2026 Physician Fee Schedule extends some virtual care payments

CMS will allow rural health centers and federally qualified health centers to bill for telehealth in 2026 and expand payment policies for digital mental health treatment services to include solutions for attention-deficit hyperactivity disorder.

The agency released its final Physician Fee Schedule (PFS) for calendar year 2026 on Oct. 31, 2025. In addition to increasing physician reimbursement, the final rule includes several changes to virtual care payments.

First, CMS is adding ADHD treatment devices to the payment pathway for digital mental health treatment devices used in conjunction with ongoing behavioral health treatment established in the 2025 PFS rule. The agency noted that it will consider feedback on establishing coding and payment policies for other digital therapy devices for potential future rulemaking.

The final rule also adopts a waiver that allows rural health centers and federally qualified health centers (FQHCs) to bill for telehealth services, including audio-only telehealth, through 2026.

Further, the agency has permanently adopted a definition of 'direct supervision' that allows physicians or supervising practitioners to provide supervision through real-time, synchronous telehealth, including at rural health centers and FQHCs. Under the new definition, physicians or supervising practitioners can provide virtual direct supervision for certain diagnostic tests and cardiac pulmonary rehabilitation services, among others.

The agency will not finalize its policy that allows teaching physicians to be paid for having a virtual presence for services furnished involving residents. This policy will end on Dec. 31, 2025. However, the final PFS rule will permanently allow teaching physicians to have a virtual presence in all teaching settings in clinical instances when the service was furnished virtually.

Per the PFS final rule, CMS will also permanently remove frequency limitations for subsequent inpatient visits, subsequent nursing facility visits and critical care consultations and streamline the process for adding services to the Medicare Telehealth Services List. 

Though the 2026 PFS expands virtual care reimbursement in many ways, trade associations are disappointed by the elimination of a pandemic-era provision that allowed telehealth providers to report and bill using the address of their practice location, even when offering after-hours telehealth services from their homes or other locations.

"If this change goes into effect in January 2026, many telehealth visits offered by practitioners from locations other than their enrolled billing location will end," the Alliance for Connected Care said in an emailed statement. "Those who continue providing such care would need to separately enroll and bill for each location from which they deliver telehealth services. This is administratively difficult and will dramatically increase regulatory burden on both these practitioners and organizations with payment systems that are not designed to accommodate this reality."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.