Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) face mandatory billing changes in the 2026 Medicare Physician Fee Schedule (MPFS) Final Rule. In Part 3 of our series, Stephanie Barnes and Sam Pinson break down the crucial compliance and billing updates that will affect virtual care and care management services in these settings.
Key Questions Answered:
Which two bundled G codes (G0071 and G0512) are no longer billable by RHCs/FQHCs starting January 1, 2026, and what replaces them?
What are the three new APCM add-on codes (G0568, G0569, G0570) CMS finalized to formally integrate Behavioral Health into Advanced Primary Care Management (APCM) for RHCs/FQHCs?
What category of services is now automatically paid separately from the visit for RHCs/FQHCs, improving transparency for care coordination?
If your business supports or operates an FQHC or RHC, you need to understand these mandatory code transitions and new APCM opportunities now.
Disclaimer: This video is for informational purposes only and does not constitute legal advice. Please consult with your legal counsel.