Will CMS propose requiring practice-employed staff for CCM by September 2027?
Prediction liftPrediction drop
Expert insights from Daniel Tashnek, Mike McSherry and Olivia RothsteinCMS's CY2027 proposal would pay for remote monitoring only when the practice's own employees do the work. It left CCM out and stated the limit applies to RPM and RTM. The agency did ask for comment on reworking care management codes, and the Inspector General has an open audit of CCM payments, so a CY2028 proposal could extend the test. Against that, more than 230 organisations and 32 House members oppose even the narrower RPM/RTM rule. The CY2027 final rule, due around 1 November 2026, will show whether CMS holds its line. The CY2028 proposal, usually released in July, is the only realistic path inside the window.
Resolves 30 September 2027 · Yes if, by 30 Sep 2027, CMS publishes a proposed or final rule (e.g. the CY2028 Physician Fee Schedule proposed rule) whose proposed regulatory text would make Medicare payment for any CCM code (99490, 99491, 99439, 99487, 99489 or successor/consolidated CCM codes), or for care-management services generally including CCM, conditional on the clinical staff being employees of the billing practitioner/practice, in whole or in part. A request for information or comment solicitation without proposed text does not count; the RPM/RTM-only restriction does not count. Source: Federal Register / CMS Physician Fee Schedule pages.
Why the forecast moved 7 events, newest first, numbered as on the chart · forecast last updated 21 October 2026
| # | Date | Event and reasoning | Change | Source |
|---|---|---|---|---|
| 7 | 6 Oct 2026 | 32 House members urge CMS to roll back RPM third-party staff ban32 bipartisan House members ask CMS to drop it; raises political cost. | -0.8 pts10.8% → 10.0% | Source |
| 6 | 24 Aug 2026 | Over 230 organizations urge CMS not to finalize RPM/RTM restrictions230+ organisations oppose; makes an extension harder. | -1.0 pts12.5% → 11.5% | Source |
| 5 | 21 Jul 2026 | ATA Action: proposal conflicts with Ways and Means bill backing remote monitoringHill-adjacent trade group says proposal clashes with pending legislation. | -0.5 pts13.0% → 12.5% | Source |
| 4 | 16 Jul 2026 | Proposed rule also asks about a two-track approach to care managementRequest for comment on reworking care management codes opens a route for CCM changes, but with no staffing text. | +1.0 pts11.7% → 12.7% | Source |
| 3 | 14 Jul 2026 | CMS proposes RPM/RTM payable only with practice-employed clinical staffCMS itself proposed the employed-staff test for RPM/RTM; it is the template that could be extended. | +4.5 pts7.2% → 11.7% | Source |
| 2 | 16 Mar 2026 | OIG adds audit of CCM payments at risk of noncomplianceLive OIG audit of CCM payments could support a staffing condition in CY2028. | +1.5 pts5.6% → 7.1% | Source |
| 1 | 5 Dec 2025 | CMS Innovation Center opens ACCESS model for tech-supported chronic careA separate model route for tech-enabled chronic care lowers pressure to change CCM codes. | -0.3 pts5.9% → 5.6% | Source |
Expert commentary 4 quotes attached to the tracked events · each checked against its source
| Who | What they said | # | Source | |
|---|---|---|---|---|
| Daniel TashnekCo-Founder and CEO, PrevounceCompany | “The ability to deliver CCM and APCM with third-party staffing support is not under review and those programs will be furnishable by contractors under general supervision moving forward regardless of the outcome of this final rule.” | 3 | blog.prevounce.com |
| Carrie NixonAttorney (co-author), Nixon Law GroupIndependent | “Chronic Care Management (“CCM”) services are explicitly not included in the proposed direct employment mandate. This means that, for now, the outsourced clinical staffing model remains intact for CCM (and presumably, other care management services), but not for RPM and RTM.” | 3 | nixonlawgroup.com | |
| Mike McSherry LinkedIn ↗Co-founder and CEO, XealthCompany | “They have found that operationally it is more effective for them to outsource that care than to try and incorporate it amongst their limited clinical staff.” | 3 | techtarget.com |
| Olivia Rothstein LinkedIn ↗Attorney (co-author), Nixon Law GroupIndependent | “Every restriction CMS proposes for RPM appears as an open question about care management in the same rule's primary care RFI.” | 4 | nixonlawgroup.com |
Built using the most accurate forecasting models on Earth, by Authority.inc. Methodology audited by Oxford AI. Last updated 21 October 2026.
