Public Reporting Completeness of Medicare Remote Monitoring Services: A Retrospective Observational Study

Background and objectiveRemote patient monitoring (RPM) uses physiologic measurements, while remote therapeutic monitoring (RTM) tracks nonphysiologic information such as symptoms and therapy adherence.Public Medicare provider files support studies of these services, but privacy-related suppression can affect service counts and provider representation differently.This study aimed to quantify reporting completeness against separately aggregated Centers for Medicare & Medicaid Services (CMS) national and state reference data. MethodsThis was a retrospective observational study with descriptive analyses that compared the CMS Medicare Physician and Other Practitioners provider-and-service and geography-and-service files for 2019-2024.The primary analysis was 2024.Service completeness was the provider-file service sum divided by the corresponding geographic total.Provider-cell completeness compared disclosed rendering-provider-codesetting records with reference counts in the same strata.RPM included 99453, 99454, 99457, and 99458 when available; RTM included 98975-98978, 98980, and 98981 when available.Code 99091 was analyzed separately.Missing reference cells remained non-estimable.Historical, state, payment, and fixed-code nonfacility analyses assessed sensitivity. ResultsThe extraction contained 77,895 provider records and 2,395 geographic records across 46 code-years.In 2024, the provider file retained 6,780,279 of 7,217,550 RPM service units (93.94%) but 21,311 of 59,185 provider-code-setting cells (36.01%).For RTM, it retained 482,639 of 547,840 units (88.10%) and 2,996 of 17,519 cells (17.10%) across published national reference strata.Service shortfalls were 437,271 for RPM and 65,201 for RTM.Code-specific RTM service completeness ranged from 76.67% to 99.31%, whereas cell completeness ranged from 13.76% to 28.29%.Median jurisdiction-level service completeness was 91.12% for RPM (51 jurisdictions) and 82.24% for RTM (48 jurisdictions).In a sensitivity analysis restricted to five fixed nonfacility RTM codes, 2022-2024 growth was 866.79% in provider data versus 804.51% in geographic data.No published national facility denominator was available for 98978 in 2024. ConclusionsPublic provider data retained most remote-monitoring service units while omitting a much larger share of provider-code-setting records.Cell-completeness percentages do not estimate the proportion of unique providers represented.Reporting completeness varied by code, geography, and year.Studies should reconcile aggregation levels and avoid interpreting absent public records as nonuse, limited patient access, or lack of clinical benefit.