When the Centers for Medicare & Medicaid Services (CMS) releases its annual Physician Fee Schedule (PFS), the health care industry pays attention. This cornerstone policy does more than set payment rates for physicians — it influences the very foundation of how care is delivered, what technologies are reimbursed, and how patients access services across the United States.

This year, the Center for Telehealth and eHealth Law (CTeL) submitted comments on the CY2026 Medicare Physician Fee Schedule (PFS), bringing more than two decades of experience in digital health law and policy to the table. Our recommendations focus on three guiding principles: safeguarding patient data, fostering innovation in telehealth and artificial intelligence (AI), and ensuring equitable access to care.

Below, we highlight the key insights and overlooked policy considerations shaping the future of digital health reimbursement.

Expanding Telehealth: Flexibility as a Foundation of Equity

CTeL strongly supports CMS’ proposal to permanently remove frequency limitations for inpatient visits, nursing facility consultations, and critical care telehealth services. Flexibility empowers physicians and patients to determine the best care pathway without arbitrary caps.

But the conversation goes deeper than reimbursement. Telehealth remains a lifeline for patients in rural communities, those facing transportation challenges, and individuals needing specialty care. A recent report found that Medicare beneficiaries in rural areas were two times more likely to rely on telehealth services than their urban counterparts (Mehrotra et al., 2022). By cementing these flexibilities, CMS can ensure care remains accessible to those most vulnerable to system-wide inequities.

Another overlooked issue is provider home address reporting. Current CMS requirements risk exposing physicians’ personal information, raising serious concerns amid rising workplace violence in healthcare settings (Ma & Thomas, 2025). CTeL urges CMS to make permanent the option for providers to list practice locations instead of home addresses — a policy that simultaneously protects providers and helps combat clinician burnout.

Strengthening Patient Data Security: PDMPs and Prescription Access

CTeL’s comments emphasize the importance of interoperability for Prescription Drug Monitoring Programs (PDMPs). With the DEA’s telemedicine prescribing waivers set to expire in 2025, continuity of care is at risk.

Research has shown that expanded telehealth prescribing during the COVID-19 pandemic not only maintained continuity of care but also reduced overdose deaths in states with telehealth parity laws (Jones et al., 2022). However, if PDMP requirements are not streamlined, clinicians could face the burden of querying 50 different state databases for a single prescription.

That administrative burden is more than a hassle — it could reduce access to life-saving treatments for patients with substance use disorders. CTeL calls on CMS, DEA, and state health agencies to coordinate efforts and ensure PDMP interoperability that supports, rather than hinders, patient care.

Remote Monitoring: Valuation, Data Overload, and AI Integration

Remote Patient Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) codes represent a critical evolution in chronic care management. CTeL applauds CMS’ acceptance of new codes covering fewer than 16 days of data collection but cautions that reimbursement must reflect the reality of clinician workload. Preparing, documenting, and interpreting patient data requires the same clinical effort regardless of monitoring duration.

Moreover, as RPM and RTM adoption grows, so does the risk of clinician data overload. One recent study found that clinicians are already spending significant time sifting through RPM data without adequate analytic support (Arora et al., 2025). CTeL encourages CMS to recognize the growing role of AI tools in filtering, prioritizing, and contextualizing RPM data — a development that could improve patient care and reduce burnout if appropriately reimbursed.

Artificial Intelligence: Responsible Payment for Responsible Use

Artificial intelligence in health care has been called both revolutionary and risky. CMS’ proposals to incorporate AI and SaaS costs into payment models are an important step, but CTeL warns that efficiency adjustments tied to AI adoption may backfire.

Reducing reimbursement when clinicians become more efficient risks incentivizing higher patient volume at the expense of quality. For example, AI scribes have been shown to improve patient experience by freeing physicians from documentation tasks (Shah et al., 2025). Yet if payments are cut, the benefit of efficiency is undermined by financial pressure on practices.

Instead, CMS should recognize that efficiency gains from AI often come only after a steep learning curve, with physicians shouldering new burdens of evaluating AI tool reliability. Reimbursement should reflect both the upfront costs of integration and the long-term value of improved patient care.

Overlooked Insights: The Workforce Crisis

One of the most under-discussed aspects of the CY2026 PFS is how policies interact with clinician workforce shortages. Policies that eliminate telehealth flexibilities for teaching physicians, for example, risk worsening shortages in psychiatry and other critical specialties. CTeL emphasizes that flexible supervision and billing rules are not just administrative tweaks — they are workforce stabilization measures that directly affect patient access.

As burnout rises and “ghost networks” limit patients’ ability to find real providers (Reed, 2024), CMS must use reimbursement policy as a lever to strengthen, rather than strain, the health care workforce.

The Path Forward

The CY2026 Physician Fee Schedule is more than a list of codes and rates; it is a blueprint for how Medicare adapts to an increasingly digital future. By embracing patient-centered, evidence-based policies, CMS can strengthen the health care system in three vital ways:

Protecting patients through secure, interoperable systems.
Empowering clinicians by valuing their time, expertise, and safety.
Driving innovation that ensures access to high-quality care for every community.

At CTeL, we believe that the success of telehealth, remote monitoring, and AI depends on thoughtful reimbursement and regulatory frameworks. With the right policies, these tools will not just support care delivery — they will redefine it.

References

Arora, L., Shetgaonkar, A., Pradhan, D., et al. (2025). Mitigating clinician information overload: Generative AI for integrated EHR and RPM data analysis. TechRxiv. https://doi.org/10.36227/techrxiv.174953189.97963312/v1

Jones, C. M., Shoff, C., Hodges, K., et al. (2022). Receipt of telehealth services, receipt and retention of medications for opioid use disorder, and medically treated overdose among Medicare beneficiaries before and during the COVID-19 pandemic. JAMA Psychiatry, 79(10), 981–992. https://doi.org/10.1001/jamapsychiatry.2022.2284

Ma, P. F., & Thomas, J. (2025). Workplace violence in healthcare. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK592384/

Mehrotra, A., Nimgaonkar, A., & Uscher-Pines, L. (2022). The impact of COVID-19 on outpatient visits in 2020: Visits remained stable, despite a late surge in cases. Commonwealth Fund.

Reed, T. (2024, October 10). Lawsuit says “ghost networks” are denying Americans mental health care. Axios. https://www.axios.com/2024/10/24/health-coverage-provider-ghost-networks

Shah, S. J., Crowell, T., Jeong, Y., et al. (2025). Physician perspectives on ambient AI scribes. JAMA Network Open, 8(3), e251904. https://doi.org/10.1001/jamanetworkopen.2025.1904

Building the Future of Care: CTeL’s Policy Recommendations for the CY2026 Medicare Physician Fee Schedule