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CMS Announces MAHA ELEVATE Model: A New Opportunity to Shape Reimbursement for Lifestyle, Functional, and Whole-Person Care Services
CMS’s new MAHA ELEVATE Model offers $100M in funding to evaluate evidence-based lifestyle, functional, and whole-person care interventions not currently covered by Medicare. Launching in 2026, this initiative creates a pathway for healthcare innovators, digital health companies, and care organizations to influence future Medicare coverage and reimbursement for chronic disease prevention and management.
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."
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.
Government Shutdown Looms: How the Medicare Telehealth Cliff Impacts Providers and Patients Starting October 1
Unless Congress acts by midnight, Medicare’s temporary telehealth flexibilities will expire on September 30, 2025. Starting October 1, many non-behavioral telehealth services face new limits, while behavioral health coverage and Medicare Advantage plans remain more flexible. Here’s what patients and providers need to know now.