Start: July 31, 2025 12:00 pm
End: July 31, 2025 1:00 pm
Host: ATA
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Policy Town Hall - Medicare Provider Fee Schedule 2026

Join our ATA Government Relations Special Interest Group for an all-member Town Hall on the just-released 2026 draft Medicare Physician Fee Schedule (PFS). Your input gathered during this meeting will help to inform our comment letter to the Centers for Medicare and Medicaid Services (CMS) on important telehealth and digital health provisions in the proposed rule, as well as items not included in the draft.

Our policy and advocacy team, including Kyle Zebley, Alexis Apple, and Lara Compton, will provide a brief summary of the PFS proposed rule. We’ll then open the meeting to hear feedback from our members – your priorities, concerns and recommendations – that will influence our comment letter to CMS, including:

Key virtual care provisions in the 2026 PFS include:

  • Changes to the Medicare Diabetes Prevention Program (MDPP).
  • Codes for 2-15 days of data collection over a 30-day period for remote treatment monitoring (RTM) and remote patient monitoring (RPM) services, and reimbursement amounts for each.
  • Simplified Medicare telehealth service list review process and new payment codes to the telehealth list.
  • Permanent definition of “direct supervision” that allows real-time audio/video presence.
  • Eliminated telehealth frequency limitations for subsequent inpatient visits, nursing facility visits, and critical care consultations.
  • Payment policies for DMHT services, including certain classified devices used to treat Attention Deficit Hyperactivity Disorder (ADHD) and clarification of practitioner billing.

The proposed rule does not address:

  • The Box 32 provision that allows virtual care providers to report their practice address rather than their home address on Medicare billing and enrollment forms.

CMS is also seeking public comment on additional avenues for digital health reimbursement, including:

  • Expansion of the DMHT codes to include additional devices.
  • Separate coding and payment for services with digital tools used by practitioners intended to maintain or encourage a healthy lifestyle, as part of a mental health treatment care plan.
  • Coding and payment similar to DMHT codes for FDA-cleared digital therapeutics that treat or manage the symptoms of chronic diseases.
  • Digital device reimbursement policies and a proposed new add-on G code to existing CPT codes to track use of an eye-tracking technology for diagnosing Autism Spectrum Disorder (ASD) in pediatric patients.

Please join us on Thursday, July 31 at 12:00 PM ET to share your feedback on the PFS that will help shape our response to CMS. All comment letters are due by midnight on September 12.