend their great staff members and programs. It could be a lifesaver."
Nsight Health remote monitoring patient

"I want to thank Nsight Health for their outstanding support, patience, knowledge, and guidance. They have provided me with the utmost care throughout my journey. My overall health and lifestyle have improved so much since I started working with them."
Nsight Health patient

"Always a pleasure to talk to the nurses. They are always concerned about me, checking to see how I am feeling and if I need anything at all. Thank you Nsight Health."
Nsight Health patient

A Year of National Recognition

The Inc. 5000 ranking joins a growing list of honors for Nsight Health in 2026:

• No. 12 on the 2026 Inc. 5000 Regionals: Southeast with 683 percent two year growth
• Best Remote Patient Monitoring Solution at the 2026 MedTech Breakthrough Awards
• Gold and Silver Stevie Awards at the 2026 American Business Awards for Best Health Products and Services and Fastest Growing Company of the Year
• Inc. Best Workplaces 2026 honoree
• Named a Top Workplace by the South Florida Sun Sentinel

Each recognition validates the same underlying thesis: when clinical outcomes lead, growth follows. The workplace honors matter just as much, because the nurses, care coordinators, and support teams behind those outcomes choose to build their careers at Nsight.

What This Means for Providers

For practices, health systems, and ACOs evaluating remote care partners, the Inc. 5000 ranking is a signal of durability. Nsight Health delivers four care management programs under one clinical infrastructure: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM).

Nsight provides the FDA cleared devices, the connectivity, and the U.S.-based clinical team employed by Nsight Health who monitor patients around the clock. Nsight runs the clinical program. You bill, collect, and grow. Today that model serves 150,000+ patients, 2,000+ providers, and 480+ clinics nationwide, with more than 40 million vitals monitored and a 4.5 out of 5 patient rating on Google.

Frequently Asked Questions

What is the Inc. 5000?

The Inc. 5000 is Inc. magazine's annual ranking of the 5,000 fastest growing private companies in America. It is considered the most prestigious growth ranking for private businesses in the United States, with past honorees including Microsoft, Meta, Oracle, and Patagonia.

Where did Nsight Health rank on the 2026 Inc. 5000?

Nsight Health ranked No. 78 out of 5,000 honorees on the 2026 Inc. 5000, placing it in the top 2 percent of the fastest growing private companies in America.

How are Inc. 5000 companies ranked?

Companies on the 2026 Inc. 5000 are ranked by verified percentage revenue growth from 2022 to 2025. Honorees must be U.S. based, privately held, for profit, and independent, and must pass Inc.'s editorial review.

How is this different from Nsight Health's earlier Inc. Regionals ranking?

The Inc. Regionals rank companies by two year revenue growth within a specific region. Nsight Health placed No. 12 in the Southeast earlier in 2026 with 683 percent two year growth. The national Inc. 5000 ranks companies across the entire country by three year revenue growth, and Nsight Health placed No. 78 nationally.

What programs does Nsight Health offer?

Nsight Health delivers four care management programs under one clinical infrastructure: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM).

What clinical results has Nsight Health observed?

Internal program data shows an 11.5 mmHg average systolic blood pressure reduction in hypertension patients, a 29.6 mmHg reduction in Stage 2 hypertension, a 71.6 mg/dL glucose reduction in the highest risk diabetes cohort by 12 to 18 months, a 72 percent reduction in critical heart failure weight alerts, and a 22 percent reduction in critical COPD hypoxia alerts. These are internal observations, not peer reviewed findings, and individual results vary.

How can my practice partner with Nsight Health?

Visit nsightcare.com/schedule-a-demo to see how Nsight Health's fully managed remote care programs work for your patient population, with no added staff and no upfront investment required.

Disclaimer: This article is for informational purposes only and does not constitute medical, clinical, legal, or financial advice. Clinical outcomes data referenced herein reflects internal, aggregate observations from Nsight Health's remote care programs, reviewed by Nsight Health's clinical leadership, and has not been independently validated through peer reviewed clinical trials. Economic findings reflect a retrospective Optum matched cohort analysis of Medicare fee for service patients age 65 and older; results were directionally favorable but did not reach conventional statistical significance, do not include RPM and CCM program costs, and are not a guarantee of savings. Individual patient outcomes and practice results vary. Revenue growth figures are based on verified data submitted to Inc. Testimonials reflect individual experiences and are not guarantees of outcomes. Patient testimonials have been de-identified. Nothing herein guarantees clinical outcomes, financial performance, or reimbursement.

Works Cited

Inc. "Inc. Unveils the 2026 Inc. 5000 List, Recognizing America's Fastest-Growing Private Companies." Inc., 11 Aug. 2026, www.inc.com/inc5000.

Inc. "Nsight Health Company Profile." Inc., 2026, www.inc.com/profile/nsight-health.

Nsight Health. "Nsight Health Ranks No. 12 on the 2026 Inc. 5000 Regionals: Southeast with 683% Growth." Nsight Health, 2026, nsightcare.com/press-release/nsight-health-ranks-no-12-on-the-2026-inc-5000-regionals-southeast-with-683-growth/.

Optum, Inc. "NSIGHT + Optum Status Update." Economic Findings From the NSIGHT-Optum Analysis, 1 May 2026.

If you recently received a phone call, text message, email, or letter from Nsight Health, you may be wondering who we are and how we got your information. That is a fair and smart question to ask any time a company reaches out to you about your health. Here is the short, honest answer.

We know that unexpected calls about health and Medicare make a lot of people cautious, and they should. This guide explains exactly why we may be contacting you, what we will and will not ever ask for, and three simple ways you can confirm that an outreach is really from us. Our goal is for you to feel comfortable and in control, not pressured.

The quick version

• Why us: Your doctor or clinic chose to partner with Nsight Health and referred you to a care program. We work as an extension of your care team.
• What it is: Supportive care that helps your doctor keep an eye on your health between office visits, so small changes can be caught early.
• What we will never do: We will never demand payment over the phone, ask for gift cards, pressure you, or ask for your full Social Security number out of the blue.
• Your choice: Taking part is completely voluntary. You can ask questions, take your time, decline, or stop at any point.
• How to verify: Call your doctor's office, or call our patient care line directly at 888-270-4225, available 24 hours a day, 7 days a week.

Who is Nsight Health?

Nsight Health is a United States based remote care company that helps doctors and clinics care for their patients beyond the walls of the office. When a condition such as high blood pressure, diabetes, or a heart or lung condition needs attention between visits, your doctor can enroll you in a care program that we help run on their behalf.

The people who call and support you are a U.S.-based clinical team employed by Nsight Health, including nurses and trained health coaches. We are not a software-only vendor and we are not a call center reading from a sales script. We follow the direction of your own provider, and your provider stays in charge of your care.

Why did my doctor have someone else reach out?

This is one of the most common questions we hear, and it is a good one. Many doctors today partner with a dedicated care team like Nsight Health so their patients get more support without long waits or extra trips to the office. Your doctor's staff is often busy caring for people in the clinic, so they ask a trusted partner to handle the regular check-ins, device setup, and day-to-day monitoring.

Think of it this way. Your doctor is still the captain of your care. We are part of the crew your doctor chose to help you stay healthy between appointments. Everything we observe is shared back with your provider so they can make decisions about your treatment.

What kind of care program were you referred to?

Depending on your health needs, your doctor may have referred you to one or more of the four programs we support. Here is what each one means in plain language.

You can read more about each program on our service pages: Remote Patient Monitoring, Chronic Care Management, Principal Care Management, and Behavioral Health Integration.

How might Nsight Health contact you?

Because everyone has a different preference, you may hear from us in more than one way. Here is what each type of outreach is for, and what we will and will not do.

Is this a scam?

No. An outreach from Nsight Health is a legitimate part of the care your own doctor set up for you. We understand the worry, because there really are health-related scams out there, and government agencies have warned the public about them.

The most important thing to know is the simple test that government watchdogs recommend. The U.S. Department of Health and Human Services Office of Inspector General advises that a trusted health care provider you already know should be the one who approves any new device or service, and that you should be cautious of unsolicited callers who request your Medicare number. With Nsight Health, that test is met, because your own provider referred you. We are connected to a doctor you already trust, not a stranger who found your number.

How to tell legitimate care from a scam

It is always worth knowing the warning signs so you can protect yourself, no matter who is calling. Here is how a legitimate care program like ours compares to a typical scam.

If anyone ever offers you free medical equipment and then asks for your Medicare number, the safest step is to hang up and check with your doctor first. You can report suspected Medicare fraud to 1-800-MEDICARE or to the HHS-OIG Hotline at 1-800-447-8477.

Three easy ways to confirm it is really us

You never have to take our word for it. If you want to be sure an outreach is genuinely from Nsight Health, here are three simple ways to check.

1. Call your doctor's office. Ask whether they referred you to Nsight Health for a care program. Your clinic can confirm the partnership.
2. Call our patient care line directly. You can reach our U.S.-based team at 888-270-4225, 24 hours a day, 7 days a week. You can also visit our patient website at getremotecare.com.
3. Watch what we ask for. A real Nsight Health team member will confirm details your clinic already has. We will never demand payment by gift card, threaten you, or ask for your full Social Security number out of nowhere.

Will this cost me anything?

Taking part in a care program is your choice, and we want you to understand any costs before you decide. These programs are typically provided as Medicare Part B services, which means Medicare usually covers most of the cost. Many patients also have secondary or supplemental insurance that helps cover the rest. Because every insurance plan is different, the best step is to let our team or your insurance provider walk you through what, if anything, would apply to you. We will help you check before you enroll, so there are no surprises.

Do I have to say yes? Can I opt out later?

Joining is always voluntary. You are free to ask as many questions as you like, take time to think, and decide what is right for you. There are no contracts and no obligations. If you join and later change your mind, you can stop at any time by telling your Nsight nurse or health coach, emailing our support team, or calling us at 888-270-4225. Choosing not to participate will not affect your relationship with your doctor.

Is my health information private?

Yes. Protecting your information is something we take seriously. Nsight Health follows federal privacy law, including HIPAA, and uses secure systems to handle your health data. We work under the authorization of your own provider, and the health information we collect is used to support your care and is shared with your doctor's team. You can learn more about how privacy and HIPAA work in healthcare in our guide to privacy, HIPAA, and healthcare compliance.

What happens if I join?

Getting started is simple, and our team guides you through every step.

• A friendly welcome call to explain the program and answer your questions.
• If your program includes a device, we mail you an easy-to-use one that is ready to go. There is no complicated setup, and our team helps if you need it.
• Regular, supportive check-ins. Most patients hear from their care team about once a month, and we adjust if your needs change.
• Your readings and updates are shared with your doctor, so your whole care team stays informed.

For a closer look at how this kind of support helps people stay healthy and independent at home, see our article on remote patient monitoring and peace of mind for seniors and their loved ones, or our plain-language overview of what remote patient monitoring is.

A note for our partner practices and providers

If you are a provider or clinic staff member reviewing this page, you can share it with confidence. We created it so your patients have a clear, reassuring answer when they search online about why they are hearing from us. Nsight Health operates as an extension of your care team, under your direction and your clinical oversight, with compliant and HIPAA-aligned processes throughout.

We encourage practices to introduce the program to patients during a visit so the first outreach feels expected rather than unexpected. A short heads-up from your office, a note in the patient portal, or a link to this page goes a long way toward building trust and supporting enrollment. If your practice would like materials to help educate your patients, or if you are exploring a partnership, you can schedule a demo with our team or reach us through our contact page.

Frequently asked questions

Why is Nsight Health calling me?

Nsight Health is calling because your doctor or clinic referred you to a care program they offer through us, such as Remote Patient Monitoring or Chronic Care Management. We reach out to welcome you, explain the program, and answer your questions. We work as an extension of your existing care team.

Is Nsight Health legitimate, or is this a scam?

Nsight Health is a legitimate, established U.S. company, and an outreach from us is a real part of the care your own doctor arranged. Government guidance suggests that a service is trustworthy when your own provider approved it, which is exactly the case here. You can confirm by calling your doctor's office or our patient line at 888-270-4225.

How did Nsight Health get my contact information?

Your information came from your own doctor or clinic when they referred you to a care program. We did not buy your information or find it on our own. We only contact patients whose providers have partnered with us.

How can I verify that a call or text is really from Nsight Health?

You can call your doctor's office to confirm the referral, or call our patient care line directly at 888-270-4225, available 24 hours a day, 7 days a week. A real Nsight Health team member will never demand payment by gift card or ask for your full Social Security number out of the blue.

Does this program cost me anything?

These are typically Medicare Part B services, so Medicare usually covers most of the cost, and many patients have secondary or supplemental insurance that covers the rest. Costs depend on your specific plan, so our team will help you check before you enroll.

Do I have to take part?

No. Taking part is completely voluntary, with no contracts and no obligations. You can ask questions, take your time, and decline if it is not right for you. Declining will not affect your relationship with your doctor.

Can I stop the program after I start?

Yes. You can stop at any time. Just tell your Nsight nurse or health coach, email our support team, or call us at 888-270-4225, and we will take care of it.

Is my health information kept private?

Yes. Nsight Health follows federal privacy law, including HIPAA, and uses secure systems. We work under your provider's authorization, and your information is used to support your care and shared with your doctor's team.

What should I do if a different caller offers me a free device and asks for my Medicare number?

Be cautious. If anyone you do not know offers free medical equipment and then asks for your Medicare number, it is safest to hang up and check with your doctor first. You can report suspected Medicare fraud to 1-800-MEDICARE or the HHS-OIG Hotline at 1-800-447-8477.

This article is for general informational purposes only and is not medical, legal, financial, or insurance advice. Participation in any care program is voluntary and is based on a referral and order from your treating provider. Coverage and any potential cost vary by individual insurance plan and circumstances; please confirm details with your insurer or our patient care team. Nsight Health programs operate under the oversight of your supervising provider in accordance with applicable guidelines. CPT is a registered trademark of the American Medical Association.

Works Cited

U.S. Department of Health and Human Services, Office of Inspector General. "Consumer Alert: Remote Patient Monitoring." oig.hhs.gov, 2023, https://oig.hhs.gov/fraud/consumer-alerts/consumer-alert-remote-monitoring/.
Centers for Medicare & Medicaid Services. "Remote Patient Monitoring." cms.gov, 2026, https://www.cms.gov/medicare/coverage/telehealth/remote-patient-monitoring.
Centers for Medicare & Medicaid Services. "Reporting Medicare Fraud & Abuse." medicare.gov, 2026, https://www.medicare.gov/basics/reporting-medicare-fraud-and-abuse.
Senior Medicare Patrol. "Scam Alert: Remote Patient Monitoring." smpresource.org, 2023, https://smpresource.org/scam-alert-remote-patient-monitoring/.

Remote patient monitoring gives nephrology teams a way to close that gap. By capturing blood pressure, weight, and glucose readings from a patient's home nearly every day, RPM turns the long silence between appointments into a continuous stream of clinical signal. This guide covers what RPM tracks for kidney patients, what the evidence shows, how a program maps to each stage of chronic kidney disease, and how the 2026 Medicare billing framework supports it, including the two new CPT codes that took effect this year.

Why remote monitoring matters in nephrology

Kidney disease progresses quietly. A patient can lose a meaningful share of kidney function between two office visits without any obvious change in how they feel. The two leading causes of kidney failure, uncontrolled hypertension and diabetes, are also the two variables that respond most directly to daily measurement and timely intervention. That makes CKD an unusually good fit for remote physiologic monitoring.

The clinical logic is straightforward. Daily blood pressure readings reveal whether a medication regimen is actually controlling pressure at home, where readings tend to be more representative than a single office measurement. Daily weight tracking surfaces fluid retention days before it becomes symptomatic, which matters enormously for patients at risk of decompensation. For the large share of CKD patients who also live with diabetes, glucose monitoring helps catch the swings that impaired kidney clearance can make more dangerous. Each of these signals gives the nephrology team a chance to act early, adjust treatment, and keep a patient out of the emergency department.

What RPM tracks for kidney patients

A well-designed nephrology RPM program focuses on the vitals that most directly reflect kidney health and the conditions that drive its decline. The table below outlines the core measurements and why each one matters in kidney care.

Devices are FDA-cleared and cellular-connected, so readings transmit automatically without the patient needing to pair equipment or manage an app. That simplicity is not a convenience feature. It is what makes it realistic for older kidney patients to reach the measurement thresholds that clinical value, and reimbursement, depend on. Learn more about how a full remote patient monitoring program is structured.

The clinical case: what the evidence shows

The published literature on remote monitoring in kidney disease is encouraging, particularly for patients on home dialysis and those managing the hypertension and diabetes that drive CKD progression. Systematic reviews of home dialysis populations have reported fewer hospitalization days when RPM follow-up supplements standard care, and studies of remote blood pressure programs have shown meaningfully improved control rates compared with office-only management. Slowing the annual decline in kidney function, even modestly, can delay the need for dialysis by months to years, which changes both quality of life and total cost of care.

In Nsight Health's own monitored population, patients enrolled in remote blood pressure management have shown an average systolic blood pressure reduction of approximately 11.5 mmHg, and patients with diabetes have shown an average blood glucose reduction of approximately 50 mg/dL. Because blood pressure and glycemic control are the two primary levers in slowing kidney disease, these are the outcomes that matter most for a nephrology population.

A note on these figures: The blood pressure and glucose results above reflect internal observations from Nsight Health's monitored patient population. They are not drawn from a peer-reviewed controlled trial, individual results vary, and nothing here is medical advice or a guarantee of clinical outcomes.

RPM across the CKD journey

Chronic kidney disease is staged from 1 through 5 based on kidney function, and the role of remote monitoring shifts as a patient moves through those stages. A single program can support the entire journey.

Early stages (CKD 1 to 3). The priority is slowing progression. Here the value of RPM is in tight blood pressure and glucose control, catching upward trends early and giving the care team the data to adjust therapy before kidney function declines further. Many patients at these stages have two or more chronic conditions, which opens the door to care coordination alongside monitoring.

Advanced stages (CKD 4 to 5). The clinical picture intensifies. Fluid status, blood pressure, and cardiovascular risk all require closer attention, and daily weight tracking becomes especially important for detecting fluid overload. Patients at these stages often benefit from the more focused, single-condition management that Medicare's principal care management pathway is designed to support.

End-stage renal disease and home dialysis. For patients on peritoneal or home hemodialysis, remote monitoring extends the clinical team's reach into the home, supporting treatment adherence and early detection of complications. This is where the evidence base is strongest, and where continuous oversight can be genuinely protective. For a broader clinical view, see our companion article on transforming kidney care with RPM.

How RPM eases the operational burden on nephrology practices

Nephrology teams are stretched. Panels are growing, the workforce is tight, and monthly appointments alone cannot capture enough data to manage a progressive disease well. Remote monitoring helps in three practical ways.

First, it moves routine data collection out of the office. Instead of relying on a single reading captured during a rushed visit, the care team sees trends built from daily measurements. Second, it converts raw data into prioritized alerts, so clinical attention flows to the patients whose readings are drifting rather than being spread evenly across a full panel. Third, when the monitoring and clinical review are delivered by an external clinical team, the practice gains the benefit of continuous oversight without hiring, training, and managing new staff to watch dashboards around the clock.

The 2026 RPM billing framework for nephrology

Medicare reimburses remote physiologic monitoring through a set of CPT codes covering device setup, device supply and data transmission, and clinical management time. The 2026 Physician Fee Schedule final rule, issued by CMS on October 31, 2025 and effective January 1, 2026, made the most significant structural change to RPM billing since the codes were introduced. It added two new codes and increased reimbursement across the code family. The table below reflects approximate national non-facility amounts.

Two points about the new codes matter for nephrology. The new device supply code for 2 to 15 days of data is reimbursed at the same approximate rate as the 16-day code, which creates a billing pathway for patients who cannot consistently hit the 16-day threshold, such as those recovering after a hospitalization or a medication change. The new shorter management code recognizes 10 to 19 minutes of clinical time that previously went uncompensated. Note that the shorter-window codes are not billed together with their longer-window counterparts in the same period, and the management codes require at least one interactive communication with the patient or caregiver per calendar month. Rates vary by geographic locality; always verify current amounts using the CMS Physician Fee Schedule look-up tool.

Stacking RPM with CCM and PCM for kidney patients

Remote monitoring rarely stands alone in a kidney population. Most CKD patients also qualify for a care coordination program, and Medicare allows monitoring to be billed alongside coordination when the time and documentation for each are kept separate. The two coordination pathways relevant to nephrology are chronic care management and principal care management. They are mutually exclusive for the same patient in the same month, so the choice comes down to the patient's clinical profile.

PCM is often the natural fit in nephrology because kidney disease is frequently the one condition that dominates the clinical picture. It also allows a nephrologist to bill for focused management of advanced CKD even when a primary care physician is separately managing the patient's other conditions. Explore the details of chronic care management and principal care management to see which pathway fits your panel.

The financial effect of stacking is meaningful. The example below shows an illustrative monthly picture for a single kidney patient enrolled in remote monitoring plus one coordination program. These are approximate figures for illustration; actual reimbursement depends on documented time and local rates.

With additional documented management time, the combined figure can rise to approximately $250 or more per patient per month. Across a panel of qualifying kidney patients, that recurring reimbursement can fund the clinical infrastructure a strong monitoring program requires. For a deeper look at billing mechanics, see our guides to the new 2026 RPM CPT codes and chronic care management CPT codes.

Building a compliant nephrology RPM program

Reimbursement follows compliance. A durable program is built on a few non-negotiable elements. Patients must consent before services begin, and that consent must be documented. An eligible practitioner must order the monitoring. Devices must be FDA-cleared and the data digitally transmitted. Clinical time must be logged accurately, with documentation that shows what data was reviewed and what clinical decisions followed, because CMS reimburses monitoring for the clinical action it drives, not for passive data collection. The management codes also require at least one interactive communication with the patient or caregiver each calendar month.

Documentation is where many programs stumble. The most common denials trace back to missing consent, insufficient time logs, or notes that record readings without recording the clinical response. A well-run program treats documentation as part of the clinical workflow rather than an afterthought.

Patient adherence is the hidden driver of a kidney program

Every clinical and financial benefit of remote monitoring depends on one thing: patients actually taking their readings. A program that enrolls patients but cannot keep them engaged produces neither the daily signal clinicians need nor the measurement days that reimbursement requires. In a kidney population that skews older and often manages several conditions at once, adherence is not automatic. It has to be designed for.

Three things move adherence. The first is device simplicity. Cellular-connected monitors that work out of the box, with no app to configure or Bluetooth to pair, remove the most common point of failure for older patients. The second is education that connects the daily habit to the patient's own health, so a blood pressure reading feels like a step in managing their kidney disease rather than a chore. The third is human contact. Regular outreach from a clinical team, checking in when readings drift or when a patient goes quiet, is what sustains a program past the first few weeks. Patients who understand that a real person is watching their numbers stay engaged far longer than those who feel they are sending data into a void.

This is also where an experienced clinical team earns its keep. Consistent, proactive outreach is labor intensive, and it is difficult to sustain inside a busy nephrology practice without dedicated staff. A managed program that owns engagement as a core function keeps measurement days high and, with them, both the clinical value and the reimbursement integrity of the program. To see how this works in practice, schedule a demo.

Why practices choose a managed partner

Standing up a compliant, high-adherence monitoring program is a significant operational lift. It requires devices and logistics, a clinical team available to review data and reach patients, careful time tracking, and billing discipline. Many nephrology practices would rather focus their clinicians on patients than on building and staffing that infrastructure.

Nsight Health delivers remote care as a fully managed program. A U.S.-based clinical team employed by Nsight Health handles enrollment, device logistics, daily monitoring, and patient outreach, and the practice receives a monthly billing file. We run the clinical program so your team does not have to build it. Nsight supports more than 130,000 patients across 1,700 provider teams and 480 clinics, with more than 40 million vitals monitored, delivering four programs under one roof: remote patient monitoring, chronic care management, behavioral health integration, and principal care management. To discuss a program for your practice, schedule a demo with our team.

Getting started

For most nephrology practices, the fastest path to value is to begin with the highest-acuity patients, those with advanced CKD, poorly controlled hypertension, or fluid management challenges, where daily data has the clearest clinical payoff. From there, a program can scale across the panel as workflows settle. If you would like to see how a managed program would work for your patients, schedule a demo with our team.

Frequently asked questions

Does Medicare cover remote patient monitoring for kidney patients?

Yes. Medicare covers RPM for patients with a chronic condition that warrants ongoing physiologic monitoring, which includes chronic kidney disease across its stages. Coverage requires an FDA-cleared device, digital transmission of data, documented patient consent, and an order from an eligible practitioner. Patients are generally responsible for standard Part B cost sharing unless they have secondary coverage.

Which CKD patients benefit most from RPM?

Patients with concurrent hypertension or diabetes tend to benefit most, because blood pressure and glucose are the primary modifiable drivers of kidney disease progression. Patients with advanced CKD or fluid management challenges also benefit substantially, since daily weight tracking can surface fluid retention before it becomes symptomatic.

What did the 2026 Physician Fee Schedule change for RPM?

The CY 2026 final rule added two new CPT codes and increased reimbursement across the RPM family. One new code covers device supply for 2 to 15 days of data in a 30-day period, reimbursed at approximately the same rate as the 16-day code. The other covers 10 to 19 minutes of clinical management, filling a gap for shorter engagements that previously went uncompensated.

Can RPM be billed together with CCM or PCM for the same kidney patient?

Yes. Remote monitoring can be billed alongside a care coordination program when the time and documentation for each are kept separate and distinct. Chronic care management and principal care management are mutually exclusive with each other for the same patient in the same month, so a practice selects one coordination pathway based on the patient's clinical profile.

Should a nephrology practice use CCM or PCM?

Use chronic care management when the patient has two or more chronic conditions requiring broad coordination. Use principal care management when a single condition, such as advanced CKD, dominates the clinical picture. PCM is frequently the better fit in nephrology and can be billed by the nephrologist even when another provider manages the patient's other conditions.

How much can a nephrology practice expect to earn per patient?

Combined reimbursement for a kidney patient enrolled in remote monitoring plus one coordination program is approximately $168 per month in a conservative scenario, and can reach approximately $250 or more per month with additional documented management time. Actual amounts depend on documented clinical time and local geographic rates.

What devices are used for kidney monitoring?

The core devices are a cellular-connected blood pressure monitor and a weight scale, with a glucose meter added for patients who also have diabetes. Cellular connectivity means readings transmit automatically, which makes it easier for patients to reach the measurement thresholds that clinical value and billing depend on.

What are the most common compliance pitfalls?

The most frequent issues are missing or undocumented patient consent, incomplete time logs for the management codes, and documentation that records readings without recording the clinical decisions those readings prompted. A program that builds documentation into the clinical workflow avoids most denials.

Does Nsight Health manage the program or just provide software?

Nsight Health delivers a fully managed program. A U.S.-based clinical team employed by Nsight Health handles enrollment, device logistics, daily monitoring, and patient communication, and the practice receives a monthly billing file. The practice keeps its clinical relationship with the patient while Nsight runs the operational program.

Works Cited

Centers for Medicare & Medicaid Services. "Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)." CMS.gov, 31 Oct. 2025, www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f.

Centers for Medicare & Medicaid Services. "Physician Fee Schedule Look-Up Tool." CMS.gov, www.cms.gov/medicare/payment/fee-schedules/physician.

National Kidney Foundation. "Kidney Disease: The Basics." Kidney.org, www.kidney.org/news/newsroom/fsindex.

Centers for Disease Control and Prevention. "Chronic Kidney Disease in the United States." CDC.gov, www.cdc.gov/kidney-disease.

Disclaimer

This article is for informational purposes only and does not constitute medical, legal, billing, or reimbursement advice. Reimbursement amounts are approximate national estimates based on the CY 2026 Medicare Physician Fee Schedule and vary by geographic locality and Medicare Administrative Contractor (MAC); always verify current rates using the CMS Physician Fee Schedule look-up tool and confirm coverage with the applicable payer. Nothing here guarantees any clinical outcome or level of reimbursement. Practices should consult qualified clinical, compliance, and billing professionals before implementing a remote care program. CPT is a registered trademark of the American Medical Association. All CPT code descriptions are paraphrased for clarity.

Quick answer: To start a remote patient monitoring program, identify patients with a chronic or acute condition that warrants monitoring, confirm the established-patient relationship, obtain and document consent, supply an FDA-cleared device that transmits data automatically, educate the patient, then review the incoming data and document the clinical time and decisions each month. Most practices reach their first billable month faster by partnering with a fully managed remote patient monitoring team rather than building the operation from scratch.

Remote patient monitoring has moved from a nice-to-have to a core part of how forward-looking practices manage chronic disease. The clinical case is strong, the 2026 Medicare rules are more flexible than ever, and the operational lift is smaller than most practices expect once the workflow is clear. This guide walks through how to start a remote patient monitoring program step by step: who qualifies, what you need before launch, the exact build sequence, the 2026 billing framework, the staffing decision, and how to scale without overloading your team.

Why start a remote patient monitoring program

Chronic disease is the reason. According to the Centers for Disease Control and Prevention, 6 in 10 U.S. adults live with a chronic disease and 4 in 10 have two or more. Those conditions, led by hypertension and diabetes, are managed largely at home, in the long stretches between office visits when the care team has almost no visibility. Remote patient monitoring closes that gap by capturing blood pressure, weight, glucose, and other vitals from the patient's home nearly every day.

The clinical payoff is earlier intervention. When a care team sees a blood pressure trend climbing or a weight gain that signals fluid retention, it can act before the patient ends up in the emergency department. Published programs have shown improved blood pressure control and fewer avoidable hospitalizations when monitoring supplements standard care. For a deeper look at the evidence, see our summary of remote patient monitoring clinical outcomes. Only after the clinical value is clear do the operational and financial benefits follow: steadier panels, better between-visit engagement, and a recurring, Medicare-reimbursed revenue stream.

How remote patient monitoring works

Before building a program, it helps to see the full loop from the patient's side, because every operational decision maps back to it. The Centers for Medicare and Medicaid Services frames it in six plain steps, using a hypertension patient as the example.

First, the provider determines that monitoring is medically necessary to manage the patient's condition, and the patient consents. Second, the provider supplies a connected device, such as a blood pressure cuff. Third, the provider educates the patient on how to set it up and use it. Fourth, the patient takes readings on their normal routine, and the device transmits the data automatically. Fifth, the care team reviews the incoming data and looks for trends or values that need attention. Sixth, the team acts on what it sees, for example adjusting a medication and calling the patient to explain the change.

That last step is the whole point. Remote patient monitoring is not a data-collection service, it is a clinical service that happens to use data. The programs that succeed treat every reading as a prompt for a possible clinical decision, and they build their staffing, workflow, and documentation around acting on the data rather than simply gathering it. If you would like to see that loop running end to end, schedule a demo.

Which patients qualify for RPM

Medicare covers remote patient monitoring under Part B for patients with a chronic or acute condition when monitoring is medically reasonable and necessary for diagnosis or treatment. There is no single approved diagnosis list. The key questions are whether the patient has a condition that benefits from ongoing physiologic data and whether the record documents why monitoring is needed.

Two eligibility rules matter most at intake. First, the patient must be an established patient, meaning they have received face-to-face professional services from the billing practitioner, or another practitioner of the same specialty in the same group, within the prior three years. Second, only one practitioner may bill remote patient monitoring for a given patient in a 30-day period. The most common conditions practices monitor include hypertension, diabetes, heart failure, chronic kidney disease, and chronic respiratory disease. Specialty practices can build focused programs as well, such as a nephrology team monitoring blood pressure and fluid status, covered in our remote patient monitoring for nephrology guide.

Remote patient monitoring across specialties and settings

Remote patient monitoring is not only for primary care. Because Medicare covers it for any chronic or acute condition that warrants monitoring, specialty practices and larger organizations can build focused programs around the vitals that matter most to their populations.

Primary care practices most often start with hypertension and diabetes, the two highest-volume chronic conditions. Cardiology teams focus on blood pressure and weight to catch fluid changes early. Pulmonology programs lean on pulse oximetry and symptom tracking for chronic respiratory disease. Nephrology practices monitor blood pressure and weight to slow kidney disease progression, a model covered in depth in our nephrology guide. Larger organizations run programs at scale: many health systems use monitoring to reduce avoidable readmissions across an attributed population, while independent provider organizations use it to extend care between visits without expanding their footprint.

The build sequence in this guide applies to all of them. What changes is the device mix, the alert thresholds, and the clinical protocols, which should be tuned to the conditions each program manages.

What you need before you launch

A remote patient monitoring program rests on a short list of non-negotiable prerequisites. Get these in place before enrolling the first patient.

How to start a remote patient monitoring program, step by step

The Centers for Medicare and Medicaid Services describes remote patient monitoring as a simple sequence: a provider determines monitoring is necessary, the patient consents, the provider supplies and explains the device, the patient transmits readings automatically, and the provider reviews the data and adjusts care. The operational build follows the same arc, with the added work of enrollment, workflow, and documentation.

Step 1: Identify eligible patients and conditions. Start with your highest-need patients, those with uncontrolled hypertension, diabetes, heart failure, or chronic kidney disease, where daily data has the clearest clinical value. Population health reports, visit notes, and discharge lists are good sources. Confirm the established-patient relationship as you build the list.

Step 2: Select FDA-cleared, cellular-connected devices. Choose devices that fit the conditions you are managing: a blood pressure monitor for hypertension, a weight scale for heart failure, a glucometer for diabetes, a pulse oximeter for respiratory disease. Cellular-connected devices that work out of the box, with no app or Wi-Fi setup, dramatically improve adherence in older patients. A cellular blood pressure monitor is the most common starting device.

Step 3: Obtain and document consent. Explain the program, confirm the patient wants to participate, note any cost sharing, and record the consent in the chart. This single step is the source of many downstream denials when it is skipped or undocumented.

Step 4: Enroll and educate the patient. Ship or hand off the device, walk the patient through taking a reading, and confirm the first transmission arrives. Good onboarding is the difference between a patient who hits the measurement threshold and one who drops off in week two.

Step 5: Build the clinical monitoring workflow. Set patient-specific alert thresholds, decide who reviews data and how often, and define escalation paths for urgent readings. The goal is that clinical attention flows to the patients whose numbers are drifting rather than being spread evenly across the whole panel.

Step 6: Document time and clinical actions every month. Reimbursement follows the clinical action taken on the data, not the collection of data itself. Log what was reviewed, what decisions followed, the time spent, and the required monthly interactive communication with the patient or caregiver.

Step 7: Bill correctly and watch denials. Submit claims aligned to the calendar month, confirm the data-day and time thresholds were met, and make sure no conflicting remote-monitoring codes were billed for the same period. Review a sample of claims each month to catch process gaps early.

The 2026 RPM billing framework

Medicare reimburses remote patient monitoring through a set of CPT codes covering device setup, device supply and data transmission, and clinical management time. The 2026 Physician Fee Schedule final rule, effective January 1, 2026, added two new codes and increased reimbursement across the family, the most significant expansion since the codes were introduced. The table below reflects approximate national non-facility amounts. For a full breakdown, see our guide to the new 2026 RPM CPT codes.

Two 2026 changes make a program easier to start. The new device supply code for 2 to 15 days of data is reimbursed at approximately the same rate as the 16-day code, which creates a billing pathway for patients who cannot always hit the 16-day threshold. The new shorter management code recognizes 10 to 19 minutes of clinical time that previously went uncompensated. The shorter-window codes are not billed together with their longer-window counterparts in the same period, and the management codes require at least one interactive communication with the patient or caregiver each calendar month. Rates vary by geographic locality and Medicare Administrative Contractor; always verify current amounts with the CMS Physician Fee Schedule look-up tool.

Should you insource or outsource the program?

This is the decision that determines whether a program launches in weeks or stalls for months. Running monitoring in-house means hiring or reassigning clinical staff to watch dashboards, reach patients, track time, and manage billing. Outsourcing means an external clinical team handles those functions while your practice keeps the clinical relationship and the patient. The table below frames the trade-off.

Most practices that want to move quickly choose a managed model. A fully managed partner is why many provider organizations and health systems launch a program without hiring a single new staff member.

What to look for in a remote patient monitoring partner

If you decide a managed partner is the faster path, the choice of partner determines whether the program is an asset or a liability. The right partner does more than ship devices. Evaluate candidates on a few dimensions that separate a real clinical operation from a software vendor.

Look first at who performs the clinical work. A partner with its own clinical team can run daily monitoring and patient outreach on your behalf, while a software-only vendor hands that work back to you. Ask where that clinical team is based and whether they are employed by the partner rather than subcontracted, because continuity and accountability matter in patient care. Next, confirm the partner supplies FDA-cleared, cellular-connected devices and manages the logistics of getting them to patients and keeping them transmitting. Then examine documentation and billing: a strong partner tracks data days, time, and clinical actions, and delivers a clean monthly billing file so your team is not reconstructing claims. Finally, check that the partner signs a business associate agreement and operates on a secure, HIPAA-compliant platform.

Nsight Health was built around exactly these functions, with a U.S.-based clinical team employed by Nsight Health, connected devices and logistics, and claims-ready documentation delivered every month. Practices keep their clinical relationship with the patient while Nsight runs the operational program. To compare a managed model against building in-house, schedule a demo with our team.

Building a compliant program

Reimbursement follows compliance, and most denials trace back to a handful of avoidable gaps. Build these into the workflow from day one.

The rule that trips up the most new programs is documentation of clinical action. Medicare reimburses monitoring for the clinical value it drives, not for passively collecting data, so the note must show what was reviewed and what happened next.

Estimating the financial opportunity

A remote patient monitoring program generates recurring monthly reimbursement per enrolled patient. The example below is illustrative and uses approximate national figures; actual amounts depend on documented time and local rates.

Stacking remote patient monitoring with chronic care management is the most common way to increase per-patient value, since many patients qualify for both when the time and documentation for each are kept separate. Our guide to combining RPM and CCM covers how that works.

How to scale without adding staff

The hardest part of a remote patient monitoring program is not starting it, it is sustaining it. Daily data review, patient outreach, time tracking, and billing discipline are ongoing work, and they are difficult to keep up inside a busy practice without dedicated staff. This is where a fully managed partner changes the math.

Nsight Health delivers remote care as a fully managed program. A U.S.-based clinical team employed by Nsight Health handles enrollment, device logistics, daily monitoring, and patient outreach, and the practice receives a monthly billing file. We run the clinical program so your team does not have to build it. Nsight supports more than 130,000 patients across 1,700 provider teams and 480 clinics, with more than 40 million vitals monitored, delivering four programs under one roof: remote patient monitoring, chronic care management, behavioral health integration, and principal care management. To see how a managed program would work for your patients, schedule a demo.

Common mistakes to avoid

New programs tend to fail in predictable ways. The most frequent is treating remote patient monitoring as a technology purchase rather than a clinical service, which leaves devices in patients' homes with no one acting on the data. The second is under-investing in onboarding, which causes patients to drop off before they reach the measurement threshold. The third is loose documentation, which turns real clinical work into denied claims. The fourth is trying to build the entire operation in-house before validating demand, when a managed pilot would prove the model faster. Avoiding these four is most of what separates a program that scales from one that stalls.

Frequently asked questions

How long does it take to start a remote patient monitoring program?

A practice building in-house typically needs several weeks to hire or assign staff, choose devices, design the workflow, and enroll the first patients. Practices that use a managed partner can begin enrolling much sooner because the clinical team, devices, and billing infrastructure already exist. The first billable month depends on when patients reach the data and time thresholds.

Does Medicare cover remote patient monitoring?

Yes. Medicare covers remote patient monitoring under Part B for patients with a chronic or acute condition when monitoring is medically reasonable and necessary. The patient is generally responsible for standard Part B cost sharing unless they have secondary coverage.

What devices do I need to start?

You need FDA-cleared devices that transmit data automatically, most commonly a cellular-connected blood pressure monitor, with a weight scale, glucometer, or pulse oximeter added based on the conditions you manage. Consumer fitness trackers and devices that require manual entry do not qualify for billing.

Who can bill for remote patient monitoring?

A physician or qualified health professional, such as a nurse practitioner or physician assistant, must order and direct the program and is the billing practitioner. Clinical staff can perform much of the day-to-day monitoring under general supervision. Only one practitioner may bill remote patient monitoring for a patient in a given 30-day period.

What are the 2026 RPM CPT codes?

The core codes are 99453 for setup, 99454 for device supply over 16 or more days, and 99457 and 99458 for clinical management time. For 2026, Medicare added 99445 for device supply over 2 to 15 days and 99470 for 10 to 19 minutes of management, giving practices more flexibility for patients who cannot always meet the higher thresholds.

How much revenue can a remote patient monitoring program generate?

Reimbursement is recurring and per patient. Device supply plus the first 20 minutes of management is approximately $102 per patient per month, and stacking chronic care management can raise combined value to approximately $168 or more. Actual amounts depend on documented clinical time and local geographic rates.

Do I need patient consent, and how is it documented?

Yes. Consent must be obtained before or at the time services begin and documented in the record, including the patient's understanding of any cost sharing. Missing or undocumented consent is one of the most common causes of denied claims.

Can I bill remote patient monitoring alongside chronic care management?

Yes. The two can be billed together when the time and documentation for each are kept separate and distinct. Many patients with chronic conditions qualify for both, which is why stacking is the most common way practices increase per-patient value.

Should I build the program in-house or use a partner?

Large groups with existing care-management staff may prefer to build in-house. Most practices that want to launch quickly without adding headcount choose a fully managed partner that supplies the clinical team, devices, and billing support while the practice keeps its clinical relationship with the patient.

Works Cited

Centers for Medicare & Medicaid Services. "Remote Patient Monitoring." CMS.gov, cms.gov.

Centers for Medicare & Medicaid Services. "Physician Fee Schedule Look-Up Tool." CMS.gov, cms.gov.

Centers for Disease Control and Prevention. "About Chronic Disease." CDC.gov, U.S. Department of Health and Human Services, cdc.gov.

Disclaimer

This article is for informational purposes only and does not constitute medical, legal, billing, or reimbursement advice. Reimbursement amounts are approximate national estimates based on the CY 2026 Medicare Physician Fee Schedule and vary by geographic locality and Medicare Administrative Contractor (MAC); always verify current rates using the CMS Physician Fee Schedule look-up tool and confirm coverage with the applicable payer. Nothing here guarantees any clinical outcome or level of reimbursement. Practices should consult qualified clinical, compliance, and billing professionals before launching a remote care program. CPT is a registered trademark of the American Medical Association. All CPT code descriptions are paraphrased for clarity.

Quick answer: Choose chronic care management (CCM) when a patient has two or more chronic conditions expected to last at least 12 months and the care need comes from coordinating across those conditions. Choose principal care management (PCM) when a single complex condition, expected to last at least three months, dominates the clinical picture. The two are mutually exclusive in the same calendar month, both can be billed alongside remote patient monitoring, and PCM can be billed by specialists as well as primary care.

Chronic care management and principal care management are two of Medicare's care coordination programs, and they are easy to confuse because they share so much: both pay for non-face-to-face time managing chronic disease, both require patient consent and a care plan, and both can be combined with remote patient monitoring. The difference that decides which one to use comes down to how many conditions are driving the patient's care. This guide breaks down the eligibility, the 2026 CPT codes and rates, and a clear framework for choosing the right program for each patient.

CCM vs PCM at a glance

The table below summarizes the practical differences. The sections that follow explain each one in depth.

What is chronic care management (CCM)?

Chronic care management pays for the ongoing, non-face-to-face work of coordinating care for patients with multiple chronic conditions. To qualify, a patient must have two or more chronic conditions expected to last at least 12 months, or until the end of life, that together place the patient at significant risk of death, acute decompensation, or functional decline. The practice maintains a comprehensive care plan and provides continuous management between visits. For the full program breakdown, see our explainer on what chronic care management is and the detailed CCM CPT codes guide.

Because most Medicare patients with chronic disease have more than one condition, CCM is the higher-volume program of the two. It is the right tool when the complexity comes from the interaction of several conditions, for example a patient managing diabetes, hypertension, and heart disease at once, where the coordination itself is the work.

A compliant CCM program also requires a few standing elements: documented patient consent, a comprehensive electronic care plan the patient can access, 24/7 access to a care team member for urgent needs, and management of care transitions. Most of the monthly work is performed by clinical staff under the general supervision of the billing practitioner, which is what makes the staff-directed codes the foundation of most programs. When a physician or qualified health professional personally provides the time, the higher physician-track codes apply instead.

What is principal care management (PCM)?

Principal care management fills the gap CCM leaves. It pays for intensive management of a single complex chronic condition, expected to last at least three months, that places the patient at significant risk and requires a disease-specific care plan with frequent medication adjustments or unusually complex management. Before PCM existed, a patient with one dominant condition, such as advanced heart failure or end-stage kidney disease, fell into a billing blind spot because they did not meet CCM's two-condition threshold.

PCM is especially useful for specialists. Unlike advanced primary care management, which is limited to primary care, PCM can be billed by any qualified practitioner, so a cardiologist managing advanced heart failure or a pulmonologist managing severe COPD can bill it for the one condition they own. Our PCM CPT codes guide covers the details.

PCM's shorter three-month duration threshold is part of what makes it flexible. A condition that is serious and demanding but may resolve or stabilize within a year, such as a cancer in active treatment or a post-acute cardiac condition, can qualify for PCM even when it would not meet CCM's twelve-month expectation. The trade-off is focus: the documentation must clearly identify one principal condition driving the care. Referencing multiple conditions as the basis for PCM is one of the fastest ways to trigger a denial.

The core difference: one condition or many

Every other distinction flows from a single question: is the patient's care need driven by one condition or by the interaction of several? If a single condition dominates and drives the risk, PCM is designed for that focused, disease-specific management. If the complexity comes from juggling multiple conditions and the coordination among them, CCM is the better fit. The duration thresholds reinforce this: CCM's 12-month horizon suits stable long-term multi-condition patients, while PCM's shorter 3-month threshold makes it available for a serious condition with an intense but potentially shorter management window.

Eligibility requirements compared

2026 CPT codes and reimbursement compared

Both programs use a two-track structure, one set of codes for time personally provided by a physician or qualified health professional and one set for clinical staff time under general supervision. The table below shows the 2026 codes with approximate national non-facility amounts. For a complete breakdown of how to start either program, see our guide on how to launch a remote care program.

CCM also includes complex-care codes, 99487 (approximately $144) and 99489 (approximately $78), for patients requiring moderate-to-high complexity medical decision-making, though only one CCM tier may be billed per patient per month. One financial point stands out: PCM's base code reimburses higher than CCM's base code, roughly $88 versus $66, so for a patient who genuinely qualifies for both, PCM can be the more favorable choice when the work centers on a single condition. Rates vary by geographic locality and Medicare Administrative Contractor; always verify current amounts with the CMS Physician Fee Schedule look-up tool.

How to choose: a decision framework

The choice is made patient by patient. Start with the number of qualifying conditions, then confirm the duration and complexity, then consider the financial angle. The scenarios below show how the decision plays out in practice. If you would rather have a partner make and operationalize this call for every eligible patient, you can schedule a demo.

The financial comparison: which program earns more

For a patient who clearly fits only one program, the clinical criteria decide the choice and the revenue follows. The interesting case is the patient who could arguably qualify for either, where the financial picture can tip the decision. Because PCM's base code reimburses at approximately $88 per month versus approximately $66 for CCM's staff base code, PCM captures roughly $22 more per patient per month when the practice expects to spend the required time on a single dominant condition.

At panel scale the difference compounds. A practice managing 200 patients under CCM's staff base code generates approximately $13,200 per month, or roughly $158,000 per year before program costs. The same panel under PCM's staff base code generates approximately $13,600 per month. Layering remote patient monitoring on top changes the math far more than the choice between CCM and PCM does: RPM plus CCM reaches approximately $168 per patient per month, and RPM plus PCM lands in a similar range, so the biggest revenue lever is usually adding monitoring rather than optimizing between the two coordination programs. These are approximate national figures for illustration; actual reimbursement depends on documented time and local rates.

Can you switch programs or bill both?

CCM and PCM cannot both be billed for the same patient in the same calendar month; they are mutually exclusive. The choice is not permanent, though. If a patient's clinical picture changes, for example a new qualifying condition is diagnosed or a dominant condition stabilizes, the practice can move the patient from one program to the other in a later month. There is also a nuance for multi-provider situations: a patient may receive PCM from one provider managing a specific condition and CCM from another provider managing the rest, when the conditions and documentation are clearly separate. The rule that trips practices up most is billing both for the same patient in the same month, which payers reject automatically.

Stacking with remote patient monitoring

Neither program has to stand alone. Both CCM and PCM can be billed alongside remote patient monitoring when the time and documentation for each are kept separate and distinct. Many chronic-disease patients qualify for monitoring as well as coordination, and stacking is the most common way practices increase per-patient value. A patient on RPM plus CCM can generate approximately $168 or more per month combined, and RPM plus PCM produces a similar layered result. Our guide to combining RPM and CCM shows how the time-tracking works in practice.

Common billing mistakes to avoid

Both programs are denied for similar, avoidable reasons. Building these checks into the workflow prevents most rejections.

Running either program without adding staff

Whichever program fits, the ongoing work is the same challenge: identifying eligible patients, maintaining care plans, logging time, and billing cleanly every month. That is difficult to sustain inside a busy practice without dedicated staff, which is why many organizations use a managed partner.

Nsight Health delivers care management as a fully managed program. A U.S.-based clinical team employed by Nsight Health handles enrollment, care coordination, documentation, and monthly billing files, and matches each patient to the right program based on their condition profile. We run the clinical program so your team does not have to build it. Nsight supports more than 130,000 patients across 1,700 provider teams and 480 clinics, with more than 40 million vitals monitored, delivering four programs under one roof: remote patient monitoring, chronic care management, behavioral health integration, and principal care management. This is how many provider organizations and health systems run care management at scale. To see how it would work for your patients, schedule a demo.

Frequently asked questions

What is the main difference between CCM and PCM?

The number of conditions. Chronic care management is for patients with two or more chronic conditions expected to last at least 12 months, while principal care management is for a single complex condition expected to last at least three months. CCM addresses the complexity of coordinating multiple conditions; PCM addresses intensive management of one dominant condition.

Can a patient be enrolled in both CCM and PCM?

Not in the same calendar month for the same patient, because the two programs are mutually exclusive. A patient can move between them in different months as their clinical picture changes, and in some multi-provider situations one provider may bill PCM for a specific condition while another bills CCM for the rest, with clearly separate documentation.

Which program pays more?

PCM's base code reimburses higher than CCM's base code, approximately $88 versus $66 per month, so for a patient who qualifies for both, PCM can be more favorable when the care centers on one condition. Actual amounts depend on documented time and local geographic rates.

Can specialists bill PCM?

Yes. Unlike advanced primary care management, which is limited to primary care, PCM can be billed by any qualified practitioner. A cardiologist managing advanced heart failure or a pulmonologist managing severe COPD can bill PCM for that condition.

Do CCM and PCM require patient consent?

Yes. Both programs require patient consent, obtained and documented before or at the time services begin, along with a care plan. Missing or undocumented consent is a common cause of denied claims for both programs.

Can CCM or PCM be billed with remote patient monitoring?

Yes. Both can be billed alongside remote patient monitoring when the time and documentation for each are kept separate. Stacking monitoring with a coordination program is the most common way practices increase per-patient value.

How long must the condition be expected to last?

CCM requires the conditions to be expected to last at least 12 months or until the end of life. PCM has a shorter threshold of at least three months, which makes it available for a serious condition with an intense but potentially shorter management window.

What happens if a patient's conditions change?

The program choice can change month to month. If a patient on PCM develops a second qualifying condition, the practice may move them to CCM the following month, and vice versa if a multi-condition patient's care narrows to one dominant condition. The key is billing only one program per patient per month.

Works Cited

Centers for Medicare & Medicaid Services. "Physician Fee Schedule Look-Up Tool." CMS.gov, cms.gov.

Centers for Medicare & Medicaid Services. "Medicare Coverage of Remote Patient Monitoring and Care Management." CMS.gov, cms.gov.

Centers for Disease Control and Prevention. "About Chronic Disease." CDC.gov, U.S. Department of Health and Human Services, cdc.gov.

Disclaimer

This article is for informational purposes only and does not constitute medical, legal, billing, or reimbursement advice. Reimbursement amounts are approximate national estimates based on the CY 2026 Medicare Physician Fee Schedule and vary by geographic locality and Medicare Administrative Contractor (MAC); always verify current rates using the CMS Physician Fee Schedule look-up tool and confirm coverage with the applicable payer. Nothing here guarantees any level of reimbursement. Practices should consult qualified clinical, compliance, and billing professionals before enrolling patients in a care management program. CPT is a registered trademark of the American Medical Association. All CPT code descriptions are paraphrased for clarity.

KEY TAKEAWAYS

• The primary Behavioral Health Integration billing code is CPT 99484, which reimburses approximately $57 per patient per month for 20 or more minutes of clinical staff time and does not require a psychiatrist.
• CMS groups several codes under the behavioral health integration umbrella. General BHI (99484) is the accessible entry point. The Collaborative Care Model codes (99492, 99493, 99494) describe a separate, more intensive model that requires a consulting psychiatrist.
• Nsight Health delivers general BHI. We do not provide Collaborative Care Model services. The CoCM codes are covered here as neutral education so practices understand the full code landscape.
• General BHI can be billed in the same month as Remote Patient Monitoring and Chronic Care Management for the same patient when documentation is kept separate. It cannot be billed with CoCM for the same patient in the same month.
• For 2026, CMS added optional Advanced Primary Care Management behavioral health add-on codes (G0568, G0569, G0570). These are additions to the landscape, not replacements. CPT 99484 and the CoCM codes remain active.
• BHI is one of the most underbilled Medicare programs in primary care. Nsight Health runs it as a fully managed service with a U.S.-based clinical team employed by Nsight Health.

Behavioral health is where the largest gap between need and care sits in American primary care. The National Institute of Mental Health estimates that more than 50 million American adults live with a mental illness in a given year, and most of them are never seen by a psychiatrist. They are managed, if they are managed at all, by a primary care team that was never resourced to do it. Depression and anxiety quietly worsen the outcomes of nearly every chronic medical condition, driving down medication adherence and driving up avoidable hospital use.

Behavioral Health Integration is the Medicare framework built to close that gap. It gives a medical practice a structured, reimbursable way to screen for behavioral health conditions, build a care plan, and manage patients between visits. The clinical case is strong, the reimbursement now follows it, and yet BHI remains one of the most underutilized care management programs in the country. The reason is almost never clinical willingness. It is billing confusion and staffing capacity.

This guide resolves the billing confusion. It lays out every 2026 BHI CPT code, what each one requires, what each one pays, how to document it, how to avoid the denials that trip up most practices, and how BHI layers with the other programs your Medicare patients already qualify for. General BHI, billed under CPT 99484, is the center of gravity because it is the model most practices can actually run, and it is the model Nsight Health delivers as a managed service.

What is Behavioral Health Integration?

Behavioral Health Integration is the practice of building mental and behavioral health screening, assessment, and care management directly into a medical practice rather than referring every patient out to separate specialty care. CMS reimburses it because integrated care produces better outcomes at a lower total cost, and because the specialty behavioral health workforce cannot meet demand on its own. In many markets, the wait for a new psychiatric appointment stretches for weeks or months, so the practical path to treatment runs through primary care.

On its care management resources, CMS classifies several billing codes together as behavioral health integration services. Those codes describe two distinct clinical models. The first is general BHI, a lighter-weight approach any practice can adopt with its existing clinical staff. The second is the Collaborative Care Model, a more intensive, team-based approach that adds a consulting psychiatrist. Knowing which model a code belongs to is the single most important thing to learn before billing, because the two are documented, staffed, and reimbursed very differently.

The complete 2026 BHI CPT code reference

The table below is the full set of codes CMS treats as behavioral health integration or its closely related pathways for 2026. General BHI is the code Nsight Health delivers. The Collaborative Care Model and the Advanced Primary Care Management add-on codes are included for completeness and are described in neutral, educational terms later in this guide.

Reimbursement figures are approximate national averages under the 2026 Medicare Physician Fee Schedule and vary by geographic locality under the Geographic Practice Cost Index (GPCI), by individual payer contract, and by Medicare Administrative Contractor (MAC) policy. Verify current rates with the CMS Physician Fee Schedule Look-Up Tool before billing.

Scope note. Nsight Health delivers general Behavioral Health Integration (CPT 99484). We do not provide Collaborative Care Model services. The CoCM and APCM add-on codes appear in this guide as neutral education so practices can understand the complete billing landscape and choose correctly.

General BHI: CPT 99484 in depth

General BHI is the entry point to integrated behavioral health for most practices. It recognizes that clinical staff spend meaningful time each month coordinating behavioral health care, and it pays for that work without requiring a psychiatrist on the team.

CPT 99484 covers 20 or more minutes of clinical staff time per calendar month, directed by a physician or other qualified healthcare professional, spent managing a patient's behavioral health condition. Eligible conditions include depression, anxiety, substance use disorders, and other mental or behavioral health diagnoses. The work is non-face-to-face care management: administering and reviewing validated assessments, updating the care plan, coordinating with any external behavioral health providers, and reaching out to the patient to support engagement and adherence.

General BHI does not require a formal collaborative care team. It is designed for practices that want to integrate behavioral health screening, care planning, and coordination using the staff they already have. That accessibility is exactly why it is the most sensible starting point for the vast majority of primary care and specialty practices, and why it is the model Nsight Health delivers as a managed service.

How CPT 99484 reimbursement is calculated in 2026

The approximately $57 national average for CPT 99484 is not a flat figure. Medicare reimbursement is built from Relative Value Units in the Physician Fee Schedule, multiplied by an annual conversion factor, then adjusted for local cost of practice. Three variables move the number your practice actually collects.

Reimbursement figures are approximate national averages under the 2026 Medicare Physician Fee Schedule and vary by geographic locality under the Geographic Practice Cost Index (GPCI), by individual payer contract, and by Medicare Administrative Contractor (MAC) policy. Verify current rates with the CMS Physician Fee Schedule Look-Up Tool before billing.

The practical takeaway is to treat approximately $57 as a planning baseline, then confirm your locality-specific rate with the CMS Physician Fee Schedule Look-Up Tool and your payer contracts before building revenue projections.

Collaborative Care Model codes (neutral education)

The Collaborative Care Model is a distinct, evidence-based program that CMS reimburses at a higher rate because it commits more clinical infrastructure. It is the more intensive tier of integrated behavioral health, and it is not part of the Nsight Health program suite. The information here is provided so practices can understand the full code set and bill correctly.

CoCM is defined by a three-person team. The treating primary care provider owns the patient relationship and submits the claims. A behavioral health care manager, typically a nurse, social worker, or counselor with behavioral health training, delivers the ongoing care management and maintains a registry that tracks each patient's measured progress. A psychiatric consultant reviews the registry and advises on treatment, generally without seeing the patient directly.

Reimbursement figures are approximate national averages under the 2026 Medicare Physician Fee Schedule and vary by geographic locality under the Geographic Practice Cost Index (GPCI), by individual payer contract, and by Medicare Administrative Contractor (MAC) policy. Verify current rates with the CMS Physician Fee Schedule Look-Up Tool before billing.

The higher reimbursement reflects the additional staffing and documentation burden. A practice cannot bill CoCM simply by intending to. It must maintain a registry with validated measures, document psychiatric consultant involvement each period, and meet the monthly time thresholds. For a practice without a consulting psychiatrist and the capacity to run a registry, CoCM is not a realistic starting point, which is why general BHI is where most integrated behavioral health programs begin.

What changed for BHI billing in 2026

The 2026 Medicare Physician Fee Schedule Final Rule made two structural changes worth understanding, on top of a rate environment that favors integrated behavioral health.

New optional add-on codes for Advanced Primary Care Management. CMS finalized three new HCPCS codes, G0568, G0569, and G0570, that can be billed as add-on services when an Advanced Primary Care Management base code is reported by the same practitioner in the same month. CMS designed them to be directly comparable to the existing CoCM and general BHI codes. They are additions to the landscape, not replacements. CPT 99484 and the CoCM codes 99492, 99493, and 99494 remain active for 2026. Any guidance claiming the older codes were retired is a misreading of the rule.

A billing change for FQHCs and RHCs. As of January 1, 2026, HCPCS code G0512, which Federally Qualified Health Centers and Rural Health Clinics previously used for collaborative care, was discontinued. Those settings now bill the standard CoCM codes and G2214 for Medicare collaborative care services. Practices in those settings should confirm current guidance with their MAC.

A favorable rate environment. CMS increased reimbursement across care management programs for 2026, which raised the general BHI rate to approximately $57 per patient per month. For practices weighing whether to formalize behavioral health integration, the financial objection is smaller than it has ever been.

BHI documentation requirements

Behavioral health integration is audited on documentation, so the program must be built to produce it. The essentials below apply to general BHI under CPT 99484.

At least one interactive contact with the patient or caregiver per calendar month is expected as part of the service. Missing any of these elements is the fastest route to a denied claim.

Which patients and conditions qualify

Any patient with a diagnosed mental, behavioral, or psychiatric condition being managed by the billing practice may be eligible for general BHI. There is no requirement for multiple conditions and no requirement that the condition be severe. Commonly documented qualifying conditions include:

• Major depressive disorder and other depressive conditions
• Generalized anxiety disorder and related anxiety conditions
• Substance use disorders, including alcohol and drug use
• Post-traumatic stress disorder
• Bipolar disorder
• Behavioral health conditions that coexist with chronic medical disease, such as depression alongside diabetes, heart failure, or COPD

The requirement is that the patient is receiving care from the billing practice and that the behavioral health condition is being actively managed and documented as part of a behavioral health integration program. That last point is what makes BHI both clinically valuable and reimbursable: it pays for care that is often already happening informally.

Common BHI denial reasons and how to avoid them

Most behavioral health integration denials trace back to a small number of documentation gaps. Building the program to prevent them is far cheaper than reworking claims.

Billing general BHI with RPM and CCM

Behavioral health rarely travels alone. The same Medicare patient often carries chronic medical conditions that qualify for other care management programs, and general BHI is designed to be billed alongside them when documentation is kept distinct for each service. Consider a patient with Type 2 diabetes, hypertension, and moderate depression.

Reimbursement figures are approximate national averages under the 2026 Medicare Physician Fee Schedule and vary by geographic locality under the Geographic Practice Cost Index (GPCI), by individual payer contract, and by Medicare Administrative Contractor (MAC) policy. Verify current rates with the CMS Physician Fee Schedule Look-Up Tool before billing.

The clinical logic matters more than the arithmetic. Treating the depression improves medication adherence for the diabetes and hypertension, which produces better biometric data through remote monitoring, which reduces the hospitalizations that chronic care management is designed to prevent. Each program reinforces the others. For a deeper look at combining programs, see the Nsight Health guide to chronic care management billing in 2026 and the behavioral health integration implementation guide.

Validated screening tools for BHI

CMS does not mandate a specific instrument, but validated tools are expected, and they double as the measured outcomes that demonstrate medical necessity. Build screening into intake so clinical staff administer it before the provider enters the room.

BHI revenue at scale

Per patient, general BHI is modest. Across an eligible panel, it becomes a meaningful, recurring line that funds the behavioral health work a practice is often already doing. The scenarios below assume general BHI only, before layering with RPM or CCM, at the approximately $57 national average.

Reimbursement figures are approximate national averages under the 2026 Medicare Physician Fee Schedule and vary by geographic locality under the Geographic Practice Cost Index (GPCI), by individual payer contract, and by Medicare Administrative Contractor (MAC) policy. Verify current rates with the CMS Physician Fee Schedule Look-Up Tool before billing.

These figures illustrate scale using the national average and are not a guarantee of reimbursement. Actual results depend on eligible panel size, enrollment, locality, and payer mix.

How Nsight Health delivers fully managed general BHI

Behavioral health integration is one of the most underutilized care management programs in primary care, and the reason is almost always operational rather than clinical. Practices know their patients need it. They lack the staff time to run monthly screening, care planning, coordination, and documentation at scale.

Nsight Health delivers general BHI as a fully managed service. A U.S.-based clinical team employed by Nsight Health administers validated screenings, maintains the care plan, delivers the monthly care management, and produces audit-ready documentation under your provider's direction. Your practice keeps clinical oversight and the patient relationship. We run the program. You bill, collect, and grow.

General BHI is one of four clinically managed programs Nsight Health delivers under one roof, alongside Remote Patient Monitoring, Chronic Care Management, and Principal Care Management. Because the same team manages every program, layering behavioral health integration onto a patient's existing care plan does not require coordinating multiple vendors.

Frequently asked questions

What is the main CPT code for Behavioral Health Integration?

The primary code is CPT 99484, general BHI, which covers 20 or more minutes of clinical staff time per calendar month directed by a physician or qualified healthcare professional. It reimburses approximately $57 per patient per month as a 2026 national average.

How much does CPT 99484 reimburse in 2026?

General BHI under CPT 99484 reimburses approximately $57 per patient per month as a national average under the 2026 Medicare Physician Fee Schedule. Actual payment varies by geographic locality, payer contract, and Medicare Administrative Contractor policy.

Does BHI require a psychiatrist?

No. General BHI (CPT 99484) requires only clinical staff directed by a physician or qualified healthcare professional. A psychiatric consultant is required for the Collaborative Care Model, not for general BHI.

What is the difference between general BHI and CoCM?

General BHI (99484) is delivered by clinical staff under the treating physician and does not require a psychiatrist. The Collaborative Care Model (99492, 99493, 99494) adds a behavioral health care manager and a consulting psychiatrist and reimburses at a higher rate. Nsight Health delivers general BHI and does not offer CoCM.

Can BHI be billed with RPM and CCM for the same patient?

Yes. General BHI can be billed in the same calendar month as Remote Patient Monitoring and Chronic Care Management for the same patient, provided the time and clinical activities are documented separately for each program.

Can general BHI and CoCM be billed in the same month?

No. General BHI and the Collaborative Care Model are mutually exclusive for the same patient in the same calendar month. A practice bills one model or the other for a given patient in a given month.

Did the new 2026 G-codes replace CPT 99484?

No. The 2026 codes G0568, G0569, and G0570 are optional add-on codes to Advanced Primary Care Management. CPT 99484 and the CoCM codes remain active for 2026. The new codes add a billing pathway; they do not retire the existing ones.

What documentation is required to bill 99484?

A behavioral health care plan, a time log showing 20 or more minutes of clinical staff time in the month, results from a validated assessment, and a documented initiating visit and consent for new or lapsed patients.

What screening tools are used for BHI?

CMS does not mandate a specific instrument, but validated tools are expected. The PHQ-9 for depression and GAD-7 for anxiety are the most widely used, with the AUDIT-C for alcohol use and DAST-10 for drug use.

How does Nsight Health support BHI?

Nsight Health provides a U.S.-based clinical team employed by Nsight Health that handles validated screening, care planning, monthly care management, and audit-ready documentation under your provider's direction, so your practice can integrate behavioral health without adding staff.

Works Cited

Centers for Medicare and Medicaid Services. "Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule." CMS.gov, www.cms.gov/medicare/payment/fee-schedules/physician.

Centers for Medicare and Medicaid Services. "Physician Fee Schedule Look-Up Tool." CMS.gov, www.cms.gov/medicare/physician-fee-schedule/search.

National Institute of Mental Health. "Mental Illness." NIMH.NIH.gov, www.nimh.nih.gov/health/statistics/mental-illness.

Agency for Healthcare Research and Quality, Academy for Integrating Behavioral Health and Primary Care. "New Medicare Billing Practices for Collaborative Care Take Effect." Integrationacademy.ahrq.gov, integrationacademy.ahrq.gov.

This article is for educational and informational purposes only and does not constitute legal, billing, clinical, or medical advice. CPT codes, reimbursement rates, and regulatory requirements referenced herein are based on publicly available CMS guidance current as of 2026 and are subject to annual updates, geographic adjustment, and payer-specific variation. Nothing in this article should be construed as a guarantee of reimbursement or a recommendation for specific billing practices. Consult a qualified billing compliance specialist, healthcare attorney, or your Medicare Administrative Contractor for guidance applicable to your practice. CPT is a registered trademark of the American Medical Association.

Nsight Health delivers clinically managed remote care, including Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management, with a U.S.-based clinical team employed by Nsight Health supporting 130,000+ patients across 1,700+ providers and 480+ clinics. Schedule a demo to learn how we can help your practice launch or expand behavioral health integration.

Quick answer: Remote patient monitoring companies generally fall into five types: software-only platforms, device and connectivity vendors, fully managed clinical partners, enterprise and hospital-at-home providers, and condition-specific point solutions. The difference that matters most is who performs the clinical monitoring work. Provider organizations that want continuous oversight without hiring and managing new staff typically choose a fully managed remote patient monitoring partner with a U.S.-based clinical team.

Search "remote patient monitoring companies" today and you will find a crowded, confusing field. The category has expanded fast, pushed by an aging population, the shift to value-based care, and Medicare's steady expansion of reimbursable remote care. The problem for a provider organization is that the companies returned by that search are not the same kind of business. Some sell software. Some ship devices. Some supply a full clinical team. Comparing them head to head is like comparing a car, an engine, and a chauffeur because all three showed up under "transportation."

This guide fixes that. Instead of a ranked list, it gives you a map of the market: the distinct types of remote patient monitoring companies, what each actually delivers, which one fits which kind of buyer, and the signals that separate a strong partner from a weak one. Once you can see the categories clearly, choosing becomes far easier. And when you are ready to evaluate specific vendors, we link to our detailed decision guide at the end.

The remote patient monitoring market in 2026

Remote patient monitoring has moved from a telehealth novelty to core clinical infrastructure. Providers face rising chronic disease prevalence, tighter margins, and payment models that increasingly reward outcomes over volume. Remote monitoring answers all three at once by extending a practice's clinical reach into the patient's home between visits.

Three trends define the current landscape. First, consolidation: the field is maturing, and buyers increasingly prefer one accountable vendor over a patchwork of point tools. Second, cellular-connected devices have become the standard, because they transmit automatically without Wi-Fi, Bluetooth pairing, or an app, which removes the biggest barrier to patient adherence. Third, program stacking: the leading companies no longer offer monitoring alone but layer complementary Medicare programs so a single patient can be served across several reimbursable services. Understanding those trends is useful, but the decision still comes down to what type of company you are actually evaluating.

The five types of remote patient monitoring companies

Nearly every company that appears under this search falls into one of five categories. The categories differ most in one respect: how much of the operational and clinical work they take on, versus how much they leave to you.

1. Software-only platforms

These companies provide a dashboard: a place to view patient data, document time, and generate billing reports. They are often well designed and affordable. The catch is that software does not monitor patients. Your staff still reviews the data every day, makes the monthly patient contact, and manages escalation. A software-only platform is a tool, not a team, so it solves the visibility problem while leaving the staffing problem exactly where it was.

2. Device and connectivity vendors

These companies specialize in the hardware and the data pipe: FDA-cleared blood pressure cuffs, glucometers, scales, and pulse oximeters, plus the cellular connectivity that gets readings from the home to a dashboard. They are essential to any program and some are excellent at logistics and fulfillment. But like software-only vendors, they hand you the inputs and leave the clinical work and billing to your team.

3. Fully managed clinical partners

These companies supply the whole operation: the devices, the software, and, critically, the clinical team that enrolls patients, reviews data daily, makes the monthly contact, documents time, and prepares the billing file. The practice keeps clinical ownership and direction while the partner runs the day-to-day program. This is the only model that actually removes the staffing barrier, which is why it has become the fastest-growing segment of the market. It is also the model that best supports practices without spare capacity to build a program in-house.

4. Enterprise and hospital-at-home providers

These companies are built for large health systems running high-acuity use cases: post-discharge monitoring to prevent readmissions, and acute hospital-at-home programs that substitute for inpatient stays. They tend to carry deep enterprise EHR integrations and operate within distinct regulatory frameworks. They are powerful for systems with the scale and internal resources to match, and often more than a typical practice or group needs.

5. Condition-specific point solutions

These companies focus on a single disease state or device type, such as continuous glucose monitoring for diabetes or cardiac device monitoring. They can be excellent within their niche. The tradeoff is fragmentation: a practice managing patients with multiple conditions can end up stitching together several point solutions, each with its own dashboard, contract, and billing workflow.

The decision that matters most: who does the clinical work

Cut through every feature list and one question decides more than any other. When a patient's blood pressure spikes on a Tuesday, who reviews it, who calls the patient, and who documents the interaction? If the answer is your staff, you have bought a tool. If the answer is the company's clinical team, you have bought a service.

This is the full-service versus software-only fork, and it determines whether a remote monitoring program actually reduces your team's workload or quietly adds to it. Many programs stall not because the technology failed but because no one at the practice had time to work the data every day. A fully managed partner is designed to prevent exactly that failure. For a complete framework on evaluating a specific vendor once you have chosen a model, see our guide on how to choose a remote patient monitoring company.

How company type maps to buyer type

There is no single best type of remote patient monitoring company. There is only the best fit for a given organization's size, resources, and goals. The mapping below is a starting point.

Nsight Health builds fully managed programs across these buyer types, including dedicated approaches for ACOs and health systems.

What separates the best remote patient monitoring companies

Within any category, quality varies. These are the signals that consistently separate a strong company from a weak one. Use them as a quick screen, then apply a full evaluation framework to your finalists.

For the full nine-point evaluation, including contracting terms and data security, work through our vendor decision guide.

The fully managed clinical partner category, and where Nsight Health fits

Among the five types, the fully managed clinical partner is the model built to deliver proactive care without adding staff, and it is the category where Nsight Health operates. Nsight is not a software platform you have to run and not a device vendor that ships hardware and steps back. Nsight supplies the devices, the software, and a U.S.-based clinical team employed by Nsight Health that monitors patients 24/7, handles enrollment and engagement, documents time, and delivers a claims-ready billing file. In the words of the MedTech Breakthrough judges, Nsight operates as "an extension of the clinical enterprise."

The clinical evidence behind the model

A fully managed model only matters if it produces results between visits, and the program's own data points that way. In its hypertension population, Nsight Health has observed an average systolic blood pressure reduction of approximately 11.5 mmHg overall, and approximately 29.6 mmHg among patients with Stage 2 hypertension, at or above the range reported in the published telemonitoring literature. It has also observed an approximately 55 mg/dL reduction in random glucose readings and meaningful blood pressure reductions in patients with chronic kidney disease. In a randomized evaluation of the legacy structured program model on which Nsight Health's heart failure monitoring was built, admissions fell by more than 50 percent reduction* and mortality fell by approximately 52 to 56 percent reduction*. These figures represent internal program data, are not the result of a peer-reviewed controlled trial, and individual results vary. The full evidence and sources are in our remote patient monitoring clinical outcomes analysis.

That model has been independently validated. Nsight Health was named the Best RPM Solution in the 2026 MedTech Breakthrough Awards, an independent program that evaluates platforms on clinical effectiveness, operational scalability, and the ability to sustain outcomes beyond initial deployment. Nsight also won a Gold Stevie Award for Best Health Products and Services at the 2026 American Business Awards, and a Silver Stevie for Fastest-Growing Company. Independent recognition of both what Nsight built and how fast it is growing points to the same conclusion: a clinical model that works.

The economic evidence

Better clinical management between visits should lower downstream cost, and an independent analysis points in that direction. Nsight Health engaged Optum to run a retrospective, matched-cohort, difference-in-difference analysis comparing Nsight patients with matched Medicare fee-for-service controls age 65 and older across three chronic disease cohorts. Nsight patients showed lower first-year total medical spending growth than matched controls, with estimated savings of approximately $2,500 to $3,000 per member per year before program costs. All six economic comparisons favored Nsight, with the diabetes and chronic kidney disease results showing the strongest statistical signal, though the findings did not reach the conventional 0.05 threshold for statistical significance. The results are best read as an early, directionally favorable economic signal rather than definitive proof. The full methodology is in our Nsight-Optum cost savings analysis.

Two things distinguish Nsight within the category. First, program breadth. Most companies offer one or two programs. Nsight delivers four under one roof, Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management, through a single integration, so a provider can layer programs for a patient without coordinating multiple vendors. Second, alignment. Nsight operates at no upfront cost, with fees tied to successful reimbursement, so the model aligns with practice collections rather than adding fixed overhead. You keep clinical ownership. You bill, collect, and grow.

Common mistakes when comparing remote patient monitoring companies

Even organizations that run a careful process tend to stumble on the same few things. Knowing them in advance saves months of wasted effort.

• Buying software and underestimating the staffing it still requires. This is the most frequent and most costly mistake. A polished dashboard looks like a solution, but if no one on your team has time to work the data every day, the program stalls. Decide who does the clinical work before you decide which tool to buy.
• Choosing on device catalog size instead of the clinical model. A long list of supported devices is easy to compare and mostly beside the point. What determines outcomes is whether someone reviews the readings and acts on them, not how many gadgets are on the shelf.
• Ignoring program breadth. Picking a company that supports only one program means adding another vendor the moment a patient needs a second one. Breadth under one roof prevents a future of stitched-together contracts, dashboards, and billing workflows.
• Overlooking billing and documentation rigor. This is where reimbursement quietly leaks and where audit risk lives. A company that captures time, consent, and care plans to CMS standards protects both your revenue and your compliance posture.
• Treating it as a pilot instead of an operation. Programs that are launched and then left to run themselves fade. The companies worth choosing are built to sustain a program at production scale, not just to switch it on.

Avoiding these comes down to the same principle that organizes this whole guide: identify the type of company first, confirm who owns the clinical work, and validate that the partner can sustain the program. If you want to pressure-test a specific vendor against a full checklist, our decision guide walks through all nine criteria, and you can always schedule a demo to see a fully managed program up close.

The bottom line

The phrase "remote patient monitoring companies" hides real differences. Before comparing features, identify which of the five types you are looking at, because that determines how much work lands on your team. For most practices, groups, and value-based entities that lack spare staff, the fully managed clinical partner is the model that delivers proactive care without new hires. Within that category, evaluate on clinical staffing, program breadth, device logistics, EHR integration, compliant billing, and independent validation. Nsight Health was built to meet all six, and has the third-party recognition and national scale to back it. When you are ready to compare specific vendors, use our decision guide, and when you want to see the fully managed model in action, the next step is a conversation.

Frequently asked questions

What are the main types of remote patient monitoring companies?

There are five common types: software-only platforms, device and connectivity vendors, fully managed clinical partners, enterprise and hospital-at-home providers, and condition-specific point solutions. They differ most in how much of the clinical and operational work they take on versus leave to your staff.

What is the difference between a software-only RPM company and a fully managed one?

A software-only company gives you a dashboard, but your staff still reviews data, contacts patients, and manages the program. A fully managed clinical partner supplies the clinical team that does that work, so the practice keeps clinical ownership without adding headcount.

Which type of remote patient monitoring company is best?

There is no single best type. The right fit depends on your organization. Independent practices and groups without spare staff capacity are usually best served by a fully managed clinical partner, while large health systems may need enterprise or hospital-at-home capabilities for high-acuity use cases.

What should I look for when comparing RPM companies?

Screen on clinical staffing, program breadth, device logistics, EHR integration, billing and compliance rigor, and independent validation. Then apply a full evaluation framework to your finalists before signing.

Is Nsight Health a software company or a service company?

Nsight Health is a fully managed clinical partner. It provides the devices, the software, and a U.S.-based clinical team that monitors patients 24/7, handles enrollment and documentation, and prepares claims-ready billing, rather than handing you a tool to run yourself.

What awards has Nsight Health won?

Nsight Health was named the Best RPM Solution in the 2026 MedTech Breakthrough Awards and won a Gold Stevie Award for Best Health Products and Services, plus a Silver Stevie for Fastest-Growing Company, at the 2026 American Business Awards.

How many programs does Nsight Health offer?

Four programs under one roof: Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management, delivered through a single integration so providers can layer programs for a patient without coordinating multiple vendors.

Does working with an RPM company require adding staff?

Not with a fully managed clinical partner. That model exists specifically so a practice can run a proactive program using the partner's clinical team, without hiring or reassigning its own staff.

How do RPM companies handle billing and reimbursement?

Approaches vary by type. Software and device vendors typically provide billing reports but leave claim capture to you. A fully managed partner captures the time and documentation each program requires and delivers a claims-ready billing file, though the practice bills and collects. Reimbursement amounts vary by geographic locality.

Is there evidence that Nsight Health's model improves outcomes?

Nsight Health reports internal program data including an average systolic blood pressure reduction of approximately 11.5 mmHg overall and approximately 29.6 mmHg in Stage 2 hypertension patients, plus an approximately 55 mg/dL reduction in random glucose readings. These are internal observations, not the result of a peer-reviewed controlled trial, and individual results vary. Heart failure figures cited by the program reflect a legacy structured heart failure program on which Nsight's model was built, not Nsight proprietary data.

Does Nsight Health reduce medical costs?

An independent retrospective analysis by Optum estimated savings of approximately $2,500 to $3,000 per member per year before program costs for Nsight patients versus matched Medicare fee-for-service controls. The findings were directionally favorable across all cohorts but did not reach the conventional 0.05 threshold for statistical significance, so they are best read as an early economic signal rather than a guarantee of savings.

Disclaimer: This article is for informational purposes only and does not constitute legal, billing, clinical, or financial advice. Comparisons of company types are general and may not reflect every vendor within a category. Award recognitions are those of the issuing organizations and reflect their opinions and criteria; they are not statements of fact and are not endorsements of any particular vendor by any government agency. Nsight Health does not guarantee any specific clinical outcome, reimbursement amount, or financial result. Clinical outcome figures (including blood pressure and glucose reductions) represent internal Nsight Health program data, are not the result of a peer-reviewed controlled trial, and individual patient results vary. *The greater than 50 percent heart failure admission reduction and the approximately 52 to 56 percent mortality reduction reflect data reported by a legacy structured heart failure remote monitoring program upon which Nsight Health's program was built and are not derived from Nsight Health proprietary data. The Nsight-Optum economic figures reflect a retrospective, matched-cohort, difference-in-difference analysis of Medicare fee-for-service patients age 65 and older; results were directionally favorable but did not reach conventional statistical significance (a p-value below 0.05), exclude program costs, and are not a guarantee of savings. Reimbursement varies by geographic locality and by your Medicare Administrative Contractor (MAC). CPT is a registered trademark of the American Medical Association.

Works Cited

Centers for Disease Control and Prevention. "About Chronic Disease." CDC.gov, U.S. Department of Health and Human Services, cdc.gov.

National Heart, Lung, and Blood Institute. "High Blood Pressure." NHLBI, National Institutes of Health, nhlbi.nih.gov.

MedTech Breakthrough. "Nsight Health Recognized for Remote Patient Monitoring Innovation in 2026 MedTech Breakthrough Awards Program." GlobeNewswire, 7 May 2026, Nsight Health Newsroom.

The Stevie Awards. "The 2026 American Business Awards: Company and Organization Category Winners." Stevie Awards, 2026, Nsight Health Newsroom.

Nsight Health. "Remote Patient Monitoring Clinical Outcomes: The Evidence." Nsight Health, 2026, blog.nsightcare.com.

Nsight Health. "Remote Patient Monitoring Cost Savings in High-Risk Medicare Patients: Early Evidence From the Nsight-Optum Economic Analysis." Nsight Health, 2026, blog.nsightcare.com.

Centers for Medicare & Medicaid Services. "Calendar Year 2026 Medicare Physician Fee Schedule Final Rule." CMS.gov, 2025, www.cms.gov/medicare/payment/fee-schedules/physician.

Proactive chronic care closes that gap. It gives a practice a continuous line of sight into patients between appointments, so a rising blood pressure trend or a missed medication pattern gets caught in days rather than months. The clinical case for it is well established. The reason more practices do not run these programs is almost never disagreement about the value. It is capacity. Primary care teams are already stretched, and building a monitoring and care-coordination operation from scratch means hiring, training, and managing staff that most practices do not have room for.

This guide explains how a primary care practice can deliver genuinely proactive, between-visit chronic care without adding a single new hire, by using a fully managed model where an outside clinical team runs the day-to-day program under the practice's direction. It covers what proactive care actually looks like clinically, how the staffing problem gets solved, the four Medicare care management programs that make it possible, how implementation works, and where the reimbursement lands.

What proactive chronic care actually looks like

Traditional primary care is reactive by design. A patient presents with a symptom, the practice responds. Proactive chronic care inverts that. Instead of waiting for the next visit or the next crisis, the care team watches the patient's condition continuously and intervenes early, while a problem is still small and correctable.

In practice, it means a few concrete things happening every day without the physician having to initiate them. Patients with chronic conditions take readings at home using connected devices, and that data flows automatically to a clinical dashboard. Clinical staff review the incoming data, establish each patient's baseline, and set alert thresholds. When a reading crosses a threshold, someone on the care team reaches out, checks in, and escalates to the provider when the clinical picture warrants it. Between the data reviews, patients receive regular contact from a care manager who helps with medication questions, coordinates follow-ups, and keeps the care plan on track.

The clinical payoff is earlier intervention and fewer things falling through the cracks. A blood pressure that trends upward over ten days gets addressed before it becomes a hypertensive event. A patient who stops taking a medication is identified through the data pattern, not discovered three months later. A heart failure patient's weight gain, an early warning of fluid retention, triggers a call rather than a hospitalization. This is the difference between managing chronic disease and merely documenting it.

It also changes what patients experience. When someone knows their numbers are being watched and that a real person will call if something looks off, the relationship with the practice shifts. Patients become more engaged with their own health day to day, not just on the mornings they have an appointment. That engagement is itself a driver of better adherence and better outcomes.

Why most primary care practices do not do this today

If the clinical value is clear, why is proactive chronic care still the exception rather than the rule in primary care? The honest answer is operational. Running one of these programs well is a real clinical operation, and it competes directly for the resource primary care has least of: staff time.

A properly run program needs people to enroll patients and obtain consent, to distribute and support connected devices, to review incoming data every day, to document time and clinical decisions for each patient every month, to make the required monthly patient contact, and to handle the billing correctly across multiple CPT codes with strict time and documentation rules. For a practice already running at capacity, that is a full workflow, not a side task. Ask a medical assistant to add daily data review on top of rooming patients and returning calls, and one of those jobs gets shortchanged.

The result is a familiar pattern. Practices either never launch, launch and then let the program stall because no one has time to sustain it, or run it at low capture, missing much of the clinical value and most of the reimbursement because the documentation and time tracking are inconsistent. The barrier is not the concept. It is the labor.

The fully managed model: proactive care without new hires

The way primary care practices solve the staffing problem is to keep the clinical direction in-house and outsource the operational labor to a partner that supplies the clinical team and the infrastructure. This is the model Nsight Health runs. The practice owns the patient relationship and the clinical decisions. The partner runs the day-to-day program.

In this model, a U.S.-based clinical team employed by Nsight Health, including registered nurses, licensed vocational nurses, and medical assistants, handles the recurring work: patient enrollment and consent, device fulfillment and setup support, daily monitoring of incoming data, monthly care coordination calls, time and documentation capture, and preparation of the monthly billing file. The practice's providers stay in the loop through the dashboard and escalation, review flagged patients, and make the clinical calls that require a physician. No one on the practice's own payroll is pulled off their existing job.

The distinction that matters here is between a software vendor and a clinical partner. A software-only tool hands the practice a dashboard and leaves the staffing problem exactly where it was, because someone at the practice still has to do all the human work. A fully managed clinical partner supplies the people who do that work. The plainest way to describe the division of labor is this: we run the clinical program, and we deliver your monthly billing file. You bill, collect, and grow.

Scale is part of what makes this dependable. Nsight Health supports more than 130,000 patients across 1,700+ providers and 480+ clinics, and has monitored more than 40 million vitals. A practice adding a program is not standing up an experiment. It is plugging into an operation that already runs at that volume every day.

Four programs under one roof

Proactive chronic care is not a single service. It is a set of complementary Medicare care management programs, each built for a different clinical situation. Nsight Health operates four of them under one roof, which lets a practice match the right program to each patient rather than forcing everyone into one framework. The four programs are Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management.

Remote Patient Monitoring (RPM)

Remote Patient Monitoring uses connected, FDA-cleared devices to track physiological data such as blood pressure, blood glucose, weight, and pulse oximetry from the patient's home. The data transmits digitally to the care team, which reviews it, spots concerning trends, and intervenes. RPM is the program that gives a practice daily, objective visibility into a patient's condition. It suits any patient with a chronic or acute condition where a measurable vital sign tells the clinical story.

Chronic Care Management (CCM)

Chronic Care Management covers non-face-to-face care coordination for patients with two or more chronic conditions expected to last at least twelve months. Where RPM watches the numbers, CCM manages the whole person: the care plan, medication reconciliation, coordination among specialists, and the regular contact that keeps a complex patient on track. RPM and CCM are complementary, and many patients benefit from both.

Behavioral Health Integration (BHI)

Behavioral Health Integration brings mental and behavioral health management into the primary care setting through proactive follow-up and care coordination for patients with conditions such as depression or anxiety. Because behavioral and physical health are deeply linked, especially in chronic disease, BHI closes a gap that purely physical monitoring leaves open.

Principal Care Management (PCM)

Principal Care Management is built for patients with a single serious, high-acuity chronic condition that requires focused ongoing management, rather than the two-or-more-condition profile that CCM addresses. It lets a practice deliver structured care coordination for a patient whose care is centered on one dominant condition.

Running all four under one partner matters operationally. The practice does not have to stitch together separate vendors, separate dashboards, and separate billing workflows. One clinical team assesses each patient, enrolls them in the program or programs that fit, and manages the whole thing under a single roof. It is worth noting that these are the four programs Nsight Health operates. Other Medicare frameworks exist, but this is the set built into a coordinated primary care program.

How RPM and CCM work together

The two workhorse programs for primary care are RPM and CCM, and they are designed to complement each other. RPM supplies the objective, day-to-day physiological data. CCM supplies the human care coordination and the care plan that turns that data into action. CMS recognizes them as distinct, separately billable services that can be provided to the same patient in the same month, as long as the time and documentation for each are tracked separately and not double counted.

Used together, they create a closed loop. The device flags a change, the care manager acts on it within the care plan, the provider is looped in when needed, and the whole interaction is documented. That loop is what proactive care looks like in operation, and it is exactly the work a fully managed clinical team takes off the practice's plate.

Implementation without disrupting your staff

The point of a managed model is that going live does not turn into a project the practice has to staff. A well-run onboarding follows a clear sequence and keeps the practice's own workload minimal.

Integration with the practice's existing systems reduces friction further. When monitoring data and care documentation surface inside the electronic health record the providers already use every day, the program becomes part of the existing workflow rather than a separate system to check. The practice's team keeps working the way it already works, and the proactive care runs alongside it.

A large share of most panels is already eligible. Practices are typically sitting on a substantial base of patients with qualifying chronic conditions who could benefit from a program today. The constraint has been the labor to reach and manage them, which is precisely the constraint a managed model removes. Schedule a demo to see how the onboarding sequence would map to your panel.

The reimbursement picture

The clinical and operational case comes first, and it should. But proactive chronic care is also financially sustainable, which is what lets a practice run it indefinitely rather than as a short-lived pilot. Medicare reimburses these programs through established CPT codes, and the 2026 Physician Fee Schedule increased care management reimbursement meaningfully. The figures below are national averages and are approximate. Actual amounts vary by geographic locality and are adjusted by your Medicare Administrative Contractor.

Because RPM and CCM can be billed for the same patient in the same month when documented separately, a practice managing a patient across both programs can generate layered, recurring monthly reimbursement per enrolled patient. Behavioral Health Integration and Principal Care Management add further reimbursable pathways for the patients they fit. In a managed model, the partner captures the time and documentation that these codes require, which is often where practices running programs alone leave legitimate reimbursement uncollected. You can model the numbers for your own panel using the RPM and CCM reimbursement calculator. For a deeper breakdown of the CCM codes specifically, see our 2026 CCM billing and reimbursement guide.

One note on program requirements: the management-time codes require at least one interactive communication with the patient per calendar month. The specifics of what CMS counts here are governed by CMS and CPT guidance, and a good clinical partner documents to that standard so the practice stays compliant.

What to look for in a partner

Not all remote care offerings are the same, and the difference determines whether the staffing problem actually gets solved. A few things separate a genuine clinical partner from a tool that leaves the work behind.

• A real clinical team, not just software. Ask who does the daily data review and the monthly patient contact. If the answer is your staff, the capacity problem has not been solved. A fully managed partner supplies a U.S.-based clinical team that does that work.
• Clinical model first. The partner should be able to describe how patients are monitored, how alerts are handled, and how escalation reaches your providers, before it talks about revenue.
• Multiple programs under one roof. A partner running RPM, CCM, BHI, and PCM together can match each patient to the right program and manage them in one place, rather than leaving you to coordinate vendors.
• Documentation and compliance rigor. Time tracking, consent, care plans, and billing files should be handled to CMS standards, because that is what protects both compliance and reimbursement.
• Integration with your EHR. Data and documentation should surface where your team already works.

The practices getting the most from proactive chronic care are the ones that kept clinical ownership and handed off the labor. That is the whole idea: better between-visit care for patients, no new hires for the practice, and a sustainable program that pays for itself. Schedule a demo to see what a program mapped to your panel would look like.

Frequently asked questions

Can a small primary care practice run these programs without hiring staff?

Yes. That is the central benefit of a fully managed model. A U.S.-based clinical team employed by the partner handles enrollment, device support, daily monitoring, monthly patient contact, documentation, and billing preparation. The practice directs the clinical care and bills for the services, but does not add headcount to run the day-to-day operation.

What is the difference between RPM and CCM?

RPM tracks physiological data from connected devices in the patient's home and focuses on early detection of concerning trends. CCM provides non-face-to-face care coordination and care planning for patients with two or more chronic conditions. They serve different functions and are designed to work together for patients who qualify for both.

Can RPM and CCM be billed for the same patient in the same month?

Yes. CMS recognizes RPM and CCM as distinct, separately billable services. They can be provided to the same patient in the same calendar month as long as the time and documentation for each are tracked separately and no time is counted twice.

Which patients are eligible?

RPM suits patients with a chronic or acute condition that can be tracked by an FDA-cleared device. CCM requires two or more chronic conditions expected to last at least twelve months. PCM is for patients with a single serious chronic condition, and BHI is for patients with a behavioral health condition being managed in primary care. Most primary care panels already contain a large base of eligible patients.

How much can a practice expect to be reimbursed?

Reimbursement depends on the programs a patient is enrolled in and the time documented each month, and rates vary by geographic locality. As a reference, 2026 national averages run approximately $66 for the first 20 minutes of CCM staff time and approximately $52 for the first 20 minutes of RPM management time, with additional codes layering on top. Because these are approximate national figures, a practice should model its own panel and confirm local rates.

Do these programs require the patient to be tech-savvy?

No. Modern connected devices, including cellular-enabled monitors, transmit readings automatically without requiring the patient to manage an app or pair equipment. The clinical team also supports patients through setup, which keeps adherence high across a typical Medicare population.

How long does implementation take?

In a managed model, most of the launch work is done by the partner, so the practice's own lift is minimal. Timelines vary by practice size and panel, but onboarding is designed to avoid becoming a project the practice has to staff.

Does this integrate with our existing EHR?

A strong partner surfaces monitoring data and care documentation inside the EHR the practice already uses, so the program fits into existing workflows rather than adding a separate system to check.

Is proactive chronic care only for Medicare patients?

These CPT codes are established Medicare pathways, and Medicare fee-for-service patients are the most straightforward fit. Many commercial payers also reimburse care management services, though coverage and rates vary by plan, so confirm payer-specific policies.

The bottom line

The gap between visits is where chronic disease gets worse, and closing it is one of the highest-value things a primary care practice can do for its patients. The reason more practices do not is capacity, not conviction. A fully managed model resolves that by supplying the clinical team and infrastructure to run proactive care every day, while the practice keeps clinical ownership and adds no new staff. Better care for patients, no new hires, and a program that sustains itself. Schedule a demo with Nsight Health to see how it would work for your practice.

Disclaimer: This article is for informational purposes only and does not constitute legal, billing, clinical, or financial advice. Reimbursement figures are approximate national averages for calendar year 2026, are subject to change, and vary by geographic locality and by your Medicare Administrative Contractor (MAC). Practices should verify current rates against the CMS Physician Fee Schedule and confirm coverage with applicable payers. Nsight Health does not guarantee any specific clinical outcome, reimbursement amount, or financial result. CPT is a registered trademark of the American Medical Association. CPT codes, descriptions, and material are copyright the American Medical Association.

Works Cited

Centers for Medicare & Medicaid Services. "Calendar Year 2026 Medicare Physician Fee Schedule Final Rule." CMS.gov, 2025, www.cms.gov/medicare/payment/fee-schedules/physician.

Centers for Medicare & Medicaid Services. "Medicare Physician Fee Schedule Final Rule Summary: CY 2026." CMS.gov, 2025, www.cms.gov/files/document/mm14315-medicare-physician-fee-schedule-final-rule-summary-cy-2026.pdf.

American Medical Association. "CPT (Current Procedural Terminology)." AMA-ASSN.org, www.ama-assn.org/practice-management/cpt.

This guide explains how remote patient monitoring and chronic care management work together to improve patient health outcomes and strengthen the healthcare revenue cycle in primary care. It covers how each service works, who qualifies, the 2026 medical billing codes that make concurrent billing more flexible, the clinical evidence behind remote monitoring, and what separates programs that succeed from those that never reach the patients who need them.

What Are RPM and CCM Programs?

Remote Patient Monitoring: Clinical Overview

Remote patient monitoring uses FDA-cleared, cellular-enabled devices to capture patient vital signs continuously between office visits and transmit that data automatically to a clinical team. The ordering provider receives real-time physiologic data without requiring the patient to schedule an appointment, travel to a clinic, or interact with any technology beyond the device itself.

The most common RPM devices include cellular-enabled blood pressure monitors, weight scales, pulse oximeters, and blood glucose monitors. In each case, the device takes a reading and transmits it automatically over a cellular connection to the patient record and to the monitoring clinical team. No WiFi. No smartphone app. No Bluetooth pairing. The patient turns the device on and takes a measurement.

That simplicity matters. The Medicare population is predominantly 65 and older, and many patients in this demographic cannot reliably manage app downloads, WiFi troubleshooting, or Bluetooth pairing. Cellular-enabled, FDA-cleared devices remove the technology barrier between a patient and their physiologic data.

RPM patient eligibility requirements:

• At least one chronic condition, or an acute condition expected to last 90 or more days
• FDA-cleared device with automated data transmission capability
• Physician order placed before the device is provided
• Patient consent obtained before the device is ordered
• New patient evaluation completed for new patients

Qualifying conditions for RPM include hypertension, heart failure, Type 1 and Type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, atrial fibrillation, obesity, coronary artery disease, and asthma, among others. In most primary care panels with a chronic disease population, a significant share of active patients qualify. RPM works best when paired with a system for reviewing and acting on incoming data, which is precisely what chronic care management provides.

Chronic Care Management: Clinical Overview

Chronic care management covers non-face-to-face care coordination for Medicare patients with two or more chronic conditions expected to last at least 12 months or until death. Where RPM provides physiologic data, CCM provides the framework to act on it: monthly care coordinator touchpoints, care plan maintenance, medication reconciliation, specialist referral coordination, and patient education.

According to the Centers for Medicare and Medicaid Services, CCM is designed for the patient population most at risk of deterioration and hospitalization. Roughly two-thirds of Medicare beneficiaries have two or more chronic conditions, so the eligible population is substantial in virtually every primary care and internal medicine practice.

CCM patient eligibility requirements:

• Two or more chronic conditions expected to last at least 12 months or until death
• Initiating visit required for new patients or patients not seen within the past 12 months
• Patient consent documented in the medical record
• Minimum 20 minutes of clinical staff time per month for CPT 99490

The distinction between the two services is direct: RPM monitors what is happening physiologically between visits, and CCM coordinates what the care team does in response. Together they create a continuous care loop rather than isolated episodes of in-person contact. For a deeper look at either program on its own, see our 2026 RPM CPT code guide and 2026 CCM CPT code guide.

Why Combine RPM and CCM?

Clinical Outcomes: The Case for Combined Programs

The clinical argument for combining the two services rests on a simple logic: monitoring without coordination misses interventions, and coordination without monitoring lacks the objective data to prioritize those interventions.

A 2025 systematic review and meta-analysis published in JMIR mHealth and uHealth found that, across 40 randomized controlled trials, remote patient monitoring was associated with a reduction in the proportion of hospitalizations compared with usual care (risk ratio 0.86, 95% CI 0.77 to 0.95). Cardiovascular disease represented the largest condition group in the analysis, and heart failure, COPD, and diabetes were among the most commonly studied conditions.

The clinical mechanism is early detection. RPM data surfaces physiologic warning signs before they escalate. A care coordinator in a CCM program who sees a patient's weight rise three pounds over five days can initiate a medication review and a provider alert before a heart failure exacerbation requires an emergency visit. That kind of intervention is only possible when continuous monitoring is paired with structured care coordination. A 2025 report in the Journal of Medical Internet Research on the state of RPM for chronic disease management in the United States found increasing patient acceptance, improved adherence to care plans, and favorable impacts on care quality.

Practice Efficiency and Revenue Cycle Impact

Once the clinical case is established, the operational and financial case follows. The opportunity in most practices is not a shortage of eligible patients. It is the reverse: the eligible base is large, and most of it never gets activated because the operational lift of outreach, consent, device delivery, education, and ongoing engagement exceeds what a busy clinical staff can sustain.

Consider the size of that base. Because roughly two-thirds of Medicare beneficiaries carry two or more chronic conditions, a panel of 500 Medicare patients commonly includes 200 to 300 who qualify for combined RPM and CCM. Every one of those patients who is not enrolled represents both a gap in continuous care and unrealized recurring revenue. The practices that benefit most are the ones that activate the largest share of that existing base, not the ones that simply have more patients.

On the revenue side, combined RPM and CCM services generate approximately $170 to $260 per patient per month under the 2026 CMS Physician Fee Schedule, depending on device transmission days, management time, and care coordination time. As an illustration, a practice with 100 enrolled patients on a combined program at approximately $220 per patient per month represents approximately $22,000 in monthly recurring revenue, or approximately $264,000 annually, without adding office visits or increasing physician time. The recurring nature of this revenue is what makes it valuable to the healthcare revenue cycle: it is predictable, monthly, and tied to care the practice is already responsible for delivering.

Can You Bill RPM and CCM Together?

The CMS Answer: Yes, With Conditions

The 2026 CMS Physician Fee Schedule Final Rule allows concurrent billing of RPM and CCM for the same patient in the same month. Time must be tracked separately for each service, and no clinical time may be counted toward both RPM management and CCM in the same billing period.

This distinction is practical, not punitive. RPM management time (CPT 99457 or 99470) covers reviewing remote monitoring data and communicating about that data with the patient or caregiver. CCM time (CPT 99490 or 99439) covers care coordination: care plan updates, medication reconciliation, specialist coordination, and general care management. These are distinct clinical activities, and CMS treats them as such. Practices that capture both services for eligible patients can generate approximately $170 to $260 per patient per month in recurring revenue.

What Cannot Be Billed Together

Not all care management codes are concurrent-billing-compatible. Understanding the mutual exclusivity rules prevents compliance issues.

• CCM and PCM: Principal care management covers patients with a single complex chronic condition; CCM covers patients with two or more. They cannot be billed in the same month. If a patient qualifies for both, bill the one that reflects the care actually delivered that month.
• 99457 and 99470: These RPM management codes are mutually exclusive. Bill 99470 for 10 to 19 minutes of management time; bill 99457 once management time reaches 20 or more minutes. Do not bill both.
• 99454 and 99445: These device supply codes are mutually exclusive. Bill 99445 for 2 to 15 days of data transmission; bill 99454 for 16 to 30 days. The number of transmission days in the calendar month determines which code applies.

Documentation Requirements for Concurrent Billing

• Separate time logs for RPM management activities and CCM activities
• Documentation that at least one interactive communication occurred for 99457 or 99470 during the calendar month
• Care plan update documentation for CCM
• Device transmission logs confirming days of readings for 99454 or 99445
• No single time entry appearing in both RPM and CCM documentation

CMS requires at least one interactive communication with the patient or caregiver per calendar month for the RPM treatment management codes. Consult current CMS guidance and your Medicare Administrative Contractor for the specific requirements that apply to your practice.

2026 Medical Billing Codes for Combined RPM and CCM Programs

RPM Code Breakdown: What Changed in 2026

The 2026 CMS Physician Fee Schedule Final Rule added two new RPM CPT codes that close a long-standing gap in the program's billing structure. Both expand revenue capture for patients with lower engagement than the previous thresholds required.

Rates are national averages from the 2026 CMS Physician Fee Schedule Final Rule. Actual reimbursement varies by geographic location (GPCI), individual payer contracts, and Medicare Administrative Contractor (MAC) policies.

CPT 99445 (new 2026): Before 2026, a patient who transmitted 15 days of readings in a month generated nothing in device supply revenue, because the 99454 threshold required 16 days. CMS created 99445 to address that gap. A patient transmitting 2 to 15 days of data now generates approximately $52 in device supply revenue, the same as 99454 for 2026.

CPT 99470 (new 2026): Previously, 99457 required 20 minutes of management time to bill, and patients who needed only 10 to 19 minutes generated nothing. CPT 99470 covers 10 to 19 minutes at approximately $26 and is mutually exclusive with 99457 in the same month.

CCM Code Breakdown

The most commonly billed CCM codes are 99490 (first 20 minutes, approximately $66) and 99439 (each additional 20 minutes, approximately $50). A patient receiving 40 minutes of non-complex care coordination per month generates approximately $116 in CCM revenue. A practice may bill only one tier of CCM for a given patient in a given month; non-complex and complex codes cannot be reported together for the same patient in the same month.

Combined Monthly Revenue Example

For a patient on a full combined RPM and CCM program in a single month:

Dollar amounts are illustrative national-average estimates and vary by locality and payer. For program-level modeling, our team can walk through your panel and payer mix during a scheduled demo.

Clinical Evidence for Combined Remote Monitoring

The evidence base for RPM in chronic disease management has grown substantially since 2020, with the strongest data concentrated in cardiovascular disease, heart failure, COPD, and diabetes.

The 2025 meta-analysis in JMIR mHealth and uHealth reviewed 40 randomized controlled trials published between 2017 and 2024 and associated RPM with a reduced proportion of hospitalizations compared with usual care (risk ratio 0.86, 95% CI 0.77 to 0.95). The authors rated evidence certainty as low, reflecting the heterogeneity of RPM program structures studied rather than a negative finding. The 2024 JMIR Formative Research study of high-risk postdischarge patients found that home telemonitoring with clinical follow-up may reduce hospital readmissions and emergency department visits, combining device-based monitoring with structured weekly clinical contact in a design that parallels a combined RPM and CCM program.

Strongest evidence by condition:

• Heart failure: The readmission-reduction signal is most consistent here. Remote weight and blood pressure monitoring enables early detection of fluid retention, the primary physiologic precursor to decompensation.
• Hypertension: Continuous readings between visits enable medication adjustments based on trend data rather than single office measurements subject to white-coat effect.
• COPD: Pulse oximetry and symptom tracking provide early warning of exacerbation, one of the most costly and preventable acute events in chronic disease populations.
• Diabetes: Glucose monitoring generates continuous trend data, creating the accountability and clinical oversight needed to tighten management without increasing appointment frequency.

The Nsight Health Approach to RPM and CCM

The gap between what an RPM program promises and what it delivers usually comes down to one variable: who runs the program. A software-only platform provides a dashboard, device management tools, and billing documentation support, then leaves the practice responsible for enrolling patients, educating them, managing engagement, triaging readings, and handling billing. That operational load is the reason so much of a practice's eligible base never gets activated.

Nsight Health operates as a fully managed program. A dedicated enrollment team contacts patients, explains the program, secures consent, delivers devices, and educates patients on use. A U.S.-based clinical team employed by Nsight Health reviews incoming data and triages alerts to the ordering provider around the clock. Billing support is included. The practice provides the physician order and the patient panel. Nsight runs the clinical program, and the practice bills, collects, and grows.

Nsight delivers four programs under one roof, RPM, CCM, behavioral health integration, and principal care management, so a practice can layer the right services for each patient without managing multiple vendors. The cellular-enabled, FDA-cleared devices are central to engagement: patients who cannot use a smartphone app or configure a WiFi device can still participate, which matters for a Medicare population where technology barriers are a primary driver of low engagement.

Implementation Guide: Starting a Combined RPM and CCM Program

Step 1: Identify and Stratify Eligible Patients

Start with your current Medicare panel. Patients eligible for CCM (two or more chronic conditions lasting 12 or more months) are also strong RPM candidates when they have a monitorable physiologic parameter: blood pressure, weight, glucose, or oxygen saturation. Prioritize the highest-risk segment first: patients with a hospitalization or ED visit in the past 90 days, patients with poorly controlled disease, patients managing three or more chronic conditions, and patients who generate frequent unscheduled calls to nursing staff.

Step 2: Secure Physician Orders and Patient Consent

RPM requires a physician order before the device is provided, with patient consent documented beforehand. CCM requires an initiating visit for patients new to the practice or not seen within the past 12 months, and consent documented in the record. Where possible, build a workflow that captures both RPM and CCM consent in a single patient interaction.

Step 3: Enroll Patients and Deliver Devices

This is where most self-managed programs lose momentum. Calling patients, explaining the program, coordinating device delivery, and educating patients on use requires consistent outreach that clinical staff often cannot sustain alongside primary patient care. A fully managed program handles outreach, device delivery, and education through a dedicated enrollment team, which is how a far larger share of the eligible base actually gets activated. All devices must be FDA-cleared and capable of automated data transmission over HIPAA-compliant, secure infrastructure.

Step 4: Monitor Remotely and Triage Alerts

Once patients are enrolled, the ongoing management infrastructure determines both clinical outcomes and billing completeness. For RPM, clinical staff review incoming readings against clinically defined thresholds, evaluate readings outside threshold, contact the patient when needed, and triage significant findings to the ordering provider. For CCM, care coordinators contact enrolled patients monthly to review care plan adherence, medication questions, symptom changes, and specialist coordination. RPM management time and CCM time must be tracked in separate documentation, because a shared time entry cannot count toward both services.

Step 5: Bill Accurately Using 2026 CPT Codes

At the end of each billing month, confirm documentation before submitting claims:

• Days of RPM device transmission: 2 to 15 days bills 99445; 16 to 30 days bills 99454
• RPM management minutes: 10 to 19 minutes bills 99470; 20 or more minutes bills 99457, plus 99458 for each additional 20 minutes
• CCM time documented: 20 minutes bills 99490; 40 or more minutes adds 99439
• At least one interactive communication documented for 99457 or 99470
• No time double-counted between RPM and CCM documentation

Frequently Asked Questions

Can RPM and CCM be billed together for the same patient in the same month?
Yes. CMS allows concurrent billing of RPM and CCM under the 2026 Physician Fee Schedule. Time must be tracked separately for each service, and no time may be counted toward both programs in the same billing period. A patient receiving both services can generate approximately $170 to $260 per month in combined billing.

How many patients in a typical primary care practice qualify for both RPM and CCM?
Because roughly two-thirds of Medicare beneficiaries have two or more chronic conditions, a panel of 500 Medicare patients commonly includes 200 to 300 who qualify for combined RPM and CCM. Patients with diabetes, hypertension, and heart failure are among the most common dual-qualifying conditions.

What chronic conditions qualify patients for RPM?
RPM requires at least one chronic condition, or an acute condition lasting 90 or more days, plus a physician order and patient consent. Common qualifying conditions include hypertension, diabetes (Type 1 and Type 2), heart failure, COPD, chronic kidney disease, atrial fibrillation, obesity, and coronary artery disease.

What is the difference between CPT 99445 and 99454?
Both cover device supply and data transmission for RPM. CPT 99445 (new in 2026) applies when the patient transmits data for 2 to 15 days in a calendar month; CPT 99454 applies for 16 to 30 days. They cannot be billed in the same month, and the number of transmission days determines which code applies.

What is the difference between CPT 99470 and 99457?
Both cover RPM treatment management time. CPT 99470 (new in 2026) applies when management time is 10 to 19 minutes in a calendar month; CPT 99457 applies once management time reaches 20 or more minutes. They are mutually exclusive, so bill one or the other based on documented minutes.

What does fully managed RPM mean compared with a software-only platform?
A software-only platform provides the technology but leaves enrollment, device delivery, education, engagement, alert review, and billing to the practice. A fully managed program such as Nsight Health handles those functions through a dedicated enrollment team, a U.S.-based clinical monitoring team, and billing support, which is what allows a practice to activate a much larger share of its eligible patient base.

How do I track time separately for RPM and CCM billing?
Maintain distinct documentation for each service. RPM management documentation should record date, minutes spent, activities performed, and whether interactive communication occurred. CCM documentation should record date, minutes spent, activities performed, and method of patient contact. No single time entry should appear in both records.

Does Medicare Advantage cover RPM?
Traditional Medicare (Parts A and B) provides comprehensive RPM coverage under the 2026 Physician Fee Schedule. Medicare Advantage coverage varies by plan, and some plans apply additional restrictions, so practices billing Medicare Advantage patients should verify coverage with the individual plan before enrolling. The most consistent RPM reimbursement is through traditional Medicare fee-for-service.

How do RPM and CCM improve patient health outcomes in primary care?
RPM surfaces physiologic changes between visits, and CCM provides the care coordination to act on them. Combined, they enable earlier intervention, better medication management, and stronger care plan adherence. Published evidence associates remote monitoring with reduced hospitalizations across several chronic conditions, with the most consistent signal in heart failure.

Conclusion: A Continuous Care Model for Primary Care

For primary care and multispecialty groups, combining RPM and CCM converts episodic visits into a continuous care model: continuous physiologic monitoring paired with structured monthly coordination. The clinical case rests on earlier intervention and reduced hospitalizations. The operational case rests on activating an eligible base that is already large in most Medicare panels. The financial case rests on predictable, recurring, concurrently billable revenue that strengthens the healthcare revenue cycle. To explore how a combined program would work in your practice, schedule a demo with Nsight Health.

Works Cited

Centers for Medicare and Medicaid Services. "Physician Fee Schedule." CMS.gov, 2025, www.cms.gov/medicare/payment/fee-schedules/physician.

"Remote Patient Monitoring for Patients With Noncommunicable Diseases: Systematic Review and Meta-Analysis." JMIR mHealth and uHealth, 2025, mhealth.jmir.org/2025/1/e68464.

"Home Telemonitoring of High-Risk Patients Following Hospital Discharge." JMIR Formative Research, 2024, formative.jmir.org/2024/1/e53455.

"State of Remote Patient Monitoring for Chronic Disease Management in the United States." Journal of Medical Internet Research, 2025, www.jmir.org/2025/1/e70422.

"Remote Patient Monitoring and Hospital Readmissions." Journal of Medical Internet Research, 2023, www.jmir.org/2023/1/e42335.

This article is for educational and informational purposes only and does not constitute legal, billing, coding, or medical advice. CPT codes and reimbursement rates are subject to annual CMS updates, and reimbursement varies by geographic locality, payer, and Medicare Administrative Contractor. Nsight Health does not guarantee specific reimbursement, revenue, or clinical results; individual results vary. Practices should consult a qualified billing compliance specialist or legal counsel for program-specific guidance and verify all rates against the current CMS Physician Fee Schedule and their MAC. CPT is a registered trademark of the American Medical Association.

Chronic disease is one of the largest challenges facing the United States healthcare system. According to the Centers for Disease Control and Prevention, three in four American adults have at least one chronic condition, and more than half have two or more. Managing those conditions requires consistent, ongoing contact between patients and care teams. A clinic visit every few months is rarely enough. Patients need monitoring between appointments, and most primary care practices cannot provide that level of contact within the constraints of their existing schedules and staffing. The gap between what patients need and what providers can deliver is wide, and it is widening.

That gap is now showing up in federal spending data. As Medicare reimbursement for remote care expands and chronic disease prevalence climbs, Nsight Health is scaling its fully managed remote patient monitoring and chronic care management services to support providers who cannot meet rising patient demand with existing staff.

Medicare Spending on Remote Patient Monitoring Has Surged Past $500 Million

Federal data reflects the scale of the shift. Based on reporting from the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Medicare payments for remote patient monitoring reached approximately $536 million in 2024, a 31 percent increase over the prior year. That is a dramatic rise from approximately $15 million in 2019, with nearly one million Medicare enrollees receiving remote patient monitoring services in 2024. The growth is driven by the rising prevalence of chronic conditions and by CMS's ongoing expansion of reimbursable remote care codes across the Medicare program.

Source: U.S. Department of Health and Human Services, Office of Inspector General. Figures reflect combined Original Medicare and Medicare Advantage payments.

Full-year 2025 Medicare payment totals have not yet been published. The trajectory through 2024 is unmistakable, and CMS policy changes that took effect in 2025, including expanded remote patient monitoring billing access for Federally Qualified Health Centers and Rural Health Clinics, have widened access further.

Why Provider Demand Is Outpacing Capacity

The spending data is a symptom of a deeper trend. Patients with conditions such as hypertension, diabetes, heart disease, and respiratory illness need regular follow-up between office visits. Staffing shortages, rising patient volumes, and tighter operating margins have made that difficult to deliver through traditional in-person care alone. At the same time, more medical groups are shifting toward value-based care models that reward patient outcomes rather than service volume, which raises the importance of continuous, between-visit oversight.

Remote patient monitoring gives care teams a way to track patient health data from home through connected medical devices and ongoing clinical support. Care teams can spot warning signs earlier and reach patients before a condition worsens. For many provider groups, that capability has moved from a convenience to core infrastructure.

How Nsight Health Extends Provider Capacity Without New Hires

Nsight Health has built a fully managed infrastructure designed to extend provider capacity without requiring new hires. The company delivers remote patient monitoring and chronic care management to more than 130,000 patients across 480+ clinics, supported by over 1,700 provider teams nationwide. It operates from Miami, Florida, and functions as a direct extension of each practice it serves.

The model is fully managed end to end. Nsight Health handles patient identification, eligibility verification, device shipping, enrollment, and ongoing clinical monitoring. A U.S.-based clinical team employed by Nsight Health, including registered nurses and licensed clinical staff, monitors patient readings around the clock. The team escalates to the provider only when clinically necessary, keeping the physician's time focused on complex cases.

The platform integrates with more than 50 EHR systems. Providers receive CMS-compliant documentation to support billing without having to build new internal workflows. Nsight Health ships FDA-cleared, cellular-enabled devices that arrive ready to use, with no Wi-Fi, Bluetooth, smartphone, or app setup required, which lowers barriers for senior and rural populations.

No Upfront Cost: A Performance-Based Model

Nsight Health operates on a performance-based model. Providers incur no upfront cost, and the company is paid only after reimbursement reaches the practice. This structure removes the financial barrier that stops many small and mid-sized practices from launching remote care programs.

Onboarding is handled entirely by Nsight Health's team, including patient outreach in multiple languages. Because Nsight Health manages outreach and enrollment directly, practices can reach the large population of eligible patients who would otherwise never be enrolled, turning an underused benefit into sustained, between-visit care.

Expanding Access for Safety-Net Providers

CMS continues to expand access to remote patient monitoring. Federally Qualified Health Centers and Rural Health Clinics began receiving Medicare payment for remote patient monitoring in 2024 through a bundled general care management code. Effective in 2025, CMS unbundled that code, allowing these safety-net providers to bill the individual remote patient monitoring CPT codes directly and capture reimbursement that more accurately reflects the services delivered. The change strengthened the financial case for remote care in clinics serving underserved and rural populations.

As coverage expands and chronic disease rates continue to rise, demand for managed remote care infrastructure is growing faster than most individual practices can scale to meet it. Nsight Health is building the operational layer that allows providers to respond effectively.

The Programs Behind Managed Remote Care

Nsight Health runs four CMS-reimbursed remote care programs as a single managed service, so providers can support the same patient population across multiple care pathways without adding headcount:

Featured Coverage

This announcement was distributed nationally and picked up across leading financial and news outlets. Selected coverage:

• Business Insider
• AP News
• Barchart
• NewsBreak
• StreetInsider

Frequently Asked Questions

How much does Medicare spend on remote patient monitoring?

Based on HHS Office of Inspector General reporting, Medicare payments for remote patient monitoring reached approximately $536 million in 2024, a 31 percent increase over the prior year and up from about $15 million in 2019. Nearly one million Medicare enrollees received remote patient monitoring services in 2024. Full-year 2025 totals have not yet been published.

What is fully managed remote patient monitoring?

Fully managed remote patient monitoring means a partner handles the full program on the practice's behalf, including patient identification, eligibility verification, device shipping, enrollment, around-the-clock clinical monitoring, and CMS-compliant documentation. The provider receives escalations only when clinically necessary and does not need to add staff to run the program.

Does Nsight Health charge an upfront fee?

No. Nsight Health operates on a performance-based model with no upfront cost. The company is paid only after reimbursement reaches the practice.

Can Federally Qualified Health Centers and Rural Health Clinics bill for remote patient monitoring?

Yes. FQHCs and RHCs began receiving Medicare payment for remote patient monitoring in 2024 through a bundled general care management code. Effective in 2025, CMS unbundled that code so these providers can bill the individual remote patient monitoring CPT codes directly.

Which remote care programs does Nsight Health offer?

Nsight Health delivers four CMS-reimbursed programs as a single managed service: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM).

About Nsight Health

Nsight Health (nsightcare.com) is a fully managed remote care company delivering Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM) programs to more than 130,000 patients across 1,700+ providers and 480+ clinics nationwide. Powered by PRVNT.ai, the company's proprietary software platform, Nsight Health combines FDA-cleared connected devices, a U.S.-based clinical team employed by Nsight Health, 24/7 monitoring, and more than 50 EHR integrations to improve chronic disease outcomes and support compliant Medicare reimbursement for health systems, community clinics, and specialty practices, including nephrology teams adopting remote patient monitoring for nephrology.

Works Cited

Centers for Disease Control and Prevention. "About Chronic Diseases." CDC.gov, U.S. Department of Health and Human Services, 2026, www.cdc.gov/chronic-disease/about/index.html.

U.S. Department of Health and Human Services, Office of Inspector General. "Billing for Remote Patient Monitoring in Medicare." OIG.hhs.gov, 2025, oig.hhs.gov/reports/all/2025/billing-for-remote-patient-monitoring/.

Centers for Medicare & Medicaid Services. "Medicare Physician Fee Schedule Final Rule, CY 2025." CMS.gov, U.S. Department of Health and Human Services, 2024, www.cms.gov/medicare/payment/fee-schedules/physician.

Medicare spending figures referenced in this article are drawn from public U.S. Department of Health and Human Services Office of Inspector General reporting and reflect combined Original Medicare and Medicare Advantage payments. Reimbursement and coverage rules vary by geographic locality, payer contract, and Medicare Administrative Contractor (MAC) policy, and are subject to change. This content is provided for general informational purposes only and does not constitute medical, legal, billing, regulatory, or financial advice. Providers should verify program eligibility and billing requirements with their compliance team and MAC. CPT is a registered trademark of the American Medical Association.

Key Takeaways

• Chronic care management (CCM) is a Medicare Part B program that reimburses providers for the ongoing, non-face-to-face work of coordinating care for patients with two or more chronic conditions expected to last at least 12 months.
• CCM is built around a comprehensive care plan, monthly clinical staff time, and around-the-clock access to a care team, all designed to keep patients healthier between office visits.
• Any two qualifying chronic conditions can make a patient eligible, including common diagnoses such as diabetes, hypertension, heart disease, COPD, chronic kidney disease, and arthritis.
• Real-world outcomes from Nsight Health's clinically managed program show meaningful clinical improvement, including an average systolic blood pressure reduction of 11.5 mmHg in hypertension and approximately 29.6 mmHg in Stage 2 hypertension.
• An Optum analysis commissioned by Nsight Health found directionally favorable first-year medical savings of approximately $2,500 to $3,000 per member per year across high-risk Medicare cohorts, an early economic signal that did not reach conventional statistical significance.
• For practices, CCM strengthens care coordination and patient engagement while creating a recurring, Medicare-reimbursed revenue stream that grew approximately 10 percent under the 2026 Physician Fee Schedule.

Chronic care management is one of the most impactful and underused services in modern primary care. If you have ever wondered what chronic care management actually is, how it works, who qualifies, what the evidence shows, and why so many practices are building programs around it, this guide answers those questions in depth for both patients and providers. More than six in ten American adults live with a chronic disease, and four in ten live with two or more, which is exactly the population this Medicare program was designed to support.

This guide covers the full picture: what chronic care management means, how the monthly care model works, which conditions and patients qualify, the clinical evidence behind the model, the economic case for payers, how reimbursement works under the 2026 fee schedule, and how to choose between building a program in-house and partnering with a fully managed provider. Wherever rates or outcomes appear, they are drawn from verified 2026 sources and Nsight Health's own clinical and economic evidence.

What Is Chronic Care Management?

Chronic care management is a Medicare Part B service that reimburses providers for the ongoing, non-face-to-face work of coordinating care for patients with multiple chronic conditions. Introduced by the Centers for Medicare and Medicaid Services (CMS) in 2015, CCM recognizes that the most important care for a patient with diabetes, heart disease, or COPD often happens between appointments, not during them.

At its core, chronic care management gives a patient a dedicated point of contact and a written plan that ties together every part of their care. A care team member checks in each month, reviews medications, helps schedule appointments and tests, coordinates with specialists, and connects patients to community resources. The goal is straightforward: keep small problems from becoming hospitalizations, and help patients take an active role in managing conditions that will be with them for years.

Unlike a one-time visit, CCM is a continuous, longitudinal service. It is delivered remotely, supported by a certified electronic health record, and grounded in a comprehensive care plan that is created with the patient and revised as their needs change. It is the connective tissue between visits that fragmented healthcare so often lacks.

A Brief History of Chronic Care Management

Chronic care management became a separately billable Medicare service in 2015, when CMS introduced CPT 99490 to pay providers for the non-face-to-face coordination that had long gone unreimbursed. The benefit reflected a growing recognition that chronic disease drives the majority of Medicare spending and that better coordination between visits could improve outcomes.

The program has expanded steadily since. CMS added complex CCM codes in 2017 for patients requiring more intensive, higher-complexity management. Add-on codes followed to capture additional clinical staff and physician time, and in 2022 the agency introduced principal care management to support focused management of a single serious condition. Most recently, the 2026 Physician Fee Schedule Final Rule increased care management reimbursement by approximately 10 percent and changed how Federally Qualified Health Centers and Rural Health Clinics bill these services.

The throughline across a decade of rulemaking is clear: CMS continues to invest in chronic care management as a cornerstone of the shift from volume-based to value-based care. For practices, that sustained federal commitment makes CCM one of the more durable and strategically important services to build a program around.

How Does Chronic Care Management Work?

A chronic care management program follows a consistent monthly rhythm. Once a patient is identified as eligible and consents to enroll, care begins with an initiating visit and the creation of a personalized care plan. From there, the program runs on recurring, month-over-month coordination.

The comprehensive care plan

Every CCM patient has an electronic care plan that lists their conditions, medications, providers, goals, and the services they need. It is shared with the patient and caregivers and updated as health status changes. The care plan is the clinical foundation of the entire program, and all monthly coordination flows from it.

Monthly care coordination

Clinical staff working under the general supervision of the billing provider deliver the required monthly care time, beginning at a minimum of 20 minutes for non-complex CCM. This time covers medication review, follow-up on care goals, gap closure, appointment and test scheduling, and coordination with the rest of the care team.

Around-the-clock access

Patients have 24/7 access to a care team member for urgent needs, so they are not left waiting until the next appointment when something changes. For patients who live alone or manage several conditions, this continuity is one of the most valuable features of the program.

Care coordination across providers

The care team manages transitions between care settings, reconciles medications, and keeps specialists, primary care, and caregivers working from a single shared plan. CMS requires at least one interactive communication with the patient each calendar month as part of the service. Practices should follow current CMS guidance on documentation requirements.

What Services Are Included in Chronic Care Management?

CCM is more than a monthly phone call. A complete program bundles a defined set of services that together create a continuous safety net around the patient:

• Structured care planning. Creation, implementation, revision, and monitoring of a comprehensive, patient-centered care plan.
• Medication management. Regular review and reconciliation to reduce interactions, duplication, and adherence problems.
• Care coordination. Communication and engagement with the patient, caregivers, and the full care team across settings.
• Transitional support. Help moving safely between care settings, such as after a hospital discharge.
• Preventive and self-management support. Reinforcement of health goals, preventive services, and self-care between visits.
• 24/7 access and continuity. Around-the-clock access to a care team member and a consistent point of contact month to month.

What to Expect as a Chronic Care Management Patient

For patients, chronic care management is designed to feel less like a clinical program and more like having a knowledgeable partner in your corner. Here is what the experience typically looks like from enrollment forward:

1. An invitation and consent. Your provider or care team explains the program, what it includes, and the small monthly cost, then asks for your consent to enroll. You can decline or unenroll at any time without affecting your other Medicare benefits.
2. Your personalized care plan. The care team builds a written plan covering your conditions, medications, goals, and the providers involved in your care. You receive a copy and can refer to it anytime.
3. Monthly check-ins. A care team member reaches out each month to see how you are doing, review medications, help schedule appointments and tests, and address any concerns before they become urgent.
4. Support whenever you need it. You have around-the-clock access to a care team member for urgent questions, so you are never left waiting until the next office visit.
5. A plan that evolves with you. As your health changes, your care plan is updated, keeping every provider on your team aligned.

The result is fewer gaps, fewer surprises, and a clearer path through what can otherwise feel like a fragmented system.

What Conditions Qualify for Chronic Care Management?

To qualify for chronic care management, a patient must have two or more chronic conditions that are expected to last at least 12 months, or until the end of life, and that place the patient at significant risk of death, acute exacerbation, decompensation, or functional decline. CMS does not publish a fixed, closed list of qualifying diagnoses. Any two conditions that meet those criteria can qualify a patient.

That said, the conditions most commonly managed under CCM reflect the most prevalent chronic diseases in the United States. The table below shows representative qualifying conditions by category.

The five most prevalent chronic conditions in the country, heart disease, cancer, diabetes, obesity, and hypertension, account for a large share of CCM enrollment, but the program is intentionally broad. If a patient is managing two or more long-term conditions that require coordinated attention, they are likely a candidate.

Who Is Eligible for CCM?

Eligibility has two sides: the patient and the practice. On the patient side, the requirements are clear:

• Enrollment in Medicare Part B, or dual eligibility for Medicare and Medicaid.
• Two or more chronic conditions expected to last at least 12 months or until the end of life.
• Conditions that place the patient at significant risk of decline, exacerbation, or death.
• Documented patient consent, given verbally or in writing, before services begin.
• An initiating visit for new patients, or for patients not seen within the prior 12 months, which can occur during an evaluation and management visit, an Annual Wellness Visit, or an Initial Preventive Physical Examination.

Patients typically pay a 20 percent coinsurance under Medicare Part B, often approximately $8 to $15 per month, which is frequently covered in full for those with supplemental coverage such as a Medigap plan or Medicaid. Only one provider may bill CCM for a given patient in any calendar month, so coordination matters.

On the practice side, eligible billing providers include physicians and qualified healthcare professionals such as nurse practitioners and physician assistants. Practices need a certified electronic health record, the staffing to deliver and document monthly care time, and the workflows to identify and enroll eligible patients. That last requirement is where many practices stall, and it is exactly the gap a managed partner is built to close.

What Are the Requirements for Chronic Care Management?

Beyond patient eligibility, CMS sets specific program requirements that must be met and documented for every billed month:

1. Initiating visit. Required for new patients or those not seen within the prior 12 months.
2. Documented consent. Verbal or written consent obtained before services begin, including acknowledgment that cost-sharing applies and that only one provider can bill CCM per month.
3. Comprehensive electronic care plan. Created, shared with the patient, and maintained in a certified EHR.
4. Monthly care time. Delivery and precise documentation of the required clinical staff or provider time each calendar month.
5. 24/7 access. Around-the-clock access to care and continuity with a designated care team member.
6. Ongoing engagement. At least one interactive communication with the patient each calendar month, documented per current CMS guidance.

Time does not carry over between months. Each calendar month starts fresh, which is why disciplined, auditable time tracking is essential to a compliant program.

The Clinical Evidence Behind Chronic Care Management

The strongest case for chronic care management is clinical. A substantial body of peer-reviewed research shows that pairing remote monitoring with longitudinal care management improves outcomes across the most common chronic diseases. Nsight Health's clinically managed program, which combines CCM with remote patient monitoring, has produced real-world results consistent with, and in several cases at the upper range of, the published literature.

The table below compares published clinical findings with real-world outcomes from Nsight Health's program, as documented in the Nsight Health Clinical Evidence White Paper.

Hypertension is one of the most responsive conditions to this model, and reductions in systolic blood pressure of roughly 10 mmHg are associated with meaningful decreases in cardiovascular events. Nsight's overall reduction of 11.5 mmHg sits at the upper range of reported outcomes, and the larger reduction in Stage 2 hypertension shows the program's impact on the highest-risk patients, where the clinical and economic stakes are greatest.

Note on heart failure data: The greater than 50 percent reduction* in hospital admissions and the approximately 52 to 56 percent mortality reduction* reflect outcomes reported by a legacy structured heart failure RPM program upon which Nsight Health's program was modeled. These figures are not derived from Nsight Health proprietary outcomes data, and Nsight Health has not yet generated independent heart failure outcomes data. The Nsight outcomes above reflect real-world program data, are not peer-reviewed, are provided for informational purposes only, are not medical advice, and individual results vary.

The Clinical and Operational Benefits of Chronic Care Management

Patients with multiple chronic conditions often juggle several specialists, long medication lists, and competing instructions. Without coordination, gaps appear, and those gaps lead to avoidable emergency visits and hospitalizations. A well-run CCM program changes that.

Clinical benefits include:

• Better disease management between visits. Monthly contact catches warning signs early, when they can still be managed in the community rather than the emergency department.
• Safer medication use. Regular medication review reduces the risk of dangerous interactions and adherence problems, a leading cause of preventable harm in older adults.
• Stronger care coordination. A single care team keeps primary care, specialists, and caregivers working from the same plan, reducing duplicate tests and conflicting treatment.
• Higher patient engagement. Patients who hear from their care team every month are more activated in their own care, which is associated with better long-term outcomes.
• Continuity for vulnerable patients. Around-the-clock access and consistent follow-up are especially valuable for patients who live alone or have limited support.

Operational benefits for practices include:

• Extending care capacity without expanding in-office visit volume.
• Reducing no-shows and last-minute scheduling chaos through proactive outreach.
• Surfacing care gaps and preventive needs before they escalate.
• Improving performance on value-based care and quality measures tied to chronic disease.
• Building a predictable, recurring service line that supports the practice financially.

The catch is that running CCM in-house requires dedicated clinical staff, disciplined time tracking, and ongoing enrollment management. For many practices, the administrative weight outweighs the benefit unless they bring in a partner to carry it.

The Economic Case for Chronic Care Management

For payers, ACOs, and Medicare risk-bearing organizations, the central question is not simply whether chronic disease can be managed, but whether a model can change the cost trajectory of high-risk patients whose spending is already elevated. To evaluate this, Nsight Health commissioned Optum to conduct a retrospective matched cohort, difference-in-difference analysis comparing Nsight patients with matched non-Nsight controls in a Medicare fee-for-service population age 65 and older.

Across three high-cost cohorts, hypertension with complications, diabetes, and chronic kidney disease, Nsight patients showed lower growth in total medical spending during the first year of care than matched controls. The estimated first-year savings are summarized below.

All six economic comparisons, three for total medical spending and three condition-specific, favored Nsight, with the diabetes and chronic kidney disease condition-specific findings approaching conventional statistical significance. The consistency of the signal across multiple disease states is notable, especially given the short 11- to 12-month evaluation window, when program costs are typically incurred early and the largest savings tend to accrue later.

Important context: These results represent an early but meaningful economic signal, not definitive proof of savings. The findings did not reach conventional thresholds for statistical significance. The savings figures reflect gross medical spending before program costs, exclude RPM and CCM reimbursement, and do not establish first-year net return on investment. The analysis evaluated Medicare fee-for-service patients age 65 and older and is most applicable to Medicare and Medicare-risk populations. Source: Optum, Inc. analysis dated May 1, 2026.

Chronic Care Management and Value-Based Care

Chronic care management sits at the center of the healthcare system's shift from fee-for-service to value-based care. As payment increasingly rewards outcomes and total cost of care rather than visit volume, the between-visit coordination that CCM formalizes becomes a strategic asset rather than an administrative afterthought.

For accountable care organizations, Medicare Advantage plans, and other risk-bearing organizations, CCM supports the core objectives of value-based contracts:

• Reducing avoidable utilization. Proactive monitoring and coordination aim to prevent the emergency visits and hospitalizations that drive total cost of care.
• Improving quality measures. Consistent management of chronic conditions supports performance on the quality metrics that determine shared-savings and risk-adjusted payments.
• Identifying high-risk patients early. Structured care management helps surface rising-risk patients before their costs escalate.
• Changing the cost trajectory. As the Nsight-Optum analysis suggests, longitudinal management of complex patients may slow medical spending growth over time, the central goal of value-based care.

In a value-based world, the organizations that succeed are those that intervene earlier and more consistently. Chronic care management is one of the most direct mechanisms for doing exactly that, which is why it features so prominently in modern population health strategy.

How Chronic Care Management Is Reimbursed

Medicare reimburses chronic care management under the Physician Fee Schedule using a set of time-based CPT codes. The 2026 Physician Fee Schedule Final Rule increased care management reimbursement by approximately 10 percent, making this one of the most favorable environments for CCM since the program began.

The table below summarizes the primary 2026 CCM codes with approximate national average reimbursement. For a complete breakdown of requirements, documentation, and revenue stacking, see our 2026 CCM CPT codes and reimbursement guide.

Reimbursement figures are approximate national averages based on the 2026 Medicare Physician Fee Schedule and vary by geographic location (GPCI), payer contract, and Medicare Administrative Contractor (MAC) policy. They are provided for educational purposes only. Consult the CMS Physician Fee Schedule Look-Up Tool and a qualified billing compliance specialist for rates specific to your practice.

A patient receiving non-complex CCM can generate approximately $66 to $166 per month depending on the time invested, and complex CCM can generate more. Because CCM can often be delivered alongside other care management programs when documentation and time requirements are met independently, many practices build layered, recurring monthly revenue while improving patient care.

CCM vs. Related Care Management Programs

Chronic care management is one of four connected programs Nsight Health delivers under one roof. Each serves a distinct clinical purpose, and they are often most powerful in combination.

The simplest way to think about it: CCM coordinates the whole patient across multiple conditions, RPM brings in real-time physiologic data, PCM zeroes in on one high-risk condition, and BHI addresses behavioral health. The clinical and economic evidence above is strongest when CCM and RPM are delivered together, because monitoring data drives more timely care coordination.

Chronic Care Management Across Medical Specialties

While CCM is rooted in primary care, its value extends across specialties that manage long-term conditions:

• Primary care. The natural home for CCM, coordinating the whole patient across every condition and provider.
• Cardiology. Hypertension and heart failure are highly responsive to structured monitoring and coordination, with blood pressure control linked to reduced cardiovascular risk.
• Nephrology. Blood pressure control is the primary modifiable driver of chronic kidney disease progression, and coordinated management may help slow decline and delay dialysis.
• Endocrinology. Diabetes management benefits from frequent monitoring and reinforcement of adherence between visits.
• Pulmonology. COPD exacerbations are a major driver of hospitalization, and early detection through monitoring and coordination can support timely intervention.

How to Start a Chronic Care Management Program

For a practice, launching CCM follows a clear sequence:

1. Identify eligible patients. Review your panel for Medicare patients with two or more qualifying chronic conditions, and prioritize those at highest risk of hospitalization.
2. Conduct the initiating visit and obtain consent. Document the patient's verbal or written consent and complete the required initiating visit when applicable.
3. Build the care plan. Create a comprehensive, patient-centered electronic care plan.
4. Deliver and document monthly care. Provide the required care coordination each month and track the time precisely.
5. Bill and maintain the program. Submit the appropriate codes monthly and keep the eligible patient list current as patients enroll, disenroll, or change status.

Each step carries administrative overhead, and sustaining the program month after month is where most in-house efforts struggle.

Common Chronic Care Management Challenges

Practices that try to run CCM alone tend to hit the same obstacles. Knowing them in advance is the first step to solving them:

• Staffing and time. Delivering at least 20 minutes of documented care per patient per month adds up quickly across a panel, and clinical staff are already stretched.
• Enrollment and consent. Identifying eligible patients, explaining the program, and capturing consent is ongoing, manual work that never ends.
• Documentation and time tracking. CMS requires detailed, auditable records of non-face-to-face time and care plan updates. Missing documentation is a common audit finding.
• Sustained engagement. Reaching patients consistently every month, in their preferred language and channel, is harder than it sounds.
• Billing complexity. Choosing the correct tier and avoiding overlapping claims with other care management services requires discipline.

A fully managed partner is designed specifically to absorb each of these burdens so the practice can focus on patient care.

In-House vs. Outsourced CCM: Choosing a Partner

Practices can run CCM internally or partner with a managed provider. When evaluating a partner, the criteria that matter most are:

• Who delivers the care. Look for a U.S.-based clinical team employed by the partner, not contractors or a software-only platform.
• Clinical and economic evidence. Ask whether the partner can show real-world outcomes data and independent economic analysis, not just feature lists.
• Compliance infrastructure. Automated time logging, audit-ready documentation, and consent management protect the practice from billing risk.
• Breadth of programs. A partner offering CCM, RPM, PCM, and BHI together enables a connected, proactive care model from a single relationship.
• Patient engagement. Multilingual, omnichannel outreach drives the consistent monthly contact the program depends on.
• Technology and integration. Strong EMR integration reduces friction and keeps documentation clean.

How Nsight Health Delivers Chronic Care Management

Many companies offer chronic care management software. Nsight Health offers something different: a complete, clinically managed service. We provide the technology, the workflow, and a U.S.-based clinical team employed by Nsight Health, including RNs, LVNs, and medical assistants, who deliver and document the monthly care your patients need.

That means your practice does not have to hire, train, or manage additional clinical staff to run a CCM program. We identify eligible patients, obtain consent, build and maintain care plans, deliver monthly care coordination, and hand you an audit-ready record. You bill, collect, and grow.

Nsight Health has supported more than 130,000 patients across 1,700 providers and 480 clinics, with more than 40 million vitals monitored. We deliver four programs under one roof, CCM, RPM, BHI, and PCM, backed by the clinical evidence and independent economic analysis described above, so practices can build a connected, proactive care model from a single partner.

Frequently Asked Questions

What is chronic care management in simple terms?
Chronic care management is a Medicare program that pays a healthcare provider to coordinate your care if you have two or more long-term health conditions. A care team helps manage your medications, appointments, and overall plan between office visits.

Who qualifies for chronic care management?
Medicare Part B patients with two or more chronic conditions expected to last at least 12 months, or until the end of life, that place them at significant risk of decline. The patient must consent before services begin, and only one provider can bill CCM per month.

What conditions qualify for CCM?
Any two qualifying chronic conditions can make a patient eligible. Common examples include diabetes, hypertension, heart disease, COPD, chronic kidney disease, arthritis, and depression. CMS does not maintain a closed list, so any condition meeting the criteria may qualify.

How much does chronic care management cost the patient?
Patients typically pay a 20 percent coinsurance under Medicare Part B, often approximately $8 to $15 per month. This cost is frequently covered in full for patients with supplemental coverage such as a Medigap plan or Medicaid.

Is chronic care management effective?
Peer-reviewed research links coordinated chronic care management with better disease control and fewer avoidable hospitalizations. Real-world outcomes from Nsight Health's program include an average 11.5 mmHg systolic blood pressure reduction in hypertension. These outcomes are not peer-reviewed, and individual results vary.

Does chronic care management save money?
An Optum analysis commissioned by Nsight Health found directionally favorable first-year medical savings of approximately $2,500 to $3,000 per member per year across high-risk Medicare cohorts. The findings did not reach conventional statistical significance and represent an early economic signal rather than proven net return on investment.

How is chronic care management different from remote patient monitoring?
CCM coordinates a patient's overall care across multiple chronic conditions, while remote patient monitoring uses connected devices to track physiologic data such as blood pressure and glucose. The two programs are complementary and are often delivered together.

Does Medicare require an in-person visit for CCM?
Most CCM care is delivered remotely. New patients, or patients not seen within the prior 12 months, need an initiating visit, which can take place during an evaluation and management visit, an Annual Wellness Visit, or an Initial Preventive Physical Examination.

How much can a practice earn from chronic care management?
A patient receiving non-complex CCM can generate approximately $66 to $166 per month depending on time invested, and complex CCM can generate more. Actual reimbursement varies by geography, payer, and MAC policy.

What are the requirements to bill CCM?
Requirements include an initiating visit when applicable, documented patient consent, a comprehensive electronic care plan, the required monthly care time with precise documentation, 24/7 access to care, and at least one interactive communication with the patient each month.

Can a practice outsource chronic care management?
Yes. A fully managed partner such as Nsight Health can identify eligible patients, obtain consent, build care plans, deliver monthly care coordination with a U.S.-based clinical team, and provide audit-ready documentation, while the practice bills and collects.

How do I start a chronic care management program?
Identify eligible Medicare patients with two or more chronic conditions, complete the initiating visit and consent, build each patient's care plan, deliver and document monthly care, and bill the appropriate codes. A managed partner can run this entire workflow on your behalf.

When did chronic care management start?
CMS introduced chronic care management as a separately billable Medicare service in 2015. The program has expanded since with complex CCM codes, add-on codes, and reimbursement increases, including an approximately 10 percent increase under the 2026 Physician Fee Schedule.

What is the difference between CCM and complex CCM?
Non-complex CCM covers routine monthly care coordination, beginning at 20 minutes of clinical staff time. Complex CCM applies to patients requiring moderate to high complexity medical decision-making and at least 60 minutes of clinical staff time. A practice may only bill one tier for a given patient in a calendar month.

Can a patient opt out of chronic care management?
Yes. Enrollment requires consent, and patients can withdraw at any time without affecting their other Medicare benefits. Patients are informed of the monthly cost-sharing and their right to unenroll before services begin.

Disclaimer: This article is provided for educational and informational purposes only and does not constitute medical, legal, billing, or financial advice. Clinical outcomes referenced from Nsight Health reflect real-world program data, are not peer-reviewed, and individual results vary. Heart failure outcomes marked with an asterisk reflect data from a legacy structured RPM program upon which Nsight Health's program was built and are not derived from Nsight Health proprietary data. Economic findings reflect an Optum analysis that was directionally favorable but did not reach conventional statistical significance, exclude program costs, and do not establish net return on investment. Reimbursement rates are approximate national averages based on the 2026 Medicare Physician Fee Schedule and are subject to change and to variation by geographic location, payer contract, and Medicare Administrative Contractor (MAC) policy. No specific clinical or financial outcome is guaranteed. Practices should consult the CMS Physician Fee Schedule Look-Up Tool, their MAC, and qualified compliance and legal advisors before making billing decisions. CPT is a registered trademark of the American Medical Association.

Works Cited

Centers for Medicare and Medicaid Services. "Chronic Care Management for Complex Conditions." CMS.gov, www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/chronic-care-management-complex-conditions.
Centers for Medicare and Medicaid Services. "Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)." CMS.gov, 31 Oct. 2025, www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f.
"Chronic Care Management Services." Medicare.gov, www.medicare.gov/coverage/chronic-care-management-services.
American Academy of Family Physicians. "Chronic Care Management." AAFP.org, www.aafp.org/family-physician/practice-and-career/getting-paid/coding/chronic-care-management.html.
Nsight Health. "Clinical Evidence Supporting Remote Patient Monitoring (RPM) and Chronic Care Management (CCM)." Nsight Health Clinical Evidence Series, Nsight Health, Inc., Apr. 2026.
Optum, Inc. "Reducing Medical Spending Growth in High-Risk Medicare Patients: Economic Findings From the Nsight-Optum Analysis." 1 May 2026.
Rural Health Information Hub. "Chronic Care Management." RuralHealthInfo.org, www.ruralhealthinfo.org/care-management/chronic-care-management.

For payers, accountable care organizations, and other Medicare risk-bearing organizations, the conversation about remote patient monitoring cost savings usually starts in the wrong place. The real economic challenge is not managing chronic conditions in the abstract. It is bending the cost curve for patients whose medical spending is already elevated and likely to climb. To test whether its care model does that, Nsight Health engaged Optum to evaluate the economic impact of its remote patient monitoring and chronic care management programs in a high-risk Medicare population. This article walks through what the Nsight-Optum analysis found, what it does and does not establish, and what it means for organizations managing Medicare risk.

The honest headline is that the analysis produced a consistent, directionally favorable economic signal across three chronic disease cohorts, and that the signal is most credible when read alongside the clinical reasons it should exist in the first place.

The clinical foundation: why better management changes the cost curve

Cost savings in chronic disease are a downstream effect, not a starting point. Patients with complex chronic disease generate high and rising expense across inpatient, emergency, outpatient, primary care, and specialist categories, and traditional episodic care is poorly suited to managing them. Office visits provide intermittent snapshots, claims data lag behind clinical reality, and care gaps often stay invisible until they surface as an emergency department visit, a hospitalization, or disease progression.

Remote patient monitoring and chronic care management exist to close that gap. By creating more frequent touchpoints between patients and a care team, the model supports earlier detection of deterioration, better medication adherence, and timely intervention. When that clinical work succeeds, avoidable utilization falls, and lower utilization is what shows up later as reduced spending growth. The economic thesis follows directly from the clinical one: manage high-risk patients more consistently between visits, and the cost trajectory should improve. The Optum analysis was designed to test whether that improvement is measurable in a real-world high-risk population. Nsight Health delivers this model through four programs under one clinical infrastructure, remote patient monitoring and chronic care management among them, supported by a U.S.-based clinical team employed by Nsight Health. Across the network, that model supports more than 130,000 patients in partnership with over 1,700 providers across 480-plus clinics, with more than 40 million vitals monitored.

Inside the Nsight-Optum economic analysis

Optum conducted a retrospective matched cohort, difference-in-difference analysis comparing Nsight patients who received RPM and CCM-supported care with a matched control population of Medicare fee-for-service beneficiaries who did not receive Nsight services. The study focused on patients age 65 and older and used a 12-month baseline period and a 12-month follow-up period. It evaluated three high-cost, clinically complex cohorts that are especially relevant to Medicare risk-bearing organizations: hypertension with complications, diabetes, and chronic kidney disease.

To reduce baseline differences between the groups, the analysis used propensity score matching across variables including gender, age, CMS HCC risk score, baseline medical spending, and emergency department, outpatient, and primary care costs. It allowed up to five matched control patients for each Nsight patient. Importantly, RPM and CCM reimbursement amounts were excluded from the total medical spending comparison, so the primary analysis reflects medical spending trends rather than program reimbursement. The analysis also reported results two ways: total medical spending, which speaks to the broad cost curve, and condition-specific spending, which tests whether savings appeared within the disease areas Nsight was actively managing.

What the analysis found

Across all three cohorts, Nsight patients had lower growth in total medical spending than matched controls during the first year of care. Estimated total medical savings ranged from approximately $2,500 to $3,000 per member per year, before accounting for program costs.

Optum also evaluated disease-affiliated allowed amounts for each cohort. These condition-specific analyses were directionally favorable across all three conditions, and the diabetes and chronic kidney disease results showed the strongest statistical signal.

Reading the results honestly: an early signal, not proof

It is important to be precise about what these numbers do and do not show. The findings did not reach conventional thresholds for statistical significance, which is typically set at a p-value below 0.05. The lowest p-value in the study, the chronic kidney disease condition-specific result at 0.0649, approached that threshold, as did the diabetes condition-specific result at 0.0880, but none crossed it. The absence of statistical significance does not mean there was no economic effect. It means the analysis did not establish the effect with the level of certainty required for definitive proof.

What gives the result weight is consistency. The study did not produce a single isolated positive finding. All six economic comparisons favored Nsight: three total medical spending analyses and three condition-specific analyses. The estimated total medical savings were similar in magnitude across very different disease states. A consistent pattern across multiple cohorts and two independent economic views is harder to dismiss as noise than a lone positive result would be. The most defensible interpretation is the one the analysis itself supports: an early but meaningful economic signal that Nsight's model likely reduces medical spending growth in appropriately selected high-risk Medicare patients.

Why the first-year timing makes the signal notable

The intervention and follow-up window was roughly one year, which is short for a care-management evaluation. That detail matters more than it might appear. In chronic disease management, program costs are front-loaded. Onboarding, device setup, monitoring infrastructure, clinical review, patient engagement, and care coordination all generate expense early. The largest economic benefits, including avoided hospitalizations, fewer emergency department visits, delayed disease progression, and reduced downstream complications, tend to accrue over a longer period.

The published economic literature makes the same point. A systematic review of economic evaluations of remote patient monitoring found that RPM was highly cost-effective for hypertension, with greater long-term savings expected from preventing high-cost health events, and that findings for other conditions varied by severity and time horizon. Reviews of blood pressure monitoring and cardiovascular RPM economics reach similar conclusions, emphasizing that costs appear early while avoided events accumulate later. Against that backdrop, observing approximately $2,500 to $3,000 PMPY in first-year total medical savings across three disease states is a demanding test to pass, and passing it early is a more impressive finding than a one-year view alone might suggest.

Cohort-level detail

Each cohort showed the same structural pattern: Nsight patients and controls increased their spending from baseline to follow-up, but Nsight patients increased less. The table below shows the per member per year spending trajectory for each group.

Chronic kidney disease deserves particular attention. CKD progression is associated with high downstream costs, comorbid cardiovascular disease, specialist involvement, hospitalization risk, and potentially catastrophic expense as patients approach advanced kidney disease. Early evidence of lower spending growth in this population, paired with the strongest statistical signal in the study, is meaningful for any organization carrying renal risk. The clinical mechanism behind these numbers, including the blood pressure and glucose improvements observed in Nsight's program, is detailed in our companion review of remote patient monitoring clinical outcomes.

The program cost and ROI question, answered honestly

A payer or ACO will rightly ask whether medical savings exceed the cost of the program. A one-year analysis is too short to answer that fully, and the Optum analysis should not be read as a complete net ROI study. RPM and CCM reimbursement was deliberately excluded from the total medical spending comparison. Separately, the analysis showed that RPM and CCM allowed amounts were higher for Nsight patients than for controls, which is expected, since those patients were receiving an active program. In some first-year views, program-related reimbursement may exceed the observed first-year medical savings.

That does not negate the savings signal. It reflects a structural feature of chronic care management: program costs are incurred immediately, while many of the benefits accrue over time. The more useful question is about cost trajectory. If Nsight patients continue to experience lower medical spending growth, the program cost may be amortized more favorably over a multi-year period. The most appropriate follow-up would evaluate 24 to 36 month outcomes, including total and condition-specific medical cost, inpatient and emergency department utilization, disease-specific outcomes, and net ROI after program cost.

What this means for payers and ACOs

Three practical implications follow from the analysis. First, the model likely reduces medical spending growth in appropriately selected high-risk patients, given that every total medical and condition-specific comparison favored Nsight across hypertension with complications, diabetes, and chronic kidney disease. Second, the value appears highest when the model is targeted, focused on patients with complex hypertension, diabetes with comorbidities, CKD stages 3b through 5, multiple chronic conditions, high baseline spending, and rising utilization, rather than applied uniformly. Third, evaluation should extend beyond first-year ROI, because a one-year window likely understates the value of chronic disease stabilization.

The analysis does not prove definitive first-year net ROI. It does support continued exploration of shared-savings, performance-based, or risk-aligned arrangements in which Nsight and payer or ACO partners jointly evaluate longer-term medical cost impact. For organizations whose success depends on identifying high-risk patients earlier and preventing avoidable utilization before it occurs, the Nsight-Optum findings are a reason to look more closely, not a reason to wait.

Frequently asked questions

What did the Nsight-Optum economic analysis find?

Across hypertension with complications, diabetes, and chronic kidney disease, Nsight patients had lower first-year total medical spending growth than matched Medicare controls. Estimated total medical savings ranged from approximately $2,500 to $3,000 per member per year before program costs. All six economic comparisons favored Nsight.

Were the remote patient monitoring cost savings statistically significant?

No. The findings did not reach the conventional 0.05 threshold for statistical significance. The chronic kidney disease condition-specific result (p-value 0.0649) and the diabetes condition-specific result (p-value 0.0880) approached significance but did not cross it. The results are best described as an early, directionally favorable economic signal rather than definitive proof.

Does the analysis prove a positive first-year return on investment?

No. RPM and CCM reimbursement was excluded from the total medical spending comparison, and in some first-year views program reimbursement may exceed first-year medical savings. The analysis is not a complete net ROI study. It measures medical spending growth, and a full ROI assessment would require longer follow-up and inclusion of program costs.

How was the study designed?

Optum conducted a retrospective matched cohort, difference-in-difference analysis comparing Nsight patients receiving RPM and CCM-supported care with matched Medicare fee-for-service controls age 65 and older, using a 12-month baseline and 12-month follow-up. Propensity score matching across age, gender, CMS HCC risk score, and baseline spending reduced differences between groups, with up to five controls per Nsight patient.

Why does the short time horizon matter?

Program costs in chronic care management are front-loaded, while the largest savings, such as avoided hospitalizations and delayed disease progression, accrue over a longer period. Observing first-year savings across three disease states is therefore a demanding test, and the published economic literature supports evaluating these programs over multi-year horizons.

Which patients benefit most?

The findings point toward the highest value when the model is targeted at patients with complex hypertension, diabetes with comorbidities, CKD stages 3b through 5, multiple chronic conditions, high baseline spending, and rising utilization, rather than applied to all patients uniformly.

What should a payer or ACO do with these findings?

The results support continued exploration of shared-savings, performance-based, or risk-aligned arrangements and a multi-year evaluation framework that captures delayed utilization impact and net ROI over time. You can schedule a demo to review the data against your own population.

What conditions and programs does Nsight Health support?

Nsight Health delivers four programs under one clinical infrastructure: remote patient monitoring, chronic care management, behavioral health integration, and principal care management, supporting patients across hypertension, diabetes, chronic kidney disease, and other complex chronic conditions.

Works Cited

When clinicians ask whether remote patient monitoring clinical outcomes justify the operational lift of a managed program, the honest answer is that the evidence depends almost entirely on what happens after the data arrives. A connected blood pressure cuff or scale generates readings. Readings only change a patient's trajectory when a clinician sees them, interprets them, and acts. This article reviews what the peer-reviewed literature shows about RPM and chronic care management across five chronic conditions, then compares that literature with the real-world results documented in the Nsight Health Clinical Evidence White Paper.

The thesis is straightforward. Monitoring is necessary but not sufficient. The clinical benefit comes from the care model wrapped around the technology, and that distinction is where Nsight Health concentrates its investment.

Why chronic disease management between visits matters

Chronic conditions, including hypertension, heart failure, chronic kidney disease, chronic obstructive pulmonary disease, and diabetes, are leading drivers of hospitalization and healthcare spending in the United States. The challenge is structural. A patient with hypertension might see a physician three or four times a year, yet blood pressure varies day to day and even hour to hour. Office readings are intermittent snapshots, and they can be distorted by white coat effect or masked hypertension.

The same gap exists in heart failure, where weight gain and rising blood pressure often precede a hospitalization by days or weeks, and in diabetes, where glycemic control responds to continuous reinforcement rather than episodic check-ins. Remote patient monitoring and chronic care management exist to close that gap. By combining remote physiologic monitoring with structured care management between visits, these programs enable earlier detection of deterioration, better medication adherence, and more timely intervention.

How RPM and CCM change the clinical trajectory

Remote patient monitoring captures physiologic data from FDA-cleared devices in the patient's home and transmits it to the care team. Chronic care management adds the longitudinal layer: a documented care plan, regular outreach, medication reconciliation, and coordination across the patient's providers. Used together, the two programs create a feedback loop that traditional episodic care cannot match.

That loop is the mechanism behind the outcomes. Frequent, provider-initiated contact improves adherence, which is a barrier for roughly one third of patients managed in traditional settings. Earlier signal detection allows medication titration before a patient decompensates. And a single accountable clinical team reduces the fragmentation that causes patients to fall through the cracks. Nsight Health builds its programs around this principle, pairing the technology and devices with a dedicated U.S.-based clinical team of registered nurses, licensed vocational nurses, and medical assistants who are employed by Nsight Health and monitor patients year round.

Nsight Health clinical outcomes at a glance

The table below summarizes the outcomes documented in the Nsight Health Clinical Evidence White Paper alongside the published clinical ranges from the peer-reviewed literature. Each condition is examined in detail in the sections that follow.

*Heart failure admission and mortality figures reflect data reported by a legacy structured heart failure RPM program upon which Nsight Health's program was built. They are not derived from Nsight Health proprietary outcomes data. Individual patient results may vary. See the disclaimer at the end of this article.

Hypertension: the most responsive condition to remote monitoring

Hypertension responds to remote patient monitoring and longitudinal care management more reliably than almost any other chronic condition. Multiple randomized trials and meta-analyses have shown that home blood pressure telemonitoring improves control, increases the share of patients reaching guideline targets, and lowers downstream cardiovascular risk. In a meta-analysis of randomized studies, home blood pressure telemonitoring was associated with better control than usual care. Contemporary telemonitoring interventions typically lower systolic blood pressure by about 4 to 11 mmHg.

The clinical significance becomes clear when those numbers are connected to outcomes. A large meta-analysis found that lowering systolic blood pressure by roughly 10 mmHg is associated with a substantial reduction in major cardiovascular events and mortality. Blood pressure control is therefore both a surrogate marker and a clinically meaningful endpoint in its own right.

Against that backdrop, the Nsight Health results stand out. The program observed an average systolic reduction of 11.5 mmHg, at the upper range of reported outcomes, and a markedly larger reduction of 29.6 mmHg among patients with Stage 2 hypertension. The Stage 2 finding matters because it shows the program reaching the highest-risk patients, the group in which clinical benefit is greatest. Nsight Health's remote patient monitoring program pairs connected devices with clinician-led outreach so that an out-of-range reading triggers a human response, not just a data point in a dashboard.

Heart failure: catching decompensation before the hospital

Heart failure is particularly well suited to remote monitoring because the physiologic changes that precede decompensation are predictable. Weight gain, blood pressure shifts, and worsening symptoms frequently appear days to weeks before an acute event, which opens a window for intervention. Clinical trials and meta-analyses, including a major randomized telemonitoring trial in heart failure, have shown that structured telemonitoring paired with active care management can reduce hospitalizations and improve survival by enabling timely medication adjustments and escalation of care.

In a randomized evaluation of the legacy structured program model on which Nsight Health's heart failure monitoring was built, admissions fell by more than 50 percent reduction* and mortality fell by approximately 52 to 56 percent reduction*. These figures exceed many published averages and illustrate the potential impact of high-touch monitoring in high-risk populations. It is important to be precise about their source. These heart failure outcomes reflect internal data reported by the original legacy program and are not derived from Nsight Health proprietary data. Nsight Health has not yet generated independent outcomes data for heart failure admissions or mortality, and individual patient results may vary.

Chronic kidney disease: protecting kidney function through blood pressure control

Hypertension is the primary modifiable driver of chronic kidney disease progression. Sustained elevations in blood pressure accelerate the decline in renal function and increase the likelihood of progression to end-stage renal disease. The clinical literature, including landmark intensive blood pressure control research and kidney disease guidelines, links improved blood pressure control to slower CKD progression, fewer cardiovascular events, and delayed initiation of dialysis. Delaying dialysis carries profound implications for both patient quality of life and total cost of care.

The Nsight Health data reinforces this pathway. Among patients with chronic kidney disease, the program observed systolic reductions of 6.5 mmHg in those with Stage 1 hypertension and 17 mmHg in those with Stage 2 hypertension. The larger effect in more severe hypertension aligns with the broader evidence and supports the role of structured care management in slowing disease progression for nephrology populations.

Diabetes: continuous feedback improves glycemic control

Diabetes management benefits from continuous monitoring and steady reinforcement of medication, diet, and lifestyle adherence. Remote patient monitoring enables more frequent data collection and feedback than traditional episodic care, and the literature documents meaningful reductions in HbA1c with telemonitoring and care management interventions, generally in the range of 0.4 to 1.5 percent.

Nsight Health observed a 55 mg/dL reduction in random glucose readings among monitored patients. That magnitude of change is consistent with the published evidence and supports improved metabolic control, which is associated with fewer long-term complications. As with hypertension, the driver is not the glucometer itself but the clinical response that the reading sets in motion through Nsight Health's chronic care management program.

COPD: monitoring to catch exacerbations early

COPD exacerbations are a major source of emergency department visits and hospitalizations. Programs that monitor symptoms, oxygen saturation, and therapy adherence can identify early signs of deterioration, and the evidence suggests that structured monitoring combined with care management can reduce exacerbation-related hospitalizations, particularly among high-risk patients with frequent prior events.

Nsight Health's COPD program is currently under evaluation, and independent outcomes data is not yet available. The program is being assessed against the same standard applied to the conditions above: whether clinician-led monitoring measurably changes the clinical course. Results will be reported as the evaluation matures.

Why clinical management, not software, drives these outcomes

The pattern across all five conditions is consistent. The published literature and the Nsight Health results both point to the same conclusion: outcomes track with the intensity and quality of the care management layer, not with the presence of a device. A connected cuff that streams data into a portal nobody acts on produces no clinical change. The same cuff, paired with a clinician who reviews the reading, contacts the patient, and adjusts the plan, produces the reductions documented above.

This is the core of Nsight Health's model and the reason its outcomes sit at the upper range of the evidence. Unlike software-only approaches, Nsight provides the technology, the FDA-cleared devices, and a dedicated U.S.-based clinical team employed by Nsight Health who monitor patients around the clock. The clinical team is the active ingredient. Across the network, that model now supports more than 130,000 patients in partnership with over 1,700 providers across 480-plus clinics, with more than 40 million vitals monitored.

What this means for your practice and your patients

For a provider, the clinical outcomes come first, and the operational and financial benefits follow from them. A managed program extends a care team's reach without adding headcount, because the monitoring and outreach are handled by Nsight Health's clinical staff. That operational relief is what allows a practice to keep eyes on a chronic panel between visits. The financial picture follows the clinical one: RPM, CCM, BHI, and PCM are reimbursable under Medicare's care management framework, and a well-run program is designed to be sustainable rather than a cost center. The sequence matters. Programs built to chase reimbursement without the clinical layer tend to underperform on both outcomes and revenue, while programs built around patient outcomes tend to succeed on both.

Nsight Health offers four programs under one roof, remote patient monitoring, chronic care management, behavioral health integration, and principal care management, so a practice can match the right level of management to each patient without stitching together multiple vendors.

Frequently asked questions

What clinical outcomes can remote patient monitoring improve?

The peer-reviewed literature documents improvements in blood pressure control, glycemic control, and heart failure hospitalization and survival when remote monitoring is paired with active care management. Nsight Health has observed an 11.5 mmHg average systolic blood pressure reduction overall, 29.6 mmHg in Stage 2 hypertension, and a 55 mg/dL reduction in random glucose readings among monitored patients.

Is remote patient monitoring effective without clinical management?

The evidence indicates that monitoring alone produces limited benefit. The clinical change comes from the care management layer, the clinician who reviews each reading, contacts the patient, and adjusts the plan. This is why Nsight Health pairs devices with a dedicated clinical team rather than offering software alone.

How much can remote monitoring lower blood pressure?

Contemporary telemonitoring interventions typically lower systolic blood pressure by about 4 to 11 mmHg in the published literature. Nsight Health observed an average reduction of 11.5 mmHg overall and 29.6 mmHg in patients with Stage 2 hypertension, at or above the upper range of reported outcomes.

Does remote monitoring help patients with chronic kidney disease?

Because hypertension is the leading modifiable driver of chronic kidney disease progression, better blood pressure control is associated with slower progression and delayed dialysis. Nsight Health observed systolic reductions of 6.5 mmHg in CKD patients with Stage 1 hypertension and 17 mmHg in those with Stage 2 hypertension.

What conditions does Nsight Health monitor?

Nsight Health supports patients across hypertension, heart failure, chronic kidney disease, diabetes, and COPD, among other chronic conditions, through four programs: remote patient monitoring, chronic care management, behavioral health integration, and principal care management.

Are the heart failure figures based on Nsight Health data?

No. The greater than 50 percent admission reduction and the approximately 52 to 56 percent mortality reduction reflect data reported by a legacy structured heart failure RPM program upon which Nsight Health's program was built. They are not derived from Nsight Health proprietary outcomes data, and individual patient results may vary.

How does a clinically managed program affect practice operations?

A managed program is designed to extend a care team's reach without adding headcount, because Nsight Health's clinical staff handle the monitoring and outreach. The programs are reimbursable under Medicare's care management framework, but the model is built to lead with patient outcomes rather than reimbursement.

How do I get started with Nsight Health?

You can schedule a demo with the Nsight Health team to review your patient population and determine which combination of programs fits your practice.

Works Cited

Last updated: June 16, 2026

If you are learning how to choose a remote patient monitoring company, you have probably noticed the same thing every provider does: nearly every vendor sounds excellent on a sales call. The hard part is separating the partners that genuinely run a remote care program from the ones that ship a device and a login and leave the rest to your staff. This guide walks through the questions that actually matter, the answers a strong partner should give, and the warning signs worth slowing down for, so you can evaluate any remote patient monitoring vendor with confidence.

Why Choosing the Right Remote Patient Monitoring Company Matters

Since January 1, 2020, CMS has allowed practices to deliver Remote Patient Monitoring and Chronic Care Management under general supervision of clinical staff. In practice, that means a physician or clinic can partner with a third-party vendor to help run the program at scale while the practice remains the entity that bills Medicare. That single rule is why vendor selection is so consequential. The company you choose effectively becomes an extension of your clinical team, your device logistics, your documentation, and your audit trail. Choose well and a remote care program can run quietly in the background. Choose poorly and it can create more work than it removes.

Remote care is also no longer a single offering. A mature partner can support a connected set of programs, including Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM). Knowing which programs a vendor can actually deliver, and whether they can grow with you, is part of the selection process.

Full-Service vs. Software-Only: The First Decision

Before comparing features, decide what kind of partner you need. Remote patient monitoring companies generally fall into three categories, and the right model depends entirely on your internal capacity.

Match the model to your goals rather than to a vendor's pitch. With that decision made, the following criteria let you compare partners on what they actually do. If you would rather talk it through against your specific patient panel, you can schedule a demo and walk the criteria together.

1. Clinical Monitoring Support

Ask: Does the vendor provide clinical monitoring, or is your clinic expected to watch every reading around the clock? This is the criterion that most affects patient care, so evaluate it first.

A full-service partner should offer a clinical team that reviews incoming vital sign data and reaches out to patients when a reading crosses a defined threshold. Nsight Health, for example, provides a U.S.-based, English and Spanish speaking clinical team employed by Nsight, made up of nurses and medical assistants, who monitor patient readings and contact patients on a recorded line when data exceeds a critical threshold. A nurse can make a clinical assessment and escalate to the ordering physician when needed, which filters out a great deal of the noise that would otherwise land on your staff.

You should also ask whether thresholds can be customized at both the practice level and the individual patient level, because no two patient panels are alike.

Watch out: Many vendors offer no clinical monitoring at all, which leaves your clinic responsible for responding to every abnormal reading, including overnight.

2. Patient Engagement and Adherence

Ask: Who onboards and trains patients, and how does the vendor keep them engaged month after month? A program only works if patients keep using their devices, so adherence is a clinical issue before it is a financial one.

Look for a partner that ships devices with tracking, then calls each patient once the device arrives to walk them through their first measurement and confirm data is flowing correctly. Beyond onboarding, ask to see the vendor's ongoing adherence program. If patients drift away after the first month or two, the program will not deliver value to them or to your practice.

Watch out: Some vendors push patient training onto clinic staff, adding work you were trying to offload in the first place.

3. Devices and Consumables

Ask: Who pays for the first device, who covers consumables, and how are devices stored and shipped?

A patient-friendly partner supplies the first device for each patient at no cost to the practice or the patient, and most patients need only one. Just as important, ask about consumables such as batteries, lancets, and test strips. Covering and replenishing those is a quiet but meaningful part of keeping patients adherent. The vendor should also manage all storage, fulfillment, shipping, and returns, so your office never becomes a warehouse.

On device type, ask whether you are locked into Bluetooth. Bluetooth devices are inexpensive, but pairing, smartphone requirements, Wi-Fi, and password issues can frustrate patients and lower long-term adherence. Cellular-enabled devices that transmit data automatically, with no patient setup, tend to be more reliable for older or less tech-comfortable patients.

Watch out: Some vendors require a one-year-plus commitment and an upfront order of 100 or even 500 devices, and some expect your office to store and distribute them.

4. EHR Integration

Ask: Do you integrate with my EHR, what does the integration actually do, and what does it cost?

This is where vendor claims and vendor reality often diverge. A real integration writes patient readings into the EHR as structured vital sign data that can be queried and reported on, lets you order remote care directly from the chart, and supports the reporting many quality programs require. Strong partners integrate with a wide range of practice-based EHR systems. Nsight integrates with more than 50 of the top practice-based EHRs and continues to add more.

Watch out: Many vendors either do not integrate at all, charge several thousand dollars for an integration, or simply drop a PDF or fax into the chart. A PDF the EHR cannot read is not a true integration, and it blocks the reporting you may need.

5. Software Platform and Audit Trail

Ask: Is there a single platform where my team can see every patient's data, and does it create an audit trail that holds up under a Medicare audit?

Because remote care relies on time-based codes, the platform should track time automatically rather than asking your staff to log it by hand. Nsight's HIPAA-compliant, SOC 2-certified platform, Evelyn, lets providers and their clinical teams log in to view patient data, monitor compliance, add clinical notes, and review documentation in one place. Time spent reviewing data and interacting with patients is captured automatically, and calls placed through the platform are time stamped and recorded as part of the medical record.

That automatic, time-stamped record is exactly what you want if a payer or regulator ever reviews the program. Ask any vendor to show you what their audit record looks like before you sign.

Watch out: Many vendors require manual time tracking or offer a thin, manually produced audit trail, both of which add work and introduce risk.

6. Billing Support

Ask: Do you help me generate claims every month, and how?

Remote care billing is detail-heavy, and a good partner removes that burden rather than adding to it. Look for a vendor that delivers a monthly billing file showing the applicable codes, the correct date of service, and the number of units for each code, so your team can submit accurate claims. With some EHRs, a partner may be able to generate those claims automatically at no extra cost. Because different remote care codes follow different timing rules, having the partner reconcile dates of service for you removes a common source of error.

Watch out: Many vendors offer little or no billing support, or provide it in a form that does not connect to your EHR.

7. Contracting Terms

Ask: What long-term commitment am I agreeing to, and what am I obligated to purchase up front?

Contracting terms are where a program's economics are quietly set. The most provider-friendly arrangements avoid forcing a large upfront device purchase or a multi-year lock-in before you have seen results. Read the commitment terms closely, and be cautious about any structure that ties you in heavily before the program has proven itself in your practice.

Watch out: Arrangements that advertise unusually high revenue splits sometimes come paired with enrollment expectations the vendor cannot actually meet.

8. Compliance and Data Security

Ask: How do you protect patient data, and how do you help me stay audit-ready?

Remote care moves sensitive patient data continuously, so a partner should demonstrate compliance with HIPAA and HITECH and maintain a proactive compliance program rather than reacting after a problem appears. Ask how they prepare practices for routine payer or regulatory audits, and confirm they will sign a Business Associate Agreement. A partner that treats compliance as part of the service, not an afterthought, protects both your patients and your practice.

A Vendor Evaluation Checklist

Use this checklist to compare any remote patient monitoring companies side by side. Strong answers to these questions separate genuine partners from well-marketed software.

How Nsight Health Approaches Remote Care

Nsight Health is a full-service, clinically managed remote care partner. Rather than handing practices software and stepping back, Nsight provides the technology, the devices and logistics, and a U.S.-based clinical team employed by Nsight that helps run the program day to day. Across the country, Nsight supports more than 130,000 patients with over 1,700 providers and 480 clinics, and has monitored more than 40 million vitals.

Nsight delivers four connected programs under one roof: Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management. Working with a single partner across those programs simplifies oversight, avoids juggling multiple vendors, and supports continuity for patients as their needs change. If you want to see how the model would fit your practice, you can schedule a demo.

Frequently Asked Questions

Q: How do I choose a remote patient monitoring company?
A: Start by deciding whether you need a software-only, full-service, or hybrid partner based on your clinical capacity. Then compare vendors on clinical monitoring, patient engagement, devices, EHR integration, the software platform and audit trail, billing support, and contracting terms.

Q: What is the difference between a full-service and a software-only RPM vendor?
A: A software-only vendor provides the platform and devices and leaves monitoring, outreach, and documentation to your team. A full-service vendor adds a clinical team and logistics so the program is largely run for you. Hybrid models sit in between.

Q: Should patients use Bluetooth or cellular devices?
A: Both can work, but cellular-enabled devices transmit data automatically with no pairing, apps, or Wi-Fi setup, which tends to improve adherence among older or less tech-comfortable patients. Bluetooth is less expensive but can create connectivity friction.

Q: What does a real EHR integration actually do?
A: A true integration writes readings into the chart as structured vital sign data you can query and report on, and often lets you order remote care from within the EHR. Dropping a PDF or fax into the chart is not a true integration because the data cannot be read or reported on automatically.

Q: Why does the audit trail matter when choosing a vendor?
A: Remote care relies on time-based documentation. A platform that automatically time stamps monitoring, notes, and patient calls creates a defensible record if a payer or regulator reviews the program, while a manual trail adds work and risk.

Q: Can one vendor support RPM, CCM, BHI, and PCM together?
A: Yes. A mature partner can deliver these programs together, which simplifies oversight and supports continuity of care. Confirm which programs a vendor actually delivers today rather than assuming a broad menu.

Q: What contract red flags should I watch for?
A: Be cautious of large upfront device purchases, multi-year lock-ins before you have seen results, and revenue-split promises that depend on enrollment numbers the vendor may not be able to deliver.

Q: Does the practice or the vendor bill Medicare?
A: Under CMS general supervision rules, the practice remains the billing entity. A vendor partner helps run the program and prepares the documentation and billing file, but your practice submits the claims.

Once you have chosen a partner, our guide on how to start a remote patient monitoring program walks through the launch step by step. See how a full-service remote care partner would work for your practice. Schedule a demo.

Works Cited

Centers for Medicare & Medicaid Services. "Telehealth." CMS.gov, U.S. Centers for Medicare & Medicaid Services, www.cms.gov/medicare/coverage/telehealth.
American Medical Association. "Remote Patient Monitoring Implementation Playbook." AMA, American Medical Association, www.ama-assn.org/practice-management/digital/remote-patient-monitoring-implementation-playbook-overview.
Centers for Medicare & Medicaid Services. "Physician Fee Schedule." CMS.gov, U.S. Centers for Medicare & Medicaid Services, www.cms.gov/medicare/payment/fee-schedules/physician.

Disclaimer: This article is provided for general informational purposes only and does not constitute legal, billing, clinical, or financial advice. Coverage rules, supervision requirements, and reimbursement policies change and vary by Medicare Administrative Contractor (MAC) and payer. Providers are responsible for verifying current requirements and confirming the accuracy of any claims they submit. CPT is a registered trademark of the American Medical Association. Individual practice results vary.

This year, Inc. recognized 507 companies nationwide following a comprehensive evaluation of hundreds of applicants. The Inc. Best Workplaces 2026 list celebrates organizations that invest meaningfully in their people, whether their teams work in person, remotely, or in a hybrid model. As a company built around remote care, we are especially honored to be recognized for the culture we have created across a distributed team that spans the country.

What the Inc. Best Workplaces 2026 Recognition Means

Inc. has spent nearly four decades championing America's most dynamic businesses. The Best Workplaces list specifically celebrates organizations that support their teams through strong leadership, meaningful benefits, professional development, and a culture people genuinely want to be part of. This year's list emphasized companies making sustained, authentic investments in their employees, even in a period when employee engagement has been declining across industries.

That distinction matters to us. Building a place where people want to work is not the result of a single perk or a one-time initiative. It is the product of consistent, intentional commitment to the team, and to the patients and providers who depend on that team. The recognition arrives during a period of meaningful growth for Nsight Health, and it affirms a principle we hold closely: the quality of care our patients receive is inseparable from the quality of the workplace our clinical and support teams experience.

It is also a recognition we did not give ourselves. The honor is the product of an independent process, anchored in the voices of the people who actually do the work. That is what makes it credible, and that is what makes it worth celebrating.

What Sets Our Culture Apart

Nsight Health was built remote-first, by design. Rather than treating distributed work as a temporary accommodation, we have structured the entire organization around it, from how we hire and onboard to how clinical teams collaborate on patient care. That approach lets us recruit exceptional clinicians and professionals wherever they live, and it gives our people the flexibility to do focused, meaningful work without sacrificing the rest of their lives.

Three things sit at the center of how we operate. The first is a shared sense of mission. Everyone at Nsight Health, whether they touch patient care directly or support the systems that make it possible, understands that the work adds up to something that matters: helping people stay healthier at home and out of the hospital. The second is investment in people. We believe professional development, clear communication, and supportive leadership are not extras but the foundation of good care. The third is accountability. We hold ourselves to a high standard because patients and provider partners are counting on us, and that standard is easier to meet when people feel trusted and supported.

Culture, in other words, is not a poster on a wall for us. It is the operating system that lets a distributed team deliver consistent, high-quality care at scale.

A Culture Built Around Patients and the People Who Serve Them

Nsight Health is not a software vendor. We are a full-service, clinically managed remote care company. That means we provide the technology, the connected cellular devices, and, most importantly, the U.S.-based clinical team employed by Nsight Health, including registered nurses, licensed vocational nurses, and medical assistants, who support patients around the clock.

When patients enroll in one of our programs, a real, licensed clinician is watching over their health and reaching out when something needs attention. That work is demanding, deeply human, and impossible to do well without a culture that supports the people doing it. Engaged, well-supported clinicians provide more attentive, more proactive, and more personalized care. In remote care, culture is not a soft benefit. It is a clinical advantage.

This is the throughline behind every milestone we report. To date, Nsight Health has supported more than 130,000 patients, served over 1,700 providers across more than 480 clinics, and monitored upward of 40 million vital sign readings. Behind each of those readings is a member of our team choosing to show up with care and rigor. This honor belongs to them.

How Inc. Selected the 2026 Best Workplaces

The Inc. Best Workplaces award is not based on self-promotion or a nomination form alone. It is grounded in what employees actually say. Inc. partnered with Quantum Workplace, an independent HR technology firm, to conduct a detailed, anonymous employee engagement survey. Each company's benefits were then independently audited, and the combined results determined every organization's overall score.

In other words, this honor was earned through the candid, confidential feedback of the people who work here. The evaluation looked across the core pillars of a healthy workplace:

Ready to see what a culture built around patients looks like in practice? Schedule a demo to meet the team behind the programs, or explore open roles on our careers page.

The State of Workplace Culture in Healthcare

This recognition lands at a moment when workplace culture has rarely mattered more. Employee engagement has been slipping across industries, and healthcare has felt that pressure acutely. Workforce strain and burnout remain real challenges, and they carry consequences that reach all the way to the bedside. When healthcare workers are stretched thin, continuity suffers, communication breaks down, and patients feel the difference.

Remote care is not immune to those pressures, but a strong culture is one of the most effective defenses against them. Teams that feel supported are more likely to stay, more likely to grow, and more likely to bring their full attention to every patient interaction. That is why we treat culture as a clinical investment, not a perk. Building a workplace people want to be part of is, in our view, one of the most direct ways to protect the quality and consistency of patient care over the long term.

Why Workplace Culture Matters in Remote Care

A clinically managed remote care model only works when the clinicians delivering it are supported, developed, and retained. Continuity of care depends on continuity of staff. When our team stays, grows, and feels invested in, our patients benefit from clinicians who know their history, understand their conditions, and can act quickly across our four core programs: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM).

It also speaks to consistency. Remote care is most effective when the same teams stay close to the same patients over months and years, learning their baselines and catching subtle changes early. That kind of attentive monitoring is far easier to sustain inside an organization people want to stay with. Culture, retention, and clinical quality reinforce one another, and an independent, employee-driven honor like this one is a credible external measure of all three.

What This Means for Patients

Patients rarely see the inside of the organization caring for them, but they feel the effects of its culture every day. A supported, stable clinical team means the nurse who reviews a patient's readings this month is likely to be familiar with that patient next month, too. It means faster, more confident outreach when a reading looks concerning. It means care that feels personal rather than transactional.

For the chronic conditions our programs are built around, that consistency is not a nicety. Conditions like hypertension, heart failure, diabetes, and COPD are managed over years, not appointments, and small, timely interventions compound into better outcomes. A workplace that keeps experienced clinicians engaged and present is, ultimately, a workplace that serves patients better.

What This Means for Our Provider Partners

For the providers and health systems who partner with us, this recognition is also a signal of reliability. When you extend your care team through Nsight Health, you are relying on our people. A strong, recognized workplace culture is one more reason partners can trust that the clinicians supporting their patients are here for the long term, delivering four programs under one roof with a single, accountable clinical team.

It also reflects how we show up as a partner. The same values that make Nsight Health a strong place to work, clear communication, accountability, and a genuine commitment to patients, are the values our partners experience in every interaction. If you are evaluating a remote care partner and want to understand how our model works, we would welcome the conversation. Schedule a demo and we will walk you through it.

Careers at Nsight Health

An honor like this is also an invitation. If you want to do meaningful work with a team that genuinely supports you, we would love to hear from you. Because we are remote-first, we hire talented people across the country, and we are growing across several parts of the organization.

Our teams span clinical care (registered nurses, licensed vocational nurses, and medical assistants), care coordination and patient experience, technology and engineering, operations, and the commercial functions that bring our programs to more providers and patients. Whatever your background, if you care about improving how people manage their health at home, there may be a place for you here.

You can explore current openings and learn what it is like to work here on our careers page. We encourage you to check back often, since new roles open as we grow. If you see a fit, we would be glad to meet you. Visit nsightcare.com/careers to apply.

Building the Team Behind Around-the-Clock Care

Recognition like this is encouraging, and it is also a responsibility. As Nsight Health continues to grow, we remain committed to investing in the team that makes our work possible: competitive benefits, real professional development, clear leadership, and a culture where people feel valued for the difference they make in patients' lives. We see this honor not as a finish line but as a baseline to keep building on, year after year, as our team and the number of patients we serve continue to expand.

To everyone on the Nsight Health team: thank you. This honor is yours. And to the clinicians, technologists, operators, and care coordinators who might be looking for a place to do meaningful work, our careers page is the place to start. You can also learn more about who we are on our About page.

Frequently Asked Questions

What is the Inc. Best Workplaces 2026 list?

It is Inc. magazine's annual recognition of companies that have built exceptional workplace cultures. The 2026 list honors 507 companies nationwide and celebrates organizations that invest meaningfully in their employees, whether they work in person, remotely, or in a hybrid environment.

How did Nsight Health earn a place on the list?

Selection was based on an independent, anonymous employee survey conducted by Quantum Workplace, measuring management effectiveness, perks, professional development, and overall culture, combined with an audit of company benefits to determine an overall score.

What does Nsight Health do?

Nsight Health is a full-service, clinically managed remote care company. We provide the technology, connected devices, and the U.S.-based clinical team that supports patients across four programs: Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management.

Why does workplace culture matter for a remote care company?

In clinically managed remote care, the quality of patient care is directly tied to the engagement and continuity of the clinical team. A supported, well-developed workforce delivers more proactive, more personalized, and more reliable care to patients and provider partners.

Does the Inc. Best Workplaces list include remote and hybrid companies?

Yes. The 2026 list recognizes exceptional workplace cultures whether teams operate in person, remotely, or in a hybrid model. As an organization built around remote care, Nsight Health is proud to be recognized for the culture we have created across a distributed team.

How many patients and providers does Nsight Health support?

Nsight Health has supported more than 130,000 patients and served over 1,700 providers across more than 480 clinics, monitoring upward of 40 million vital sign readings to date.

Is Nsight Health hiring?

Yes. As a growing, remote-first company, we hire across clinical care, patient experience, technology, operations, and commercial roles. You can view current openings on our careers page.

Does Nsight Health hire remote employees?

Nsight Health is built remote-first, so we recruit talented people across the country. Details for each role are listed on our careers page.

How can I work with or join Nsight Health?

Providers and health systems interested in partnering with us can schedule a demo. If you are interested in joining the team, visit our careers page to see open roles.

Works Cited

"Best Workplaces 2026." Inc., Inc. Business Media, 2026, www.inc.com/best-workplaces/2026.
"Employee Engagement and Workplace Survey Solutions." Quantum Workplace, 2026, www.quantumworkplace.com.
Nsight Health. "Careers." Nsight Health, 2026, nsightcare.com/careers.

Nsight Health delivers clinically managed remote care, including Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM), backed by a U.S.-based clinical team that supports patients around the clock. To learn how we can extend your care team, schedule a demo. To join our team, visit our careers page.

Disclaimer: This article is for informational purposes only and does not constitute medical, legal, or financial advice. The Inc. Best Workplaces designation reflects an independent evaluation conducted by Inc. and its survey partner. Program availability and clinical services are subject to applicable eligibility and regulatory requirements.

Key Takeaways

• Remote patient monitoring (RPM) is a healthcare service that uses internet-connected medical devices to collect physiologic data from patients at home and transmit it to their care team for clinical review and treatment management.
• Medicare has covered RPM since 2018, and CMS finalized a 2.5 percent payment increase for 2026 along with two new CPT codes (99445 and 99470) that expanded reimbursement to patients with lighter engagement patterns.
• Common RPM devices include cellular-connected blood pressure monitors, glucometers, weight scales, pulse oximeters, spirometers, and ECG monitors, all of which must meet FDA medical device criteria.
• RPM has produced measurable clinical outcomes including a documented 17 mmHg average reduction in systolic blood pressure among Nsight Health patients with stage 3 to 5 chronic kidney disease.
• Nsight Health supports more than 130,000 patients across 1,700 providers and 480 clinics with a 24/7/365 U.S.-based clinical team delivering RPM, Chronic Care Management, Behavioral Health Integration, and Principal Care Management under one operating model.

What is Remote Patient Monitoring? A Clear Definition

Remote patient monitoring, often abbreviated RPM, is a healthcare service in which patients use connected medical devices in their homes to collect physiologic data, which is then automatically transmitted to their healthcare provider for clinical review and treatment decisions. The Centers for Medicare and Medicaid Services formally defines RPM as the collection of patient-generated health data using a digital medical device, the transmission of that data to the provider, and the provider's use of that data to treat or manage the patient's condition.

RPM is part of the broader category of telehealth, but it is distinct from telehealth visits. A telehealth visit is a live audio or audio-video clinical encounter that substitutes for an in-person appointment. RPM, by contrast, is the ongoing collection and clinical management of health data between visits. The two services are complementary, have separate Current Procedural Terminology (CPT) codes, and serve different clinical purposes.

At Nsight Health, remote patient monitoring is delivered as a clinically managed service. Devices are shipped to patients, education and onboarding are handled by a dedicated care team, and a team of U.S.-based clinicians employed by Nsight Health reviews data 24 hours a day, 7 days a week, 365 days a year. The goal is not to generate data for the sake of data. The goal is to convert data into earlier interventions, fewer avoidable hospitalizations, and better disease control.

How Does Remote Patient Monitoring Work?

A well-designed RPM program operates through four stages, each of which has specific clinical and operational requirements.

Stage 1: Patient Identification and Enrollment

The provider identifies patients who would benefit from monitoring, most commonly during an Annual Wellness Visit, a routine appointment, or after a hospital discharge. The patient consents to participate, either verbally or in writing, and consent is documented in the medical record. CMS requires this consent to be captured before any RPM service is billed.

Stage 2: Device Setup and Patient Education

The patient receives a connected medical device shipped to their home, typically along with onboarding instructions and a training call. The device is paired to the monitoring platform, the patient is taught how to take readings, and the provider's care team confirms the first successful data transmission. CMS bills this initial setup once per device under CPT 99453.

Stage 3: Daily or Periodic Data Collection

The patient uses the device on a regular cadence, often daily, to take readings of the relevant vital sign. Data flows automatically from the device through the cellular network or Bluetooth-paired smartphone to the monitoring platform, where it is stored, displayed in dashboards, and flagged when readings cross clinical thresholds.

Stage 4: Clinical Review, Intervention, and Care Plan Adjustment

A clinical team reviews incoming data, intervenes when readings indicate a problem, escalates urgent cases to the patient's provider, and documents time spent on monitoring and treatment management. Readings that show worsening hypertension trigger a medication titration conversation. A blood pressure spike at midnight triggers an after-hours protocol. Persistent glucose elevations prompt a diet, medication, or specialist referral.

This is the part of RPM that creates clinical value. The technology is only the input. The clinical workflow on top of the data is what improves outcomes.

Common Remote Patient Monitoring Devices

To qualify under CMS rules, an RPM device must be a defined medical device under section 201(h) of the Federal Food, Drug, and Cosmetic Act, must automatically upload patient data without manual transcription, and must collect data on a clinically relevant cadence. The most commonly deployed devices include:

• Blood pressure monitors for hypertension, chronic kidney disease, heart failure, and post-acute monitoring
• Glucometers for type 2 diabetes management and glycemic control
• Weight scales for congestive heart failure fluid overload tracking and obesity management
• Pulse oximeters for COPD, asthma, and post-respiratory illness recovery
• Spirometers for COPD and asthma lung function tracking
• Peak flow meters for asthma management
• ECG devices for arrhythmia, atrial fibrillation, and cardiac monitoring

One important distinction in device selection: cellular-connected devices versus Bluetooth-paired devices. Cellular devices transmit data directly through the mobile network, without requiring a smartphone, app, or home Wi-Fi setup. Adherence rates with cellular devices are consistently higher than with Bluetooth-paired devices, particularly among older adult Medicare populations who often struggle with smartphone pairing.

Which Patients and Conditions Qualify for RPM?

CMS does not maintain a fixed list of conditions eligible for RPM. The standard is that the monitoring must be medically necessary and must inform the patient's treatment plan. In practice, the most common qualifying conditions are:

• Hypertension. The largest single RPM population. Blood pressure monitoring at home produces more accurate readings than office-only measurement and drives better medication titration.
• Type 2 diabetes. Continuous or periodic glucose data enables medication adjustments, dietary interventions, and earlier identification of patients drifting out of glycemic control.
• Congestive heart failure. Daily weight and vital sign monitoring identifies fluid overload days before it becomes a hospitalization.
• Chronic kidney disease. Blood pressure control is the single most important intervention in slowing CKD progression, and RPM-driven BP management has produced significant systolic reductions in advanced CKD populations.
• Chronic obstructive pulmonary disease (COPD) and asthma. Pulse oximetry, spirometry, and peak flow tracking detect exacerbations early enough for intervention.
• Obesity. Weight monitoring supports medical weight management and bariatric surgery follow-up.
• Post-acute and transitional care. The 30 to 90 day window after a hospital discharge, particularly for heart failure, pneumonia, COPD, and acute myocardial infarction, is the highest-risk readmission window and benefits most from active monitoring.
• Pregnancy and high-risk maternity. Blood pressure, weight, and glucose tracking for preeclampsia risk and gestational diabetes management.

RPM also increasingly supports specialty populations including post-surgical recovery, oncology symptom monitoring, behavioral health vital sign tracking, and dialysis patient management.

The Benefits of Remote Patient Monitoring

RPM produces measurable benefits across three audiences: patients, providers, and the broader health system.

Benefits for Patients

Patients receive earlier intervention when their health changes. They spend less time in waiting rooms, less time in emergency departments, and less time in hospitals. They become more engaged in their own disease management because they can see their own data trends. For chronically ill patients, particularly those managing multiple conditions, RPM converts what would otherwise be intermittent, reactive care into continuous, proactive care.

Benefits for Providers

Providers gain visibility into how their patients are actually doing between visits, not just on the day of an appointment. They can make medication adjustments based on weeks of data rather than a single in-office reading. They generate new Medicare-reimbursed revenue per enrolled patient. They perform better on value-based care contracts and quality measures including blood pressure control, HbA1c control, and readmission rates.

Benefits for Health Systems and ACOs

Health systems and accountable care organizations use RPM to reduce avoidable readmissions, particularly under the CMS Hospital Readmissions Reduction Program (HRRP) where excess readmissions for heart failure, pneumonia, COPD, and acute myocardial infarction trigger up to a 3 percent Medicare payment reduction across all DRGs. RPM-driven monitoring during the 30 to 90 day post-discharge window is one of the most effective operational levers for reducing these penalties.

Clinical Evidence: What RPM Actually Delivers

RPM is a clinical service, and the evidence base supporting its impact has grown substantially over the past decade. Nsight Health's clinical evidence white paper documents the following outcomes across the patient populations Nsight serves:

• Hypertension overall: An average reduction of 11.5 mmHg in systolic blood pressure across the broader hypertensive population enrolled in structured RPM.
• Stage 2 hypertension: An average reduction of 29.6 mmHg systolic among patients with the most poorly controlled blood pressure.
• Chronic kidney disease, stages 3 to 5: An average 17 mmHg systolic reduction, a clinically meaningful improvement given that systolic BP control is the single largest intervention in slowing CKD progression.
• Diabetes: A documented 55 mg/dL average reduction in fasting glucose among enrolled patients with type 2 diabetes.
• Heart failure: A reduction of greater than 50 percent in hospital admissions for patients in structured RPM programs. Reflects legacy RPM literature; individual results vary by patient population and program design.

Independent published research supports these findings. A widely cited Mayo Clinic study found that patients receiving remote monitoring after hospital discharge experienced fewer readmissions and required less follow-up care than patients without monitoring. JAMA Network research on remote symptom monitoring with electronic patient-reported outcomes in cancer populations documented 19 percent and 13 percent reductions in hospitalizations at 3 and 6 months respectively.

2026 Reimbursement and Billing Basics

Medicare has covered remote patient monitoring as a billable service since 2018, and 2026 represents the largest expansion of RPM reimbursement in several years. CMS finalized a 2.5 percent payment increase for the 2026 Medicare Physician Fee Schedule, the first material payment increase in five years, and introduced two new CPT codes effective January 1, 2026.

The current RPM CPT code family includes:

• CPT 99453: Initial setup and patient education, billed once per device episode. National average reimbursement is approximately $20.
• CPT 99454: Device supply with daily recording for at least 16 days in a 30-day period. National average reimbursement is approximately $47.
• CPT 99445 (new for 2026): Device supply for 2 to 15 days of monitoring in a 30-day period, with national average reimbursement of approximately $47. Removes the long-standing 16-day cliff that excluded patients with lighter engagement patterns from billing.
• CPT 99457: First 20 minutes of treatment management services per calendar month, requiring at least one interactive communication with the patient or caregiver. National average reimbursement is approximately $48.
• CPT 99458: Each additional 20 minutes of treatment management. Add-on to 99457. National average reimbursement is approximately $39.
• CPT 99470 (new for 2026): First 10 minutes of treatment management services per calendar month, reimbursed at approximately $26 nationally. Provides a billing pathway for shorter clinically meaningful touchpoints.
• CPT 99091: Physician or qualified health professional time spent collecting and interpreting RPM data. Often billed less frequently due to overlap with 99457.

For most practices with a mature program, the realistic gross revenue per fully enrolled RPM patient ranges from $120 to $170 per month before vendor costs. To model your specific scenario with locality-adjusted rates and your payer mix, the Nsight RPM Reimbursement Calculator covers all 2026 codes across more than 110 Medicare localities.

One operational note: CMS requires at least one live, real-time interactive communication with the patient or caregiver during the calendar month to bill 99457, 99458, or 99470. CMS guidance on what specifically qualifies as interactive communication remains intentionally broad, and ongoing CMS clarifications mean practices should consult their RPM partner or compliance counsel for current operational interpretation.

Programs You Can Stack With RPM

RPM is often most clinically and financially effective when stacked with complementary Medicare programs. CMS expressly permits concurrent billing across the following services when each program's individual requirements are met:

• Chronic Care Management (CCM). Provides reimbursement for non-face-to-face care coordination time for patients with two or more chronic conditions expected to last at least 12 months. Frequently stacked with RPM for hypertensive, diabetic, and cardiac patient populations.
• Principal Care Management (PCM). Reimburses care management focused on a single high-risk chronic condition. Useful for patients managing one dominant disease such as advanced CKD or severe COPD.
• Behavioral Health Integration (BHI). Reimburses care management for patients with behavioral health diagnoses including depression and anxiety, frequently co-occurring with chronic medical conditions.
• Transitional Care Management (TCM). Covers care coordination in the 30-day window immediately after a hospital or skilled nursing facility discharge.

For patient populations with multiple chronic conditions, the combined economics of these stacked programs can produce significantly higher monthly per-patient revenue than RPM alone, while simultaneously improving clinical outcomes by aligning monitoring with active care coordination.

How to Get Started with Remote Patient Monitoring

For providers and practice administrators evaluating RPM for the first time, the practical path forward usually looks like this:

1. Define your use case. RPM serves different purposes in chronic care, post-acute care, and Hospital-at-Home environments. Defining which use case applies to your patient population shapes vendor selection, device choice, and clinical workflow design.
2. Model the economics. Use a locality-adjusted reimbursement calculator with your specific Medicare payer mix to understand realistic monthly revenue per enrolled patient.
3. Evaluate vendors against published criteria. The clinical staffing model (employed versus contracted), audit-readiness, EHR integration depth, and published outcomes vary widely across the market.
4. Plan implementation. A competent vendor moves you from contract signature to first billable encounter within 30 to 60 days for ambulatory practices. Health systems and ACOs typically run longer. For a full walkthrough, see our guide on how to start a remote patient monitoring program.
5. Schedule a strategy conversation. If you would like to discuss whether Nsight Health is the right partner for your practice or health system, schedule a strategy session with our team. We will walk through your patient population, your EHR environment, and your reimbursement assumptions before discussing a contract.

For patients who are interested in RPM, the first conversation is with your primary care provider, cardiologist, nephrologist, or other treating specialist. Ask whether RPM is appropriate for your condition, what device or devices would be involved, and whether your practice has a managed RPM partner that handles education, monitoring, and outreach on the provider's behalf.

Frequently Asked Questions

What is remote patient monitoring in simple terms?
Remote patient monitoring is a service in which patients use connected medical devices at home to take readings such as blood pressure, blood glucose, or weight, with the data automatically sent to their healthcare provider. The provider's team reviews the data, intervenes when needed, and adjusts the treatment plan over time.

What is the difference between remote patient monitoring and telehealth?
Telehealth refers to live audio or audio-video clinical visits that substitute for or supplement in-person appointments. Remote patient monitoring is the ongoing collection and clinical management of physiologic data between visits. The two services are complementary, have separate CPT codes, and serve different clinical purposes.

What conditions qualify for remote patient monitoring?
CMS does not maintain a fixed list. Common qualifying conditions include hypertension, type 2 diabetes, congestive heart failure, chronic kidney disease, chronic obstructive pulmonary disease, asthma, and obesity. The clinical standard is that the monitoring must be medically necessary and must inform the treatment plan.

Does Medicare cover remote patient monitoring?
Yes. Medicare has covered RPM as a billable service since 2018. CMS finalized a 2.5 percent payment increase for 2026 and introduced two new RPM CPT codes (99445 and 99470) effective January 1, 2026. Patients are typically responsible for a Medicare Part B copay; Medicare Advantage and supplemental plans vary.

How much does Medicare pay for remote patient monitoring?
National average rates for the 2026 RPM code family are approximately $20 for setup (99453), $47 for monthly device supply (99454 or new code 99445), $48 for the first 20 minutes of treatment management (99457), $39 for each additional 20 minutes (99458), and $26 for the new 10-minute code (99470). Actual reimbursement varies by Medicare locality.

What devices are used in remote patient monitoring?
Common devices include blood pressure monitors, glucometers, weight scales, pulse oximeters, spirometers, peak flow meters, and ECG monitors. All devices must qualify as medical devices under FDA criteria and must automatically transmit data without manual transcription. Cellular-connected devices generally produce higher adherence than Bluetooth-paired devices, particularly in older adult populations.

Is remote patient monitoring effective?
Published evidence supports meaningful clinical impact across multiple conditions. Nsight Health's documented outcomes include an average 17 mmHg systolic blood pressure reduction in stage 3 to 5 chronic kidney disease patients and an 11.5 mmHg reduction across the broader hypertensive population. Independent research from Mayo Clinic and JAMA Network has documented readmission reductions and lower hospitalization rates across various RPM-enrolled populations.

How long does it take to launch an RPM program?
With a competent vendor partner, most primary care practices reach their first billable encounter within 30 to 60 days of contract signature, and reach steady-state operations within 90 days. Specialty practices, large health systems, and ACOs with multiple integration touchpoints typically run longer.

Can RPM be billed alongside Chronic Care Management?
Yes. CMS expressly permits concurrent billing of RPM with CCM, PCM, BHI, and TCM provided that each program's individual requirements are met. Stacking these services frequently produces stronger clinical outcomes and higher per-patient revenue than RPM alone.

What is the new RPM CPT code 99445 for?
CPT 99445, effective January 1, 2026, covers device supply for 2 to 15 days of monitoring in a 30-day period. It reimburses at approximately the same national average as 99454 (around $47) and creates a billing pathway for patients whose engagement falls below the long-standing 16-day threshold required by 99454.

Nsight Health delivers clinically managed remote care for more than 130,000 patients across 1,700 providers and 480 clinics nationwide. Our U.S.-based clinical team supports patients 24 hours a day, 7 days a week, 365 days a year through Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management. Schedule a strategy session to learn how we can support your practice and your patients.

Clinical review: Nsight Health clinical leadership. Outcomes cited are documented in Nsight Health's Clinical Evidence White Paper.

Sources: Centers for Medicare and Medicaid Services, "Remote Patient Monitoring," cms.gov. Centers for Medicare and Medicaid Services, "Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)," October 31, 2025, cms.gov. Telehealth.HHS.gov, "Introduction to telehealth and remote patient monitoring," telehealth.hhs.gov. Agency for Healthcare Research and Quality, Patient Safety Network, "Remote Patient Monitoring," psnet.ahrq.gov. American Medical Association, "Remote Patient Monitoring Implementation Playbook," ama-assn.org.

This article is for educational and informational purposes only and does not constitute legal, billing, clinical, or medical advice. CPT codes, reimbursement rates, and regulatory requirements referenced herein are based on publicly available CMS guidance current as of early 2026 and are subject to annual updates, geographic adjustments, and payer-specific variation. Nothing in this article should be construed as a guarantee of reimbursement or a recommendation for specific billing practices. CPT is a registered trademark of the American Medical Association. Consult a qualified billing compliance specialist, healthcare attorney, or your Medicare Administrative Contractor for program-specific guidance applicable to your practice.

• Nsight Health proudly sponsored the 2026 National Kidney Foundation Golf Classic at Hollywood Golf Club in Deal, New Jersey, joining a national community working to advance kidney health.
• The NKF Golf Classic is the Premier Amateur Golf Event for Charity, raising more than $3.5 million annually for kidney research, education, and patient support.
• The 2026 tournament arrived during NKF's 75th anniversary year, marking three quarters of a century of progress in kidney care, advocacy, and research.
• About 1 in 3 U.S. adults is at risk for kidney disease, and roughly 90 percent of the 37 million Americans living with chronic kidney disease do not know they have it.
• Nsight's clinically managed remote care programs, including remote patient monitoring and chronic care management, serve patients living with the conditions that drive most kidney disease cases.

On the morning of May 12, 2026, the fairways of Hollywood Golf Club in Deal, New Jersey filled with golfers united by a single purpose: advancing kidney health for the more than 37 million Americans living with chronic kidney disease. Nsight Health was proud to sponsor the 2026 National Kidney Foundation Golf Classic, and our team showed up ready to play, ready to listen, and ready to stand alongside the patients, families, and clinicians who refuse to let kidney disease remain invisible.

For our team, this was more than a day on the course. It was a chance to support an organization that has shaped American kidney care for the past 75 years, and to reaffirm the work we do every day for people living with kidney disease, hypertension, diabetes, and the chronic conditions that put kidney function at risk.

The Nsight Health team at the 2026 NKF Golf Classic, Hollywood Golf Club, Deal, NJ.

A 75-Year Mission We Are Proud to Support

The National Kidney Foundation was founded in 1950 by Ada and Harry DeBold, parents of a young son diagnosed with nephrotic syndrome at a time when there were almost no treatment options for kidney disease. What began as the Committee for Nephrosis Research has grown into the country's most comprehensive voice for kidney patients, contributing to landmark milestones that have shaped modern care: the Uniform Anatomical Gift Act in 1968, the establishment of the Medicare End-Stage Renal Disease benefit in 1972, the National Transplant Act in 1984, the KDOQI clinical practice guidelines in 1995, and the adoption of the race-free eGFR equation in 2021.

Seventy-five years later, NKF's mission has never been more relevant. The Foundation continues to lead on advocacy, research funding, patient education, professional guidelines, and equitable access to care across dialysis and transplantation. Sponsoring the Golf Classic is one way our team can give back to an organization whose work touches almost every aspect of the patients we serve.

Since its founding in 1987, the NKF Golf Classic has grown into the Premier Amateur Golf Event for Charity, with nearly 30 tournaments held each year at top venues across the country. Together, golfers like the ones who joined us at Hollywood raise more than $3.5 million annually for NKF, with cumulative giving now exceeding $100 million. The top finishing teams from each local event earn a place at the National Finals at Pebble Beach Resorts, but the real win is the awareness and funding the tournaments generate for kidney patients nationwide.

The Stakes for Kidney Health

Walking the course at Hollywood, the message on every tee box told the story plainly. Early detection and treatment can slow or prevent kidney disease. High blood pressure causes kidney disease, and kidney disease causes high blood pressure. Sodium is a sand trap most people never see coming. Take a minute between rounds, because 1 in 3 U.S. adults is at risk and you might be the 33 percent.

The numbers behind those signs are sobering. According to the National Kidney Foundation, more than 37 million U.S. adults are estimated to have chronic kidney disease, and approximately 90 percent of them do not know they have it. The primary risk factors are diabetes, high blood pressure, heart disease, obesity, and family history. Black, Hispanic, American Indian, Alaska Native, Asian American, Native Hawaiian, and other Pacific Islander populations bear a disproportionate share of kidney failure cases, including rates of kidney failure that are roughly four times higher among Black adults compared to White adults.

The clinical picture is equally direct. Kidney disease rarely shows up by itself. It moves in with high blood pressure, with poorly controlled diabetes, with congestive heart failure. Each of those conditions accelerates the others, and the longer they remain undetected or unmanaged, the more nephrons quietly disappear. By the time symptoms become unmistakable, much of the damage is already done.

That is the case for early detection, and it is also the case for the kind of ongoing, between-visit care that gives clinicians a real picture of how a patient is doing in the weeks and months that pass between in-office appointments. A blood pressure reading captured every day from home tells a different story than one captured once every three months in a clinic waiting room. A weight trend over six weeks tells a different story than a single number on a chart.

Why This Cause Sits at the Heart of Our Work

Nsight Health is a clinically managed remote care company. We serve more than 130,000 patients across 1,700 providers and 480 clinics, and we have captured more than 40 million vital sign readings on behalf of the clinicians who trust us with their patients. Our four active programs, Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM), give primary care, cardiology, nephrology, and behavioral health teams an extended clinical presence in their patients' lives.

Many of the patients on our service are managing exactly the conditions that drive kidney disease. Hypertension. Type 2 diabetes. Heart failure. Each one represents an opportunity to intervene earlier, communicate more often, and adjust care before a small problem becomes a hospitalization. Our team of W2 clinicians, including registered nurses, licensed vocational nurses, and medical assistants, monitors patients 24 hours a day, 7 days a week, 365 days a year, and works in close partnership with the patient's own provider to escalate when readings drift outside the safe range.

The clinical case for this kind of care continues to strengthen. In our own clinical evidence white paper, we have documented an average reduction of 17 mmHg in systolic blood pressure among patients with stage 3 to 5 chronic kidney disease enrolled in structured remote monitoring programs, alongside meaningful reductions across broader hypertensive populations and improvements in glycemic control among patients with diabetes. These are the kinds of clinical outcomes that translate, downstream, into slower disease progression and fewer adverse events for kidney patients.

From there, the operational and financial benefits follow. Practices that integrate remote care into their hypertension, diabetes, and CKD workflows reduce no-shows on follow-up visits, capture more accurate longitudinal data, and unlock additional Medicare reimbursement under existing CMS programs. But the clinical impact comes first, and it is what brought our team to Deal in the first place.

Inside the Day at Hollywood Golf Club

Hollywood Golf Club is one of the great old courses on the Jersey Shore, with mature trees, classic bunkering, and views that make even a difficult round feel like a privilege. The NKF Eastern Pennsylvania and New Jersey team did a beautiful job staging the day. The course was lined with educational signage, the practice green was busy from the first arrival, and the energy at registration was the kind you only get when the field believes in the cause.

Our foursome played out of carts branded with the Nsight Health logo, traded stories on the back nine, and met members of the New Jersey nephrology community we had not seen since this spring's renal conference circuit. The conversations ranged from CKD screening workflows, to evolving CMS billing rules, to which short game drills actually work. Mostly we listened. There is a particular humility that comes with spending the day at an event where many of the people you meet are themselves living with kidney disease, are caring for someone who is, or are part of a transplant story that ended well.

By the end of the day, scores had been signed, prizes had been handed out, and a course full of golfers had collectively contributed to a tournament whose proceeds will fund NKF programs across the region. None of us came home with a Pebble Beach invite. All of us came home grateful.

Looking Ahead

Sponsoring the 2026 NKF Golf Classic is one part of a broader commitment Nsight Health has made to the kidney community. Earlier this year, our team served as an Innovator sponsor at the Renal Physicians Association Annual Meeting, where Alex Bienemann presented our latest clinical evidence in nephrology. We continue to invest in clinical content, professional education, and partnerships with nephrology practices that want to extend the reach of their care beyond the four walls of the clinic.

If you are a nephrologist, a primary care physician managing hypertension and diabetes at scale, or a health system leader thinking about how to slow CKD progression across your patient population, we would be glad to talk. There is no single solution to a disease that hides as effectively as chronic kidney disease, but there is a body of evidence that says continuous, clinically managed engagement helps. We are proud to be part of that work, and we are proud to support the National Kidney Foundation as it enters its next 75 years.

To learn more about how Nsight Health partners with clinicians to deliver clinically managed remote care for kidney patients and the populations at greatest risk, schedule a strategy session with our team. To learn more about NKF and the Golf Classic series, visit kidney.org/golf.

Frequently Asked Questions

Q: What is the NKF Golf Classic?
A: The NKF Golf Classic is the National Kidney Foundation's signature golf fundraising series, founded in 1987 and held at nearly 30 venues across the United States each year. It is recognized as the Premier Amateur Golf Event for Charity, raising more than $3.5 million annually for kidney research, advocacy, education, and patient programs. The top finishing teams from local tournaments qualify for the National Finals at Pebble Beach Resorts.

Q: Where was the 2026 NKF Golf Classic that Nsight Health sponsored?
A: Nsight Health sponsored the NKF Eastern Pennsylvania and New Jersey region's 2026 tournament, held on May 12, 2026 at Hollywood Golf Club in Deal, New Jersey. The event benefits NKF's mission to enhance the lives of kidney patients through advocacy, education, and research.

Q: How common is chronic kidney disease, and why does it matter?
A: According to the National Kidney Foundation, more than 37 million U.S. adults are estimated to have chronic kidney disease (CKD), and approximately 90 percent of them are unaware of their condition. About 1 in 3 U.S. adults is at risk. Diabetes, high blood pressure, heart disease, obesity, and family history are the leading risk factors, which makes early detection and proactive chronic care management critical for slowing disease progression.

Q: How does Nsight Health support patients at risk for or living with kidney disease?
A: Nsight Health provides clinically managed remote care for patients managing the chronic conditions that drive most kidney disease, including hypertension, type 2 diabetes, and heart failure. Our W2 clinical team, working 24 hours a day, 7 days a week, supports patients with Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management in partnership with their treating provider.

Q: How can my practice get involved with NKF or with Nsight Health?
A: Practices interested in supporting NKF can learn more about local Golf Classic tournaments, Kidney Walks, and Renal Roundtable programs at kidney.org. Clinicians interested in extending their care for kidney patients through remote patient monitoring and chronic care management can schedule a strategy session with the Nsight Health team to discuss program design, clinical workflows, and reimbursement.

Nsight Health delivers clinically managed remote care for more than 130,000 patients across 1,700 providers and 480 clinics nationwide. Our W2 clinical team supports patients 24 hours a day, 7 days a week, 365 days a year through Remote Patient Monitoring, Chronic Care Management, Behavioral Health Integration, and Principal Care Management. Schedule a strategy session to learn how we can support your practice and your patients.

This is the third major industry award for Nsight Health in 2026, following the company's Gold and Silver Stevie Awards at the American Business Awards and its No. 12 ranking on the Inc. 5000 Regionals Southeast list. Together, these recognitions validate what Nsight Health has built: a clinically managed remote care model that delivers measurable patient outcomes at scale.

What the Best RPM Solution Award Recognizes

The MedTech Breakthrough Awards program is an independent market intelligence organization that recognizes the most innovative companies, technologies, and products in the global digital health and medical technology market. Now in its 10th year, the program received a record-breaking number of nominations from leading companies and startups across more than 20 countries.

The Best RPM Solution category evaluates remote patient monitoring platforms on clinical effectiveness, operational scalability, patient engagement, and the ability to deliver sustained outcomes beyond initial deployment. Nsight Health was selected for its vertically integrated approach that combines connected medical devices, proprietary software, patient engagement strategies, and 24/7 clinical support into a single operating solution.

"Nsight Health transforms remote care from a collection of tools into a sustainable clinical model. Healthcare organizations do not struggle with access to technology, but with execution from point solutions. This operational complexity prevents virtual care programs from delivering consistent clinical and financial performance," said Steve Johansson, managing director, MedTech Breakthrough. "Nsight Health operates as an extension of the clinical enterprise. By aligning software, devices, patient engagement, and clinical services into a single operating solution, this platform transforms remote monitoring from a capability into a competitive advantage."

Why the Clinically Managed Model Won

Most remote patient monitoring companies sell software. Some add device fulfillment. A smaller number include basic clinical monitoring. Nsight Health does all of this, but goes further by operating as a fully managed clinical service that functions as an extension of the provider's care team.

The distinction matters because clinical outcomes depend on execution, not technology alone. A blood pressure cuff sitting in a box does not improve hypertension management. A dashboard that nobody monitors does not reduce hospitalizations. What changes patient outcomes is the combination of the right device in the patient's hands, consistent daily readings flowing into a monitored system, and a clinical team that acts on abnormal data in real time.

That is what Nsight Health has built. The company delivers four clinically managed programs under one roof: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM). Each program is supported by W2 registered nurses and care coordinators who provide 24/7/365 clinical coverage.

Today, Nsight Health supports more than 130,000 patients across 1,700+ provider teams and 480+ clinics nationwide, with more than 40 million vitals monitored to date.

From the Founder

"Our always-on RPM model blends technology and clinical infrastructure into a single system that is difficult to replicate. We designed it not just to enable virtual care, but to make it durable, scalable, and financially viable. This fully managed approach allows practices to deploy RPM confidently, without adding headcount or operational strain," said Michael Ciullo, Founder and CEO of Nsight Health. "We will continue to focus on enrollment optimization, first-reading activation, and long-term adherence to enable partners to move beyond pilot programs and operate RPM at production scale with measurable operational and financial impact."

Three Awards in 2026: A Pattern, Not a Coincidence

The MedTech Breakthrough Award is the third major recognition Nsight Health has received in 2026:

Each award evaluates a different dimension of the business. Inc. measured how fast Nsight grew. The Stevie Awards measured the quality of what Nsight built. MedTech Breakthrough measured the clinical and technical innovation behind the platform. Winning across all three categories in a single year reflects a company where growth, quality, and innovation are driven by the same thing: a clinical model that works.

What This Means for Healthcare Providers

For healthcare organizations evaluating remote patient monitoring solutions, the MedTech Breakthrough Award provides independent, third-party validation of a model that is already delivering results for 1,700+ provider teams nationwide.

Providers who partner with Nsight Health receive a fully managed remote care program that includes device procurement and fulfillment, patient onboarding and engagement, 24/7 clinical monitoring by W2 registered nurses, care plan documentation and provider coordination, compliant billing support for RPM, CCM, BHI, and PCM, and a proprietary software platform (PRVNT.ai) that powers the entire workflow.

The result is a remote care program that generates clinical outcomes without requiring the practice to hire additional staff, manage devices, or build clinical workflows from scratch.

If your organization is exploring remote patient monitoring, chronic care management, or any of the four CMS-reimbursed remote care programs, schedule a demo to see how Nsight Health's award-winning model works in practice.

About the MedTech Breakthrough Awards

Part of Tech Breakthrough, a leading market intelligence and recognition platform for global technology innovation, the MedTech Breakthrough Awards program is devoted to honoring excellence in medical and health-related technology companies, products, services, and people. The program provides public recognition for achievements across categories including Patient Engagement, mHealth, Clinical Administration, Healthcare IoT, Medical Data, and more. For more information, visit medtechbreakthrough.com.

Frequently Asked Questions

What is the MedTech Breakthrough Awards program?

The MedTech Breakthrough Awards is an independent market intelligence organization that recognizes the most innovative companies, technologies, and products in the global digital health and medical technology market. The 2026 program marks its 10th anniversary and received a record-breaking number of nominations from organizations across more than 20 countries.

What award did Nsight Health win?

Nsight Health was named the winner of the "Best Remote Patient Monitoring (RPM) Solution" in the 2026 MedTech Breakthrough Awards program.

What other companies won MedTech Breakthrough Awards in 2026?

The 2026 winner list includes globally recognized healthcare organizations such as Boston Scientific, Medtronic, Teladoc, CVS Health, Noom, and Thermo Fisher Scientific, among many others across more than 20 countries.

How many awards has Nsight Health won in 2026?

The MedTech Breakthrough Award is the third major industry recognition for Nsight Health in 2026, following the Gold and Silver Stevie Awards at the American Business Awards and a No. 12 ranking on the Inc. 5000 Regionals Southeast list.

What programs does Nsight Health offer?

Nsight Health delivers four clinically managed remote care programs: Remote Patient Monitoring (RPM), Chronic Care Management (CCM), Behavioral Health Integration (BHI), and Principal Care Management (PCM). All four programs are supported by W2 registered nurses and care coordinators who provide 24/7/365 clinical coverage.

What makes Nsight Health different from other RPM companies?

Nsight Health operates as a fully managed clinical service, not a software platform. The company combines connected medical devices, proprietary software (PRVNT.ai), patient engagement strategies, and 24/7 W2 clinical staff into a single integrated solution. This model eliminates the operational complexity that prevents most virtual care programs from delivering consistent clinical and financial performance.

How can my practice get started with Nsight Health?

Healthcare organizations interested in deploying a fully managed RPM, CCM, BHI, or PCM program can schedule a demo to see how Nsight Health's award-winning model works in practice.

Nsight Health is a fully managed remote care company delivering RPM, CCM, PCM, and BHI with 24/7 W2 clinician support for 130,000+ patients across 1,700+ provider teams. Nsight Health is a self-funded, founder-led company headquartered in Miami, Florida. For more information, visit nsightcare.com.

Read the full press release: Nsight Health Recognized for Remote Patient Monitoring Innovation in 2026 MedTech Breakthrough Awards Program

This article is for informational purposes only and does not constitute medical, clinical, legal, or financial advice. The MedTech Breakthrough Awards recognition consists of the opinions of the Tech Breakthrough LLC organization and should not be construed as statements of fact. Tech Breakthrough LLC disclaims all warranties, expressed or implied, with respect to this recognition program.

Works Cited

"Nsight Health Recognized for Remote Patient Monitoring Innovation in 2026 MedTech Breakthrough Awards Program." GlobeNewsWire, 7 May 2026, www.globenewswire.com/news-release/2026/05/07/3290207/0/en/nsight-health-recognized-for-remote-patient-monitoring-innovation-in-2026-medtech-breakthrough-awards-program.html.

"A Decade of Digital Health Innovation: MedTech Breakthrough Announces Winners of the 10th Annual Awards Program." GlobeNewsWire, 7 May 2026, www.globenewswire.com/news-release/2026/05/07/3290202/0/en/a-decade-of-digital-health-innovation-medtech-breakthrough-announces-winners-of-the-10th-annual-awards-program.html.

"2026 Winners." MedTech Breakthrough, medtechbreakthrough.com/2026-winners/.

Nsight Health has been named a two-time winner at the 2026 American Business Awards, earning a Gold Stevie Award for Best Health Products and Services and a Silver Stevie Award for Fastest Growing Company of the Year. The American Business Awards, widely recognized as one of the premier business award programs in the United States, received more than 12,000 nominations this year across categories spanning every industry and company size.

For a self-funded, founder-led company competing against venture-backed organizations with far greater resources, winning two Stevie Awards in the same year is a statement about what is possible when clinical outcomes drive growth.

Two Awards, One Thesis

The two categories Nsight Health won are connected by the same underlying thesis: that building the best remote care products and services is what drives the fastest growth.

The Gold Stevie Award for Best Health Products and Services recognizes the breadth, depth, and clinical rigor of Nsight Health's fully managed remote care platform. Nsight is one of the only companies in the country that delivers four clinically managed remote care programs, RPM, CCM, PCM, and BHI, under one roof, supported by a W2 clinical team of registered nurses and care coordinators who monitor patients 24/7/365.

The Silver Stevie Award for Fastest Growing Company of the Year recognizes the trajectory that product excellence produces. Nsight Health achieved 140% year-over-year growth in 2025, more than doubling the business in a single year. Cumulative growth since the company's founding now exceeds 23,000%, one of the most sustained growth trajectories in the remote care industry.

Clinical Outcomes That Drive Everything

Both award submissions were anchored by clinical outcome data validated by Nsight Health's clinical leadership. Across four chronic disease cohorts, Nsight's monitored patient population has shown meaningful, measurable improvements*:

• Hypertension (n=11,148): 21% increase in patients within normal blood pressure limits, 15% reduction in Stage 2 hypertension prevalence, and 49% reduction in critical hypertensive alerts, with improvements measurable within three months of enrollment
• Diabetes (n=227): Average blood glucose reduction of approximately 50 mg/dL sustained over 12 to 18 months, with a 24.5% average reduction in the 12 to 18 month cohort
• COPD (n=776): 22% reduction in critical oxygen desaturation alerts and 8.5% increase in patients maintaining normal oxygen ranges over five months of continuous monitoring
• Heart Failure (n=97): 72% reduction in critical fluid-gain alerts within two months and 75% reduction within two to three months, significantly reducing hospitalization risk for one of healthcare's highest-cost patient populations

*Clinical outcomes data reflects internal observations from Nsight Health's remote patient monitoring programs reviewed by our clinical leadership. These figures represent aggregate trends across our monitored patient population and are specific to Nsight Health's clinical protocols, patient demographics, and monitoring infrastructure. Results have not been independently validated through peer-reviewed research or randomized controlled trials. Individual patient outcomes vary based on condition severity, medication adherence, patient engagement, and other clinical and social factors. Nothing in this article constitutes medical advice or a guarantee of specific clinical outcomes.

These observed improvements matter because they are the reason providers expand their programs and refer their colleagues. Clinical credibility is the engine behind Nsight's growth.

Growth by the Numbers

The Fastest Growing Company nomination detailed a growth trajectory that has accelerated rather than plateaued as the company has scaled:

• 140% growth in 2025, following 69% in 2024 and 47% in 2023, with each year outperforming the last
• 23,000%+ cumulative growth since 2021
• 437 employees, including nearly 200 clinical professionals, up from 100 just two years ago
• 130,000+ patients currently receiving remote care services
• 1,700+ provider teams across primary care, specialty, and multi-site health systems
• 480+ clinics actively using Nsight's fully managed remote care infrastructure
• 40M+ vital sign readings collected, analyzed, and acted upon by our clinical team
• 50+ EMR integrations ensuring seamless data flow between Nsight and existing practice systems

All of this has been accomplished without a single dollar of outside capital. Nsight Health is a self-funded, founder-led company that has built its growth on clinical results and operational discipline, not on venture capital.

What Makes Nsight Health's Model Different

The Stevie Awards judges evaluated Nsight against the full landscape of health products and services companies, and the fastest-growing companies across all industries. What set Nsight apart was the combination of clinical substance, cross-sector capability, and the operational model that holds it all together.

Fully managed, not software-only. Nsight Health provides the technology, the FDA-cleared Tenovi cellular devices, and the W2 clinical team that monitors patients around the clock. Practices do not need to hire additional staff or manage new workflows. Nsight handles patient enrollment, device deployment, monthly care coordination, documentation, and claims-ready billing.

Four programs under one roof. Most remote care companies offer one or two programs. Nsight delivers four clinically managed programs through a single integration, giving providers the ability to layer RPM, CCM, PCM, and BHI for their Medicare patients without coordinating multiple vendors.

Cross-sector capability. Nsight serves the full healthcare continuum: individual patients, physician practices, health systems, ACOs, health plans, life sciences organizations, and employers. The same clinical infrastructure and standard of care applies across every customer type.

Recognized by industry leaders. Hippocratic AI selected Nsight as an inaugural preferred services partner. Elation Health designated Nsight a preferred partner. Nsight's platform is listed on the AthenaHealth Marketplace, reflecting enterprise-level vetting that few remote care companies achieve.

A Year of Recognition

The Gold and Silver Stevie Awards join a growing list of industry recognition for Nsight Health in 2026. Earlier this year, Nsight was named No. 12 on the 2026 Inc. Regionals: Southeast with 683% two-year growth, placing among the fastest-growing private companies in the region.

Each recognition validates the same underlying model: that a self-funded company can compete against venture-backed organizations and win, not by outspending them, but by out-executing them clinically. When patients get better, providers stay. When providers stay, growth follows.

About the American Business Awards

The American Business Awards, also known as the Stevie Awards, are among the most coveted and widely recognized business awards in the United States. Now in their 24th year, the awards honor achievement in the workplace across every industry and company size. Gold, Silver, and Bronze Stevie Awards are determined by the average scores of more than 300 professionals worldwide who participate in the judging process. The Gold Stevie represents the highest level of achievement in each category.

What This Means for Our Partners

For the providers, health systems, health plans, and employers who partner with Nsight Health, these awards are external validation of a decision they have already made. They chose a remote care partner that prioritizes clinical outcomes, invests in W2 clinical staff, and delivers four CMS programs through a single, scalable integration.

If your organization is exploring remote patient monitoring, chronic care management, or CMS-reimbursed remote care programs like RPM, CCM, PCM, or BHI, Nsight Health's model has now been recognized as both the best in its class and the fastest growing. Schedule a demo to see how we can help your practice deliver better outcomes in 2026.

Nsight Health is a fully managed remote care company delivering RPM, CCM, PCM, and BHI with 24/7 W2 clinician support for 130,000+ patients across 1,700+ provider teams. Nsight Health is a self-funded, founder-led company headquartered in Miami, Florida. For more information, visit nsightcare.com.

This article is for informational purposes only and does not constitute medical, clinical, legal, or financial advice. Clinical outcomes data referenced herein reflects internal observations from Nsight Health's remote patient monitoring programs and has not been independently validated through peer-reviewed clinical trials. Past performance and observed trends are not guarantees of future results. Individual patient outcomes depend on numerous factors including condition severity, comorbidities, medication adherence, patient engagement, and social determinants of health. Revenue growth figures cited in this article are based on data submitted to the American Business Awards and reflect company-level financial performance; they should not be interpreted as projections of revenue achievable by Nsight Health's provider partners. Nothing in this article should be construed as a guarantee of clinical outcomes, financial performance, or reimbursement.

If you are attending RPA 2026, stop by Booth #609 to meet the team and see firsthand how Nsight Health operationalizes Remote Patient Monitoring (RPM), Chronic Care Management (CCM), and all six CMS-reimbursed remote care programs for nephrology practices.

Speaking Session: The RPM CCM Nephrology Opportunity

Today at 10:40 AM, Nsight Health's Head of Sales Alex Bienemann joined Ron Reynolds, Practice Manager at CSRA Renal Services, to present "The RPM CCM Nephrology Opportunity" to a room of nephrologists and renal care leaders.

The session explored how nephrology practices can leverage RPM and CCM to improve clinical outcomes for CKD patients while building sustainable revenue streams through Medicare's care management reimbursement framework. Ron Reynolds brought the provider perspective, sharing how CSRA Renal Services has integrated remote monitoring into its care delivery model and what that integration looks like operationally for a busy nephrology practice.

Ron Reynolds, Practice Manager at CSRA Renal Services, presenting on the RPM and CCM opportunity for nephrology practices at RPA 2026.

"Nephrology practices are sitting on one of the largest untapped opportunities in remote care," said Alex Bienemann. "CKD patients require continuous monitoring between visits. Blood pressure management alone can change the trajectory of disease progression. When you pair RPM with CCM under a fully managed model, you get better outcomes for patients and a meaningful revenue stream for the practice without adding staff or complexity."

Alex Bienemann, Head of Sales at Nsight Health, presenting alongside the Nsight clinical evidence platform at RPA 2026.

The presentation drew on real-world clinical evidence from Nsight Health's monitored patient population, including observed blood pressure reductions among CKD patients enrolled in RPM programs. These data points reinforce what the nephrology community increasingly recognizes: that proactive, between-visit monitoring can meaningfully impact the management of hypertension, one of the primary accelerators of kidney disease progression.

Why Nephrology Is a Natural Fit for Remote Care

Chronic kidney disease affects an estimated 37 million Americans, and the vast majority of those patients also live with hypertension, diabetes, or both. These are precisely the conditions that benefit most from continuous remote monitoring and structured care coordination.

For nephrology practices specifically, the clinical case for RPM and CCM is compelling:

• Blood pressure is the primary modifiable risk factor for CKD progression. RPM enables daily BP monitoring between office visits, giving care teams real-time visibility into trends that would otherwise go undetected until the next appointment.
• CKD patients are high-utilization Medicare beneficiaries. They frequently qualify for multiple care management programs simultaneously, including RPM for physiological monitoring, CCM for multi-condition coordination, and BHI for the depression and anxiety that commonly accompany chronic kidney disease.
• Nephrology practices face capacity constraints. Most nephrology groups are already operating at or above capacity. A fully managed remote care partner like Nsight Health can operationalize RPM and CCM without requiring the practice to hire additional clinical staff.

What We Are Showing at Booth #609

Our team of ten, including four dedicated booth staff, is demonstrating Nsight Health's fully managed remote care platform throughout the conference. Visitors to Booth #609 can see:

• The Nsight clinical workflow for nephrology-specific RPM, including how our W2 clinical team monitors blood pressure, weight, and other vital signs for CKD patients around the clock
• Our Clinical Evidence White Paper, which details observed clinical outcomes across our monitored patient population
• The Nephrology One-Pager, a practice-ready overview of how Nsight Health's six-program model applies specifically to renal care delivery
• Live revenue modeling showing how nephrology practices can generate layered reimbursement through RPM, CCM, PCM, and BHI for their existing Medicare patient panels

The Nsight Health team engaging with nephrology professionals at Booth #609, with the Nsight Health platform and Tenovi devices on display.

Attendees at the Nsight Health booth during RPA 2026, with the "RPM and CCM Built for Nephrology Practices" display visible.

The Nsight Health team connecting with renal care leaders on the RPA 2026 exhibit floor in Atlanta.

Building Brand Awareness in Nephrology

RPA 2026 represents a strategic investment in Nsight Health's growing presence in the nephrology space. As one of the fastest-growing remote care companies in the country, recently ranked No. 12 on the 2026 Inc. Regionals: Southeast with 683% two-year revenue growth, Nsight Health is expanding into specialty verticals where remote monitoring has the highest clinical impact.

Nephrology is at the top of that list. The combination of high patient acuity, multi-condition complexity, Medicare coverage, and a pressing need for between-visit monitoring makes renal care one of the most natural applications for a fully managed RPM and CCM program.

Our presence at RPA 2026, as both an exhibitor and a speaker alongside an active nephrology practice partner, reflects Nsight Health's commitment to building long-term relationships in the nephrology community. This is not a one-time conference activation. It is the beginning of a sustained investment in understanding and serving the unique clinical and operational needs of renal care teams.

About Nsight Health's Approach to Remote Care

Nsight Health is not a software platform. We are a fully managed remote care company that provides the clinical staff, devices, documentation, and billing infrastructure to operationalize all six CMS-reimbursed programs: RPM, CCM, PCM, BHI, CoCM, and RTM.

Our W2 clinical team currently supports 130,000+ patients across 1,700+ provider teams and 480+ clinics, with more than 40 million vital sign readings collected and analyzed. Every patient has a named care coordinator, a personalized care plan, and access to 24/7 clinical monitoring by licensed clinicians based in the United States.

For nephrology practices, this means your team can focus on in-office patient care while Nsight Health handles the between-visit monitoring, care coordination, documentation, and billing across every program your patients qualify for.

Connect with Us at RPA 2026

The Nsight Health team at Booth #609, RPA 2026 in Atlanta.

If you are attending RPA 2026 in Atlanta, visit us at Booth #609 to meet the team, see the platform, and discuss how Nsight Health can help your nephrology practice deliver better outcomes while capturing the full value of remote care reimbursement.

Not at the conference? Schedule a demo to learn how Nsight Health can operationalize RPM, CCM, and all six CMS programs for your practice.

Nsight Health is a fully managed remote care company delivering RPM, CCM, PCM, BHI, CoCM, and RTM with 24/7 W2 clinician support for 130,000+ patients across 1,700+ provider teams. Nsight Health is headquartered in Miami, Florida, and was recently named No. 12 on the 2026 Inc. Regionals: Southeast list with 683% two-year revenue growth. For more information, visit nsightcare.com.

Clinical outcomes data referenced herein reflects internal observations from Nsight Health's remote patient monitoring programs and has not been independently validated through peer-reviewed clinical trials. Individual patient outcomes vary based on condition severity, medication adherence, patient engagement, and other clinical factors. Nothing in this article constitutes medical advice or a guarantee of clinical outcomes.