The Economics of Remote Patient Monitoring (RPM) and Test Strips

Revolutionizing Diabetes Care: The Economics of RPM and [Test Strips](/sell-diabetic-supplies/)

Remote patient monitoring (RPM) means a clinic supplies a connected device, such as a blood glucose meter, and bills Medicare for that device and for reviewing the readings it sends back [1]. That changes who pays for the strip. In a pharmacy sale, the strip is the product. In an RPM program or an employer-paid subscription, it's a cost the program carries to keep the data coming in [2]. (Our CGM hub covers the data side in Data Ecosystems and Remote Monitoring.)

What's Driving the Change?

• Subscription business models: Livongo, which merged with Teladoc Health on October 30, 2020 [4], built its diabetes program around a cellular-connected meter and unlimited test strips at no extra cost to the member. It first sold the program through employers, health providers and health plans, and in 2017 added a $49.99-a-month plan sold directly to consumers [2]. DarioHealth describes a similar bundle: its own meter, an app, coaching, and unlimited test strip and lancet refills sent to the member's door [3][8].
• Connected hardware: Here's what surprised us. These two companies took different routes. Livongo's meter had its own cellular connection [2], while Dario's meter plugs directly into the user's smartphone [8]. Medicare's rule is about the upload, not the radio: in its 2021 payment rule, CMS said an RPM device must meet the FDA's definition of a medical device and must upload data automatically, not readings the patient writes down or reports [5]. We found no primary source that measures how many RPM programs now use cellular meters rather than Bluetooth or phone-connected ones.
• Reimbursement rules: For years, CPT 99454, the Medicare code that pays for supplying the device and transmitting its data, could be billed only when at least 16 days of data were collected in a 30-day period [5]. That changed on January 1, 2026. The 2026 physician fee schedule added CPT 99445 for 2 to 15 days of data in a 30-day period and kept 99454 for 16 to 30 days [1]. A practice bills one or the other, and CMS gave both the same value because the device is supplied for the full 30 days either way [1]. For someone using a meter, a day of data means at least one fingerstick that day, so the old 16-day line put a floor under strip use in billed programs. As of October 2026, that floor is 2 days. How often any one person should check is a decision for their care team.

Legacy Players Adapt

Legacy manufacturers like Roche and Ascensia partner with digital health platforms and position their strips as the reliable hardware layer within broader care management ecosystems. The consumer side of that is easy to confirm: Roche lists its mySugr app alongside its Accu-Chek Guide meters and strips [6], and Ascensia offers a free Contour Diabetes app with its Contour Next meters [7].

The billing codes explain why clinics hand out connected glucose meters at all. The device-supply codes, CPT 99445 and 99454, pay once per 30-day period. Separate codes pay for the clinician's time reviewing the data each calendar month, and since 2026 that starts with CPT 99470 for the first 10 minutes [1].