CMS updates telehealth and remote monitoring guidance

Revenue integrity professionals should take note of recent updates to CMS’ MLN Booklet on telehealth and remote monitoring requirements. The guidance now includes key policy changes and payment updates in the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) final rule.

CMS provided additional information on how practitioners can suppress their home address in the Provider Enrollment, Chain, and Ownership System (PECOS). The agency clarified that virtual-only telehealth providers who only have a physical practice location at their home address must enroll it as their practice location. However, they can suppress their address details from the public by marking is as a “home office for administrative or telehealth use only” in their PECOS enrollment application.

In the CY 2026 MPFS final rule, CMS removed telehealth frequency limitations for the following services:

• Subsequent inpatient visits (Current Procedural Terminology [CPT®] codes 99231–99233)
• Subsequent nursing facility visits (CPT codes 99307–99310)
• Critical care consultations (Healthcare Common Procedure Coding System [HCPCS] codes G0508 and G0509)

In addition, CMS revised the definition of direct supervision to allow virtual presence using real-time audio-visual interactive telecommunications for services without a global surgery indicator of 010 or 090. The agency will continue to pay Rural Health Clinics and Federally Qualified Health Centers for non-behavioral and non-mental telehealth services through December 31, 2026.

CMS removed the provisional service distinction from the Medicare telehealth services list and will consider every list addition moving forward to be permanent. For CY 2026, the agency added the following five services to the list:

• Multiple family group psychotherapy (CPT code 90849)
• Group behavioral counseling for obesity (HCPCS code G0473)
• Infectious disease add-on (HCPCS code G0545)
• Auditory integrated sound processor (CPT codes 92622 and 92623)

Lastly, facilities should take note of the CY 2026 originating site fee ($31.85) and Medicare Economic Index increase (2.7%).

Revenue integrity professionals at organizations that provide telehealth or remote monitoring services should review the 2026 MPFS final rule and monitor for additional guidance. Visit CMS’ telehealth web page for more information.

Editor’s note: Find additional NAHRI coverage on telehealth coding and billing here.