CMS 2026 Medicare Fee Schedule: Key Telehealth Changes for Providers
Yes, CMS made real changes to telehealth in this year’s fee schedule, a streamlined process for adding services, new codes, a higher originating site fee, and a permanent supervision rule. It also turned down a few things telehealth advocates were pushing for, which matters just as much.
What’s the Biggest Procedural Change to the Telehealth Services List?
In the CY 2026 Physician Fee Schedule final rule (CMS-1832-F), effective January 1, 2026, CMS cut its review process for adding services to the Medicare Telehealth Services List from five steps down to three.
It also eliminated the “provisional” category entirely. Every service on the list, whether it’s been there for years or just got added, is now treated as permanent. CMS still has the authority to remove a service later, but nothing defaults back to provisional status anymore.
What New Services Got Added to the Telehealth List for 2026?
Five codes made the cut: CPT 90849 (multiple-family group psychotherapy), HCPCS G0473 (group behavioral counseling for obesity), HCPCS G0545 (infectious disease add-on), and CPT 92622 and 92623 (auditory osseointegrated sound processor diagnostic analysis and programming).
If your practice does behavioral health groups, obesity counseling, or audiology work tied to cochlear-type devices, these are worth checking against your current billing setup.
What Changed for Payment and Supervision?
The originating site facility fee goes up to $31.85 for 2026, up from $31.01. CMS also permanently removed frequency limits on subsequent inpatient visits, subsequent nursing facility visits, and critical care consultations delivered via telehealth, so you’re no longer capped on how often you can bill those.
On supervision, CMS made permanent a rule that real-time audio-video telecommunications can satisfy “direct supervision” requirements. Audio-only doesn’t count. If your practice uses remote supervising physicians for incident-to billing, this is the standard you need to be meeting now, not a temporary flexibility that might lapse.
What Did CMS Decline to Expand Telehealth Coverage To?
Three things telehealth advocates pushed for didn’t make it in: dialysis services, telemedicine E/M visits, and home INR monitoring. CMS cited insufficient evidence or misalignment with statutory requirements, depending on the service.
Teaching settings got a narrower outcome too. Virtual presence for teaching physicians is now permanent, but only for encounters that are fully virtual, meaning the patient, resident, and teaching physician are all in separate locations. For in-person teaching settings, physical presence requirements are back, with the existing rural exception still intact.
What Should Telehealth Providers Do About These Changes?
- Check whether your service mix overlaps with the five newly added codes, especially if you run behavioral health groups or audiology services, and update your billing workflows accordingly.
- Update your originating site fee expectations to $31.85 if that’s part of your revenue.
- If you use remote direct supervision for incident-to billing, confirm your setup runs on real-time audio-video. Audio-only no longer qualifies under the permanent rule.
- If you run an academic or teaching telehealth program, separate which encounters are fully virtual versus in-person with a remote resident, since the supervision rules now differ between the two.
- Consult your compliance counsel.
Source
CMS Fact Sheet, October 31, 2025: Calendar Year 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F)
This post is for educational purposes only and does not constitute legal or compliance advice. Consult a qualified attorney or compliance professional before acting on this information.
