All PlansPrior AuthHigh impact
Prior Authorization Guidelines for Select Remote Patient and Remote Therapeutic Monitoring Services
Healthfirst·Prior Authorization
We identified it
Jun 20, 2026
Summary
New prior authorization requirements are being implemented for select Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) services. Healthcare practices must now obtain prior authorization before providing certain remote monitoring services to avoid claim denials.
Action Required
Immediately: Billing team must identify all RTM and RPM service codes currently billed and determine which require new prior authorization. Update billing system to flag these services for prior auth verification before claim submission. Train staff on new prior authorization workflow for remote monitoring services. Contact insurance plans to understand specific prior auth requirements for RTM codes. Claims submitted without required prior authorization will be denied.