Revenue Cycle Management — Rural telehealth billing changes on October 1

TODAY'S SIGNAL

For dates of service on or after October 1, rural health clinics and federally qualified health centers must stop using the single G2025 code for Medicare distant-site telehealth. CMS says they must report the individual CPT or HCPCS code for the service, the appropriate revenue code, and modifier 93 for audio-only or 95 for audio-video visits.

This is a claim-format transition, not evidence of higher or lower reimbursement. CMS lists the 2026 payment rate at $97.53 and says the payment methodology remains tied to the volume-weighted average for Physician Fee Schedule telehealth-list services. The immediate practice question is whether charge capture, claim edits and staff instructions are ready for October dates of service.

This applies to RHCs and FQHCs furnishing qualifying Medicare distant-site telehealth services, not every medical practice or every payer. CMS lists October 5 as the implementation date for its systems; that does not change the October 1 effective date for covered dates of service.

Finance: No separate worthwhile Signal today.

Operations: No separate worthwhile Signal today.

This week, briefly: Last week's accepted Healthcare edition covered the January 1 move from global maternity bundles to service-level reporting.

Public information only. Not professional advice.