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CMS Sharpens Focus on “Upstream Drivers” of Health in the 2026 Medicare Physician Fee Schedule
Articles Carrie Nixon Articles Carrie Nixon

CMS Sharpens Focus on “Upstream Drivers” of Health in the 2026 Medicare Physician Fee Schedule

The final 2026 Medicare Physician Fee Schedule (MPFS) solidifies Medicare’s shift toward paying for the assessment and mitigation of "upstream drivers" (e.g., nutrition, housing, social support). Discover how the revised HCPCS G0136 for physical activity/nutrition assessment and the broadened HCPCS G0019 descriptor for Community Health Integration (CHI) unlock new, aligned reimbursement streams for digital health and comprehensive care models. Also, learn how MFTs and MHCs can now initiate CHI services.

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