TRICARE covers medically necessary remote physiological monitoring (RPM) services for patients with chronic or acute conditions who meet specific criteria. RPM includes, but is not limited to, the monitoring of weight, blood pressure, pulse oximetry, and respiratory flow rate. RPM services are a limited benefit and covered as ancillary services.
To be eligible, the beneficiary must require RPM services of at least 20 minutes in a 30-day period and have one of the following:
- A chronic condition(s) that is expected to last at least 12 months, or until death of the beneficiary; or
- An acute condition(s) that place the beneficiary at significant risk of death, acute exacerbation/decompensation or functional decline.
Coverage of RPM services includes set up and patient/caregiver education on use of the equipment, collection and interpretation of the data and follow up with the beneficiary. Durable medical equipment (DME) used for RPM must meet TRICARE requirements. DME such as blood pressure cuffs, personal computers, smart phones, tablets, smart watches, non-medical trackers, and weight scales are specifically excluded.