Payment Models and Reimbursement Challenges for Remote Patient Monitoring: A Scoping Review

Objective To map provider payment models and reimbursement policies for remote patient monitoring (RPM) across settings, and describe barriers, facilitators, and economic or operational consequences. Introduction RPM use is growing, yet reimbursement remains unsettled. Fragmented policies and misaligned payment incentives may limit scale-up and sustainability. Inclusion criteria Peer-reviewed sources on providers, payers or RPM recipients reported an RPM payment model, reimbursement policy or gap plus economic, operational or implementation findings. Grey sources provided RPM-specific payment, policy or coverage mechanics. Methods A JBI-aligned scoping review used database and four-strand grey-literature searches, dual independent title and abstract screening, Excel charting, ATLAS.ti coding, and MMAT appraisal of peer-reviewed studies to support interpretive caution. Results Fifty-six sources were included (34 peer-reviewed; 22 grey). Among peer-reviewed studies, fee-for-service predominated, often using management windows aligned with review frequency. Episode payments and shared-savings were less common and programme-specific. Across both source types, common barriers included coverage uncertainty, administrative workload, and misaligned incentives, while facilitators included value-oriented elements and transition funding. Economic findings were mixed, and utilisation outcomes were often unreported. Sources emphasised clear eligibility, supervision and frequency rules, brief documentation, and responsibility for devices, platforms, and connectivity. Three cross-cutting mechanisms concerned incentives and money flow, rules and billing gates, and workflow and workload. Conclusions Based on recurring patterns in the evidence, we propose prospective evaluation of a substitutive fee-for-service management window aligned with review frequency. Bundles and shared-savings may suit longitudinal monitoring but require attribution and data infrastructure. Public Interest Summary Remote patient monitoring lets clinicians track health between visits using data sent from home. We reviewed 56 sources to see how these services are paid for and what makes them easier or harder to run. Among peer-reviewed studies, fee-for-service was the most frequently reported payment model, often through monthly payments covering monitoring and review. Fewer studies described fixed-period payments or shared-savings contracts. Common hurdles were unclear rules, heavy paperwork, and incentives that do not align, for example when clinics pay while savings appear elsewhere. Helpful features were clear eligibility, short checklists, and temporary funds to start services. Our main takeaway: match payment to how monitoring works over time. One option for future evaluation is a monthly “management window” that replaces some clinic visits and states who pays for equipment and platforms. Other models may also be considered as data sharing improves. This may support more sustainable remote care.