Quick facts
- RPM and RTM: a separately reportable initiating visit is required when monitoring starts. RTM is for established patients only
- Staffing rule delayed: the requirement that only practice-employed clinical staff provide RPM and RTM now starts January 1, 2029
- Advance care planning: new G0572 and G0573 for clinical staff under direct supervision. 99497 and 99498 are only for the billing practitioner's own time
- Group visits: new coding and payment for shared medical appointments, plus an add-on for extra time
- When: January 1, 2027 unless noted
Remote monitoring (RPM and RTM): what changed?
If you run a remote monitoring program, three things matter:
Start with a visit. When a patient begins RPM or RTM, you must provide a separately reportable initiating visit. In practice, that means you need a real visit on the books before the monitoring codes start.
RTM is for established patients only. New patients need to become established first.
Contracted staff can keep working, for now. CMS planned to require that only practice-employed clinical staff provide RPM and RTM. That requirement is delayed until January 1, 2029. If you use an outside vendor's staff, you have time, but start planning.
CMS also finalized updated values for these codes and says it may look at bundling and new codes in the future.
Advance care planning: who can do it now?
Advance care planning conversations take time. For 2027, CMS created G0572 and G0573 so trained clinical staff can provide advance care planning under the billing practitioner's direct supervision. CPT 99497 and 99498 are now for time the billing practitioner personally spends. If your nurses or care coordinators help with these conversations, this gives you a cleaner way to bill their time. Just make sure the codes match who actually did the work.
Group visits (shared medical appointments)
CMS noted that no code specifically described shared medical appointments. For 2027 it finalized separate coding and payment, plus an add-on code for extra time. If you run diabetes, weight-management or prenatal group visits, watch for the code numbers in the final rule and the 2027 code files before you schedule your first 2027 groups.
Telehealth and behavioral health notes
- The in-person visit requirement for Medicare mental health telehealth is waived for services through December 31, 2027.
- Rural health clinics and FQHCs can keep billing non-behavioral telecommunication visits through December 31, 2027.
- Work values for collaborative care (CoCM) codes go up, and timed behavioral health codes finish their transition.
What should I do now?
How HealthRescue Partners can help
We set up compliant billing workflows for care management programs and can provide virtual coders to keep RPM, RTM and advance care planning claims clean. See medical billing services (4% of collections), telehealth practices and behavioral health, or request a free audit.
Frequently asked questions
Do I need a visit before starting RPM or RTM in 2027?
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Yes. CMS's 2027 rule requires a separately reportable initiating visit with the onset of RPM or RTM services.
Can I bill RTM for a new patient in 2027?
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No. CMS finalized limiting RTM to established patients.
When does the employed-staff requirement for RPM and RTM start?
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CMS delayed the requirement that only practice-employed clinical staff perform RPM and RTM until January 1, 2029.
What are G0572 and G0573?
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They are new 2027 codes for advance care planning provided by clinical staff under the direct supervision of the billing practitioner. CPT 99497 and 99498 are used only for time the billing practitioner personally spends.
Is Medicare mental health telehealth still allowed without an in-person visit?
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Yes, through December 31, 2027. The in-person requirement for mental health visits is waived for services furnished through that date.
Sources
This article explains payer and CMS rules in plain language for practice owners. It is not legal advice. Rules can change after publication, so always confirm against the source document before changing how you bill. Last reviewed November 9, 2026.