How to Launch a Successful RPM Program in Your Practice

It is 7:42 a.m. and your MA is already triaging voicemails: a caregiver worried about Dad’s oxygen levels, a patient whose home blood pressure cuffs disagree by 15 points, and a recent discharge for heart failure who “feels puffy” but has no ride to clinic. Every outpatient practice lives this story; the difference between constant fire drills and calm, proactive management is whether you have a structured Remote Patient Monitoring (RPM) program. RPM turns scattered moments into a connected care loop: devices stream data, a team reviews trends, patients hear from you before problems spiral, and interventions happen days earlier than they used to.

RPM is both clinical strategy and business strategy. It requires clear goals, patient-friendly devices, dependable software, thoughtful workflows, and Medicare-compliant documentation. Done well, it improves outcomes, strengthens patient relationships, and creates a sustainable revenue stream that funds the staff who make all of this possible.

‍

Why RPM is essential for a modern practice

A modern practice must be sustainable clinically and financially. RPM advances both.

First, RPM shifts care from episodic to continuous. Most deterioration in hypertension, COPD, heart failure, and diabetes happens between visits. Waiting months to adjust therapy wastes precious time. With RPM, outlier readings surface immediately, staff validate signals, and small changes: an extra diuretic dose, a sodium reminder, a recheck in 24 hours can prevent big crises. Over a panel of high-risk patients, this steadying effect lowers avoidable ED visits and readmissions, improves control rates, and builds trust because patients feel watched over rather than left alone.

Second, RPM diversifies revenue. As professional fees tighten and value-based contracts weigh total cost of care, recurring, policy-defined programs like RPM help finance the care coordination that value-based performance requires. At scale, monthly RPM reimbursement helps fund nurses, MAs, and digital infrastructure: precisely the resources that make preventive, between-visit work reliable instead of ad hoc.

Third, RPM matches patient expectations. The people you serve already use connected tech for banking, travel, and home security. They reasonably expect connected care. A thoughtful RPM experience—simple devices, reminders that feel human, quick call-backs—becomes a competitive differentiator. Patients stay; caregivers recommend you.

‍

The complementarity of RPM and CCM

Chronic Care Management (CCM) and RPM are not competitors, they are complements:

• RPM answers “what is happening right now?”, daily weights, blood pressure, glucose, O₂ saturations.
• CCM answers “what are we going to do about it?”, medication reconciliation, lifestyle coaching, care plan updates, care coordination and documentation.

Imagine a heart-failure patient up three pounds overnight. RPM flags the trend; the CCM nurse calls, assesses symptoms, relays to the clinician, documents the plan, and schedules follow-up. Together, RPM + CCM create a closed loop that patients actually feel: data → contact → decision → documentation → reinforcement next month. Operationally, running both in one platform avoids duplicate clicks and fragmented notes. Financially, when requirements are met and time is not double-counted, practices can bill for both services in the same month, making the care team that powers engagement self-funding.

‍

Launching a successful RPM program

Before you pick a platform or buy devices, decide what “good” looks like for your practice:

• Cardiology example. Cohorts: heart failure, resistant hypertension, post-ablation rhythm surveillance. Device mix: cellular scale + BP cuff for HF; add mobile cardiac telemetry (MCT) for targeted rhythm evaluation. Clinical aims: pre-empt fluid overload, tighten BP control, catch symptomatic arrhythmias that intermittent checks miss. Operational nuance: daily weight review with same-day outreach threshold; BP weekly review with titration protocol; MCT used as an ordered diagnostic episode, not as RPM.
• Endocrinology example. Cohorts: insulin-treated diabetes, brittle type 2, metabolic syndrome. Device mix: continuous glucose monitor (CGM) + BP cuff; optional scale for cardiometabolic risk. Clinical aims: bring time-in-range up, reduce hypoglycemia, support medication titration and nutrition coaching. Operational nuance: CGM review cadence weekly; monthly shared decisions around meds and diet; escalate to pharmacist or educator via tasking.
• Family practice example. Cohorts: uncontrolled hypertension, COPD/asthma, post-discharge risk. Device mix: BP cuff + pulse oximeter ± scale. Clinical aims: raise the percent at goal BP, reduce COPD exacerbations, stabilize high-utilizers post-discharge. Operational nuance: nurse-led dashboard triage daily; clinician huddles 2–3 times/week for overrides; tight callback SLAs keep trust high.
  

This framing prevents a generic program and ensures devices, alerts, and staffing match real clinical goals. Here is a clear step-by-step framework on launching a successful RPM program:

Step 1: Define your goals and scope. Document three things: (1) the clinical outcomes you will move in 6–12 months (e.g., % of hypertensive patients <130/80, 30-day HF readmissions, average CGM time-in-range), (2) the operational outcomes you expect (e.g., “alerts handled same day,” “<48-hour callback on outliers”), and (3) the financial result (program margin after staffing).
Scope realistically. If you insist on building everything by hand (DIY), cap your pilot at 20–30 patients while you learn. If you start on a leading platform like Lara Health, plan for ≥100 patients at launch: you can take advantage of their expertise and to see population-level impact, as well as real economic benefit for your practice.

Step 2: Select your RPM platform. Your platform is the backbone. It determines whether RPM scales or stalls. What “good” looks like:

• Device breadth & plug-and-play connectivity. Native integrations for BP, scales, oximeters, CGMs, and support for MCT workflows; cellular options for patients without smartphones.
• Clinical signal over noise. Rules-based and ML-assisted triage surfaces what needs a human today; everything else is quietly logged.
• Embedded compliance. Time capture for 99457/99458, 16-day tracking for 99454, consent prompts, audit-ready reports, role-based permissions, and PHI safeguards.
• EHR integration. Orders out; discrete vitals, care-plan updates, and notes back in—without swivel-chair documentation.
• Team workflow. Queues by cohort/risk; templates for outreach; escalation rules that actually match how your clinic works.
  

This really shows you why going "DIY" with your RPM program might not be the best option. Homegrown spreadsheets and disparate device portals are fragile: data gaps, missed alerts, and audit exposure multiply as you grow. Staff spend time copy-pasting instead of calling patients. A mature platform like Lara Health wires together devices, alerts, timekeeping, documentation, and messaging so a two-minute call remains two minutes of work, not ten minutes of clicks.

Step 3: Select devices for your patient population. Devices translate strategy into action, and the mix matters"

• Blood pressure monitors (prefer cellular for reliability). Foundation for HTN, CAD, HF.
• Weight scales (cellular recommended). Critical for fluid management in HF.
• Pulse oximeters. Important for COPD, asthma, and post-viral recovery.
• Glucometers and CGMs. Finger-stick meters offer snapshots; CGMs provide continuous trends that empower patient behavior change and safer titration.
• Mobile cardiac telemetry (MCT). Near-continuous ECG monitoring for targeted diagnostic episodes when you need to capture clinically significant arrhythmias.
  

Engagement is the core design principle. Devices must be simple, apps must be forgiving, and nudges must be humane. Aim for daily use where appropriate, or several times per week at minimum. For complex cardiometabolic patients, pairing devices (e.g., BP + scale + CGM) gives a fuller clinical picture and reinforces the habit loop: patients see how behavior affects multiple measures, not just one. Lara Health’s patient apps (reminders, tips, progress views) and seamless connectivity reduce friction so patients actually use the devices you prescribe.

Step 4: Build workflows and assign roles. Write it down so it happens the same way, every time.

• Enrollment: who identifies candidates, educates, obtains consent, and activates devices.
• Daily review: who watches dashboards, which thresholds create alerts, and what the same-day response looks like.
• Escalation: who calls whom, when, and how decisions are documented.
• Documentation: what note templates capture assessment/plan and time for 99457/99458; how the system tracks 16 days of data for 99454.
• Feedback loops: weekly huddles to refine rules and redistribute load.
  

Lara Health bakes these steps into guided workflows so training new staff is measured in hours, not weeks.

Step 5: Identify and enroll patients. Start where impact is highest: uncontrolled HTN, heart failure, COPD/asthma, insulin-treated diabetes (especially with CGM), and patients with symptomatic rhythm concerns requiring an MCT episode. Build a simple script for enrollment that explains why RPM matters, what readings you expect, and how quickly the team will respond to alerts. Confidence at onboarding predicts adherence later.

Step 6: Ensure compliance and billing readiness. Teach the team the handful of rules that matter:

• 99453: one-time device setup and education per episode of care.
• 99454: device supply/data transmission each 30 days; requires ≥16 days of physiologic data in the period.
• 99457/99458: 20 minutes of treatment management time (first/additional 20) per calendar month; includes at least one real-time, two-way interaction with the patient or caregiver; clinical staff may contribute under general supervision.
• Consent & medical device: obtain and document consent; use devices that meet the FDA’s “medical device” definition; ensure data are electronically and automatically transmitted and stored securely.
• Concurrency: only one practitioner bills RPM per 30-day period; RPM cannot be billed with RTM in the same period; RPM or RTM may be billed concurrently with CCM/TCM when requirements are independently met and time is not double-counted.
• MCT & CGM: understand that MCT is a separate diagnostic service (its own CPT family) and CGM includes separate professional and supply codes; they are compatible clinical tools but are not billed under RPM codes.
  

Lara Health’s compliance rails (consent prompts, 16-day counters, time capture, and audit reports) turn “remember to” into “already done.”

Step 7: Monitor, evaluate, and scale. Treat RPM like any other service line: manage it by the numbers across three domains.

• Financial performance. Track enrolled patients, billed 99454 cycles, billed 99457/99458 units, denial rates, average RPM revenue per patient per month, staff time per alert, and fully loaded program margin. As you scale, confirm that revenue covers coordinator FTEs and platform costs, and that alert volume per FTE remains stable.
• Patient engagement. Watch average days of readings per month, percent of patients achieving the 16-day threshold, response times to alerts, successful outreach rate, and device connectivity uptime. If engagement dips, revisit device choice (cellular vs. Bluetooth), reminder cadence, and coaching scripts.
• Health outcomes. Follow hypertension control rates, mean BP change, CGM time-in-range and hypoglycemia events, COPD exacerbations, HF weight stability, ED visits and 30-day readmissions. Use run charts so your team sees progress—and where you are stalling.
  

Scale plan. Grow cohorts intentionally (e.g., add HF once HTN is stable). Layer CCM so every RPM alert has an action home. Calibrate staffing ratios quarterly. Lara Health’s dashboards unify these metrics so you can steer with data instead of anecdotes.

‍

ROI and financial impact

Assume a blended $120 per patient per month across 99454 and typical 99457/99458 time. Actual amounts vary by locality, payer mix, and minutes documented. Use your own fee schedules (the example below is illustrative):

‍

DIY builds rarely scale beyond 20-30 patients without burning staff time. If you intend to grow, launch at at least 100 patients on a platform like Lara Health so your staffing model, automation, and documentation discipline pay for themselves. Pair RPM with CCM to stabilize engagement and increase clinical touch without overwhelming clinicians.

‍

Common pitfalls and how to avoid them

• Under-engineering engagement. Great devices with poor reminders still fail. Build a nudge layer (timing, tone, channel) and celebrate small wins so habits stick.

• Noise without context. If every outlier beeps, staff will mute alerts. Calibrate thresholds, require trend confirmation, and define exactly what merits a same-day call.

• Documentation drift. Minutes not captured are minutes not reimbursed. Use workflow-embedded timers and note templates; audit weekly at first.

• Overcomplicating device mix. Start with the fewest devices that answer your clinical question; add a second device only when it changes decisions.

• DIY beyond its limits. The leap from 25 to 100 patients is where spreadsheets crack. Move to a real platform before leakage becomes inevitable.

‍

Conclusion

RPM is how modern practices make between-visit care real. When you connect the right devices to the right platform, wrap it with human outreach, and measure what matters, your sickest patients get steadier, your team’s days get calmer, and your business model stops depending on chance. For a cautious DIY pilot, start with 20–30 patients. If you want scale and staying power, launch on a leading platform like Lara Health so compliance, automation, and documentation work for you rather than against you. Book a demo with Lara Health and see how the right RPM workflows, prompts, and processes make remote care feel effortless, and ready to be combined with CCM as well, once you feel ready for it.

‍

FAQs

What kinds of patients qualify for RPM?

Any patient with a monitored acute or chronic condition where a connected medical device can transmit physiologic data automatically (for example, BP, weight, O₂, glucose). Eligibility is clinical; start with cohorts where between-visit data changes decisions.

Can I bill RPM and CCM in the same month?

Yes, when both services independently meet their requirements and time is not double-counted. RPM or RTM may be billed concurrently with CCM/TCM, but RPM and RTM cannot be billed together in the same period.

Where do CGM and MCT fit?

CGM is ideal for diabetes management and has its own professional and supply code families; pair CGM clinically with RPM BP/weight when appropriate. MCT is a separate diagnostic service (different CPT family) used episodically to capture arrhythmias; it complements RPM but is not billed as RPM.

Should I start DIY or with a platform?

Taking a DIY approach can prove feasibility for 20–30 patients. If you aim for scale, launch at at least 100 patients on a platform like Lara Health for integrated devices, automated timekeeping, and audit-ready notes.

How many devices per patient are ideal?

Start with the fewest that answer your clinical question (for example, BP for HTN). For complex cardiometabolic patients, pairing devices (for example, BP + scale + CGM) increases signal quality and improves engagement.

‍

Sources

Centers for Medicare & Medicaid Services (CMS). Telehealth & Remote Patient Monitoring MLN Booklet (April 2025).

U.S. Department of Health and Human Services (HHS). Billing for remote patient monitoring (Jan 17, 2025).

CMS. CY2021 Physician Fee Schedule Final Rule Fact Sheet (Dec 2020) — interactive communication definition for 99457/99458.

CMS. Chronic Care Management Services MLN Booklet (June 2025).

CMS Medicare Coverage Database. Electrocardiographic (EKG or ECG) Monitoring — External Mobile Cardiac Telemetry (current versions for CPT 93228/93229).

CMS. LCD L33822 – Glucose Monitors and Policy Article A52464 – Glucose Monitor (current versions).

CMS. Federally Qualified Health Centers (FQHC) Center — Care Coordination Services Update (2025).

Tan SY et al. Impacts of digital sensor alerting systems in remote monitoring: systematic review. npj Digital Medicine. 2024.