2026 Medicare Final Rule Part 2: Rapid-Fire Q&A on Upstream Drivers of Health
The 2026 Medicare Physician Fee Schedule Final Rule confirms CMS’s strong push toward whole-person care, creating new reimbursement pathways for models focused on nutrition, physical activity, and social supports. In Part 2 of our series, Mike Pappas and Olivia Goldner analyze the updates to "Upstream Drivers of Health."
Key Questions Answered:
How did CMS repurpose HCPCS code G0136, shifting its focus from a broad SDOH assessment to specific physical activity and nutrition risk factors?
How was the Community Health Integration (CHI) code G0119 revised to reflect the broader concept of "Upstream Drivers of Health?"
Who is now permitted to initiate and bill for CHI services, expanding opportunities for licensed clinical social workers, marriage and family therapists, and mental health counselors?
This video is critical for business owners in metabolic care, behavioral health, and community-based support services looking to monetize holistic care strategies under Medicare.
Disclaimer: This video is for informational purposes only and does not constitute legal advice. Please consult with your legal counsel.