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The 2026 MPFS Final Rule: A Pivot Point for Digital Health in RHCs and FQHCs
The CMS CY 2026 MPFS Final Rule ends simplified G-code billing (G0071, G0512) for safety net providers. FQHCs and RHCs must shift to granular CPT/HCPCS coding for virtual check-ins, Chronic Care Management (CCM), and Behavioral Health Integration (BHI). This structural change is a major product roadmap update for digital health vendors serving the rural and community health market. Learn the 4 key billing changes to maintain revenue for your RHC/FQHC partners.
2026 Medicare Final Rule Part 1: Rapid-Fire Q&A on RPM and RTM Codes
The 2026 Medicare Physician Fee Schedule (MPFS) Final Rule introduces some of the most consequential updates for Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) since their inception. In Part 1 of our rapid-fire video series, health law experts Carrie Nixon and Reema Taneja break down the most significant changes impacting digital health innovators and care management companies.
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."
2026 Medicare Final Rule Part 3: Rapid-Fire Q&A on FQHC and RHC Bundled Code Unbundling
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.
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.
CMS Finalizes 2026 Remote Monitoring Reimbursement Updates: What Changed for RPM and RTM
CMS Finalizes Major 2026 RPM/RTM Rule: New Short-Duration Codes & OPPS Valuation Shift. The CY 2026 Medicare Physician Fee Schedule (MPFS) introduces unprecedented flexibility for digital health companies by finalizing new CPT codes for 2–15 day RPM/RTM monitoring (e.g., CPT 99445, 98984–98986) and 10-minute treatment management codes (e.g., 99470, 98979). Crucially, CMS is adopting Outpatient Prospective Payment System (OPPS) data for device supply code valuation, setting a precedent for valuing SaaS infrastructure costs. Learn how these changes—including the "sometimes therapy" designation for RTM—will reshape hybrid virtual care models, episodic monitoring, and reimbursement strategy going forward.