Current Announcements
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 - Beginning October 1, 2026, RHCs and FQHCs will bill for telehealth services using the individual Current Procedural Terminology (CPT) or HCPCS codes that describe the distant site telehealth service furnished along with the appropriate telehealth modifier, instead of the single HCPCS code G2025. These distant site telehealth codes are published annually on the CMS webpage at https://www.cms.gov/medicare/coverage/telehealth/list-services. RHCs and FQHCs shall report the HCPCS code along with one of the following modifiers:
- 93 -Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
- 95 - Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System
The payment rate for these services will continue to be based on the average amount for all PFS telehealth services on the telehealth list, weighted by volume for those services reported under the PFS.
- 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 1, 2028. The CY 2026 payment rate for distant site telehealth services furnished by RHCs and FQHCs is $97.53.
- Telecommunications Services – See the Telehealth FAQs (PDF) for additional telehealth related updates.
- 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 on the CY 2026 PFS Final Rule page.