What Medicare reimbursement changes for RPM cardiac services take effect in 2025?
Executive summary
Medicare reimbursement for remote patient monitoring (RPM) cardiac services in 2025 is governed by the 2025 Medicare Physician Fee Schedule (PFS) final rule and related CMS guidance: CMS set the 2025 PFS conversion factor at $32.3465 (a 2.83% reduction from 2024), and CMS continued pandemic-era telehealth flexibilities through calendar year 2025 that affect supervision and telehealth billing for services including cardiac rehabilitation and monitoring [1]. Specific RPM CPT codes remain available under Medicare, and Medicare continues to reimburse both remote physiological monitoring and remote therapeutic monitoring per CMS guidance [2] [1].
1. What the 2025 PFS change means for RPM payments: the conversion-factor backdrop
CMS finalized a 2025 conversion factor of $32.3465 — a 2.83% cut from 2024 — which reduces the dollar multiplier applied to RVUs and therefore affects payments across nearly all PFS codes, including RPM-related CPT codes [1]. That change is a broad, across-the-board payment input; it does not itself reprice individual CPT code work or practice-expense RVUs unless CMS separately revalues those CPT codes in the rule [1].
2. Telehealth and supervision flexibilities that shape RPM cardiac care in 2025
CMS extended pandemic-era telehealth policies through calendar year 2025 that matter to RPM and cardiac rehab: distant-site practitioners could continue to use their currently enrolled practice location instead of their home address for telehealth, and cardiac rehabilitation and other services that require direct supervision were permitted to meet that requirement via immediate availability through real-time audio/video interactive telecommunications through 2025 [1]. These flexibilities make it administratively easier for clinicians to supervise and bill for remote monitoring and supervised rehab during 2025 [1].
3. Codes, scope and what remains unchanged for RPM
CMS and HHS guidance continue to list CPT/HCPCS codes commonly used for RPM and RTM and state Medicare reimburses for remote physiological monitoring and RTM — meaning the coding framework for RPM remained operative in 2025 [2]. The ACC reporting on the 2025 final rule notes no sweeping new cardiovascular CPT code revaluations for 2025 that would specifically reprice RPM codes, so providers should expect the existing RPM CPT code set to remain the mechanism for reimbursement in 2025 [1].
4. Net practical impact for cardiac RPM services in 2025
Because the overall conversion factor dropped in 2025, aggregate Medicare payments per RVU were lower unless CMS separately increased the RVUs or made budget-neutral reallocations to specific CPT codes — actions the 2025 rule did not broadly do for cardiovascular services [1]. The ACC characterized overall cardiovascular reimbursement as projected to remain roughly flat compared with 2024 after policy and code changes balanced out; that indicates some individual service-level offsets but a general squeeze from the conversion-factor reduction [1].
5. What providers and administrators should watch for operationally
Clinics billing RPM for cardiac patients should verify they meet RPM documentation and device rules (physiologic data collection/upload, FDA device definition, patient consent) and continue to use the established CPT/HCPCS codes listed by CMS — Telehealth.HHS points providers to the PFS for the latest coding guidance [2]. Practices must also model revenue with the lower 2025 conversion factor in mind and check whether any CPT-specific revaluations effective in 2025 affect practice-expense or work RVUs for RPM-related services [1] [2].
6. Broader context and what reporting does not say
Available sources do not mention a distinct, standalone CMS policy in 2025 that specifically raises or lowers the dollar rates of individual RPM CPT codes for cardiac monitoring beyond the general PFS conversion-factor change and routine policy adjustments (not found in current reporting) [1] [2]. Industry summaries (private vendors and ACC analyses) emphasize that telehealth flexibilities and the PFS conversion-factor change are the main levers affecting RPM reimbursement in 2025, and they flag proposed 2026 adjustments (including conversion-factor increases and efficiency adjustments) that could alter future reimbursement dynamics [1] [3] [4].
7. Competing perspectives and near-term outlook
Advocates such as the ACC note the conversion-factor cut and broader PFS mechanics threaten practice revenue and urge policy fixes; at the same time, CMS and subsequent 2026 proposals seek partial increases to the conversion factor while applying efficiency adjustments that may blunt gains — signaling uncertainty for RPM reimbursement beyond 2025 [1] [4] [5]. Practices therefore face a 2025 environment of continuing code-based reimbursement for RPM but with a lower conversion-factor multiplier and temporary telehealth/supervision flexibilities that ease operational delivery [1] [2].
If you want, I can (A) list the specific RPM CPT codes Medicare commonly recognizes and summarize how each was paid in 2025 using the PFS tables, or (B) model an example payment calculation for a hypothetical RPM service in 2025 using the $32.3465 conversion factor. Which would be most helpful?