2026 CCM & RPM Changes: CMS Updates, Billing Rules & Virtual Care Readiness

Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) remain central to Medicare’s virtual care strategy, and the 2026 CMS updates are reshaping how these services are structured, billed, and monitored. From eligibility and consent to code selection, documentation, and compliance safeguards, even small shifts in policy can meaningfully affect day-to-day workflows.

This session is designed to help providers, administrators, billers, coders, and clinical leaders interpret the 2026 CCM/RPM changes, understand current CMS expectations, and review practical best practices for building or strengthening compliant, sustainable programs. It focuses on clear explanations and real-world considerations, so attendees can better assess their own processes and identify where updates may be needed.

Webinar Highlights:

1. CMS Policy Direction for CCM & RPM
   How CCM and RPM fit into CMS’s broader strategy for virtual care and chronic disease management, and what the 2026 rulemaking signals for the future.
2. Eligibility, Consent & Documentation Clarity
   Practical review of who qualifies, what consent must include, and which documentation elements support compliant claims under current CMS guidance.
3. Billing Rules & Code Use in 2026
   High-level overview of relevant CCM/RPM codes, time/interaction requirements, and where the 2026 updates may require adjustment to existing workflows.
4. Program Design & Operational Best Practices
   How successful organizations structure CCM/RPM workflows, coordinate care, and use technology platforms to support consistent delivery and tracking.
5. Risk Awareness & Compliance Focus
   Common trouble spots—such as inadequate documentation, unclear responsibility for billing, or weak follow-up processes—and ways to strengthen internal oversight.

Learning Objectives:

By the end of the session, participants should be able to:

1. Explain the core structure of CCM and RPM programs in the context of current CMS regulations and 2026 updates.
2. Identify key patient eligibility and consent requirements for CCM and RPM services.
3. Outline major billing codes and documentation expectations that support compliant reimbursement for CCM/RPM.
4. Recognize common implementation challenges (e.g., workflow, staffing, follow-up) and discuss practical strategies to address them.
5. Describe how CCM and RPM can be integrated into broader care-coordination models, including the role of digital health platforms.
6. Discuss how to monitor performance using basic quality and reporting measures aligned with CMS requirements.
7. Summarize the main components of effective CCM and RPM programs and highlight where 2026 CMS changes may influence program design.

Areas Covered in the Session:

• CMS Policy Framework for CCM & RPM

How CMS defines and positions CCM and RPM in its virtual care strategy.

• Patient Qualification & Enrollment Fundamentals

Core clinical and administrative criteria for CCM/RPM participation.

• Billing & Responsibility for Codes

Overview of who may bill for CCM/RPM services, key codes, and high-level billing rules.

• Consent & Comprehensive Care Plan Elements

What CMS expects regarding consent documentation and care-plan structure for compliant CCM/RPM programs.

• Best Practices for Compliance & Program Stability

Practical tips for documentation, communication, and internal reviews to support long-term program reliability.

• 2026 CMS Changes Affecting Virtual Programs

High-level discussion of proposed/final changes that may impact how CCM and RPM are delivered and billed in 2026.

Attendees:

• Nurses 
• Doctors 
• Nurse Practitioner 
• Population Health Officers 
• Innovation Officers
• CNO/ CMO 
• Billers 
• Population Health Officers 
• Innovation Officers 
• Chief Nursing Officers 
• Chief Medical Officers 
• Billers and Coding Professionals 
• Primary Care Provider (MD, NP, PA) 
• Specialists (MD, NP, PA) 
• Nurse Managers 
• C-Suite Healthcare Executives