If your Rural Health Clinic provides telehealth services, an important billing change is coming this fall.
Beginning October 1, 2026, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) will no longer bill HCPCS code G2025 for distant site telehealth services. Instead, clinics must report the individual CPT or HCPCS code that describes the telehealth service provided. This change was announced by CMS in Change Request (CR) 14468.
What’s Changing?
For dates of service on or after October 1, 2026, clinics must:
- Bill the appropriate CPT or HCPCS code for the telehealth service furnished instead of G2025.
- Continue reporting the appropriate revenue code.
- Include one of the required telehealth modifiers:
- Modifier 93 Synchronous telemedicine service provided using audio-only technology.
- Modifier 95 Synchronous telemedicine service provided using real-time audio and video technology.
CMS will continue to publish the list of eligible telehealth CPT and HCPCS codes each year as part of the Physician Fee Schedule (PFS) rulemaking.
Why This Matters:
For years, RHCs have become accustomed to billing G2025 for non-behavioral health distant site telehealth services. Beginning October 1, that process changes.
Using the correct CPT or HCPCS code will:
- More accurately identify the service performed.
- Improve claims reporting and data collection.
- Better support quality reporting and participation in value-based care initiatives, including Accountable Care Organizations (ACOs).
While the payment methodology for distant site telehealth services remains in place through December 31, 2027, the way those services are billed is changing.
What Your Clinic Should Do Now:
October may seem far away, but preparation should begin now.
We recommend that clinics:
- Review their current telehealth billing workflows.
- Update billing software and charge masters.
- Ensure coding staff understand the new CPT/HCPCS reporting requirements.
- Train providers and billing personnel on when to use Modifier 93 versus Modifier 95.
- Review the current CMS list of approved telehealth services before implementation.
Preparing now can help avoid claim denials, delayed reimbursement, and unnecessary confusion when the change takes effect.
HSA Can Help:
Keeping up with CMS billing changes is a full-time joband that’s why we’re here.
Whether you need assistance with RHC billing, reimbursement, compliance, or operational guidance, HSA works alongside Rural Health Clinics across the country to help ensure you’re prepared before regulatory changes become compliance problems.
If you have questions about how this update may affect your clinic, our team is here to help.
Learn More:
For complete billing instructions and the current list of approved Medicare telehealth services, visit these official CMS resources:
- CMS Change Request (CR) 14468: View the MLN Matters Article (MM14468)
- CMS List of Telehealth Services: View the Current Telehealth Services List