Federally Qualified Health Centers (FQHC) Center

Spotlights

CY 2026 Physician Fee Schedule (PFS) Final Rule Effective January 1, 2026 

Highlights for CY 2026 include:

• Telecommunications Services - permanently adopted a definition of direct supervision that allows the physician or supervising practitioner to provide such supervision through real-time audio and visual interactive telecommunications (excluding audio-only).
• Telecommunications Services - non-behavioral health visits furnished via telecommunication technology can continue to be reported with HCPCS code G2025, including services furnished using audio-only communications technology through December 31, 2026.
• Telecommunications Services – The requirement that an in-person mental health visit must occur within 6 months before a telehealth mental health service at least every 12 months while a beneficiary receives telecommunications services for diagnosis, evaluation, or treatment of mental health disorders in RHCs and FQHCs will not take effect until after January 30, 2026. The CY 2026 payment rate for G2025 is $97.53.
• Telecommunications Services – For additional telehealth related updates, please refer to: https://www.cms.gov/files/document/telehealth-faq-updated-11-20-2025.pdf
• Advanced Primary Care Management - new optional add-on codes are available that would facilitate billing for Behavioral Health Integration (BHI) and/or Psychiatric Collaborative Care Model (CoCM) using HCPCS codes G0568, G0569, and G0570. These services when furnished are paid at the national non-facility rate.
• G0512 and G0071 Changes - report individual codes that make up both the CoCM and the Communications Technology-Based Services (CTBS) and Remote Evaluation Services, previously reported under HCPCS codes G0512 and G0071, respectively. G0512 and G0071 are no longer reportable beginning January 1, 2026. A reminder that G0511 is also terminated.
• Care Coordination Services – going forward, we’ll pay the national non-facility rate for services that are established under the PFS and designated as care management services as care coordination services for purposes of separate payment for RHCs and FQHCs. Please see the CY 2026 Designated Care Management Services Assigned General Supervision table at https://www.cms.gov/medicare/payment/fee-schedules/physician/federal-regulation-notices/cms-1832-f.  

Payment Rates

RHC/FQHC CY 2026 Non-Facility Payment Rates (ZIP)