Opening case (illustrative). A 64-year-old with hypertension wears a smart ring to bed and a watch to work. Her phone holds eight months of heart rate, sleep, and activity data. At her annual visit, none of it reaches her chart. Her office takes one blood pressure reading, changes nothing, and books her back in a year. Every trend that could have shaped her care, and every minute of follow-up her practice could have billed, stays on her phone.

Her situation is common, and it points to two gaps: one in data, one in billing.

The data gap: patients collect, practices don't receive

Wearable use is growing quickly. The share of US adults using a wearable to monitor their health rose from 30.2% in 2020 to 41.1% in 2024. Patients are willing to share that data, but few actually do: willingness to share with clinicians dipped from 81.3% to 73.4% over those years, while actual sharing stayed between 14.2% and 19.2%. Watches, rings, phone apps, and connected cuffs now record a near-continuous picture of patients' lives, and very little of it reaches the medical record.

The billing gap: benefits that exist but go unclaimed

Medicare has paid for between-visit care for more than a decade, yet practices rarely claim it. Among beneficiaries eligible for chronic care management, the share receiving it grew only from 1.1% in 2015 to 3.4% in 2019. Uptake has improved, with close to 1.3 million beneficiaries receiving CCM in 2023, but two-thirds of Medicare beneficiaries have two or more chronic conditions. Transitional care follows the same pattern: two years after the codes launched, TCM was billed for just 7% of eligible discharges.

Remote monitoring is expanding, but documentation hasn't kept pace. Medicare RPM payments reached $536 million in 2024, and nearly one million Medicare enrollees received RPM that year. Yet federal auditors found that about 43% of RPM enrollees were missing at least one of the three required service components. Another 12% never received treatment management, the part where a clinician acts on the data. Care that isn't documented can't be billed, and it can't be defended in an audit.

Why most wearable data doesn't count toward billing

Under CMS rules, RPM must use a device that meets the FDA's medical-device definition and uploads physiologic data automatically; readings the patient records or reports by hand don't qualify. Some payers are explicit: one plan's policy states that personal devices such as Apple Watch or Fitbit are not approved for RPM. Smart rings and other consumer trackers generally fall in the same category.

That doesn't make consumer data worthless. It is still useful clinical context, and structured symptom check-ins can support other billable pathways, such as remote therapeutic monitoring and care management. The key is knowing which pathway applies.

What changed in 2026

The 2026 Medicare Physician Fee Schedule added shorter-duration remote-monitoring pathways rather than eliminating the existing longer-duration thresholds. New RPM coding includes a 2–15-day device-supply pathway and a first-10-minute treatment-management pathway, while the established longer-duration codes remain. Payment varies by geography and setting, so practices should verify current rates and billing edits in the Medicare Physician Fee Schedule and with their Medicare Administrative Contractor.

  • 99445 pays $52.11 for 2 to 15 days of device data, the same as the full-month code.
  • 99470 pays $26.05 for 10 to 19 minutes of clinical staff time.
  • 98985 pays $51.44 for a short musculoskeletal monitoring episode, and 98979 pays $26.39 for 10 minutes of management.
  • 99495, Transitional Care Management, pays $220.11. It hinges on one interactive contact within two business days of discharge, and that contact can be a secure message.

Rates include patient coinsurance and vary by locality.

What documented follow-up does for outcomes

The case isn't only financial. When patients receiving chemotherapy reported their symptoms between visits, researchers found about a five-month survival benefit compared with usual care. In behavioral health, one large measurement-based care rollout saw a 23.5% relative improvement on combined PHQ-9 and GAD-7 scores, though its design couldn't prove causation. After hospital discharge, a study of more than 18 million eligible Medicare discharges found that patients who received TCM had lower mortality (1.0% vs. 1.6%) and lower adjusted costs ($3,033 vs. $3,358 per patient in days 31–60).

Where practices start

  1. Audit the device. Bill monitoring only through FDA-defined devices that transmit automatically. Treat consumer wearable data as context.
  2. Document every component. Keep consent, the ordering clinician, transmission days, and timestamped interactive minutes in one record.
  3. Capture short episodes. Post-procedure weeks and brief follow-up calls now qualify.
  4. Close the loop. A reading improves care only when someone acts on it and records the action.

The articles that follow take these gaps one at a time, across ambulatory surgery, behavioral health, perioperative care, and multi-specialty practice. Each one opens with a single remote interaction and shows what it codes to.

Reimbursement information is provided for educational purposes and reflects publicly available guidance reviewed as of September 28, 2026. Coverage, coding, documentation requirements, medical necessity and payment vary by payer, locality, patient circumstances and service. PatientTrac supports clinical and documentation workflows and does not determine code selection or guarantee reimbursement. Qualified billing and clinical staff should verify current payer requirements.

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