CY26 CMS: Physician Fee Schedule: Deep Dive Webinar
Key Webinar Topics
Telehealth Reimbursement and Eligibility: The presenters detailed how current telehealth reimbursement policies are set to expire on September 30th, 2025. This will lead to new restrictions, particularly for urban areas and certain provider types like physical therapists, occupational therapists, speech-language pathologists, and audiologists. The webinar emphasized that after this date, urban patients may lose eligibility for facility-based telehealth reimbursement.
Billing and Supervision Rules: The discussion covered new billing codes and permanent changes for 2026, including the inclusion of group therapy and specific audiology codes. It also clarified different types of healthcare supervision (general, direct, personal) and highlighted concerns about proposed restrictions on telehealth supervision for urban teaching hospitals, which could worsen physician shortages. The presenters also noted a positive development: the permanent allowance of virtual supervision via real-time audio and video for some services.
Behavioral Health and Digital Tools: The webinar addressed extensions for behavioral health services, noting that pandemic-era flexibilities will expire on September 30th unless made permanent. A positive update was the proposed expanded coverage for remote monitoring in digital mental health.
Request for Information (RFI) and Public Comment: A major focus of the webinar was the need for attendees to act. The presenters stressed the importance of commenting on the proposed rule before the September 12th deadline. Specific RFIs discussed included the valuation of practice expenses for AI and software as a service, the valuation differences between remote patient monitoring (RPM) and remote therapeutic monitoring (RTM), and digital tools for promoting healthy lifestyles.
Call to Action
The webinar ended with a clear set of next steps, urging all attendees to submit comments to CMS on several key proposals, including:
Upcoming telehealth restrictions.
Physician supervision rules for urban teaching hospitals.
The display of practice locations on patient statements.
Behavioral health in-person requirements.
The various RFIs related to practice expense valuation and digital health.
