The insurer was set to limit reimbursement, starting Jan. 1, 2026, for remote physiologic services to heart failure and hypertensive disorders of pregnancy.
UnitedHealthcare is delaying implementation of a policy limiting coverage for remote physiologic monitoring.
Starting Jan. 1, 2026, the insurer was set to limit reimbursement for remote patient monitoring of physiologic services to two conditions, heart failure and hypertensive disorders of pregnancy.
UnitedHealthcare is delaying the policy until later in the year.
“We are postponing the Remote Physiologic Monitoring (RPM) policy scheduled to take effect on Jan. 1, 2026. We intend to implement this policy in 2026 and will share additional details and an updated timeline once finalized,” a spokesperson for UnitedHealthcare said.
WHY THIS MATTERS
According to policy posted by the insurer, with an effective date of Jan. 1, 2026, Remote Physiologic Monitoring (RPM) is proven and medically necessary when the individual has heart failure and hypertensive disorders of pregnancy.
Remote Physiologic Monitoring is “unproven and not medically necessary due to insufficient evidence of efficacy” for all other indications including anxiety, bipolar disorder, chronic obstructive pulmonary disease (COPD), depression, diabetes mellitus, gestational diabetes, hypertension other than hypertensive disorders of pregnancy and obstructive sleep apnea.
This conclusion, according to Health Affairs, is at odds with scientific evidence, clinical guidelines, federal policy direction and years of real-world experience showing that RPM is a well-validated technology.
“RPM has a robust and growing evidence-base supporting its use, particularly in hypertension management when implemented within structured, team-based care. Eliminating this coverage risks reversing gains in cardiovascular disease prevention and care for all adults,” according to Health Affairs.
A report this past summer from the Department of Health and Human Services’ Office of Inspector General (OIG) found growing use of remote patient monitoring in Medicare. In 2024, this came to more than $500 million in payments. The use of such services, with additional CMS oversight, “has the potential to greatly expand in the future,” the OIG said.
The economic data for remote patient monitoring is also promising, Health Affairs said. One multisystem study of Medicare patients with hypertension, heart failure and diabetes found a $1,308 annual savings per patient, driven by a 27% reduction in hospitalizations for heart failure and stroke.
“UHC’s rollback risks replacing these savings with avoidable acute-care costs — an outcome that benefits neither patients nor payers,” the report said.
THE LARGER TREND
UnitedHealthcare gave no reason for the delay in implementing the policy.
UnitedHealth Group is scheduled to release its full year 2025 financial results and provide 2026 financial guidance on Tuesday, Jan. 27, 2026, and will host a teleconference at 8 a.m. ET with analysts and investors.
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