If your FQHC bills Medicare for distant-site telehealth services, there’s a billing change to have on your radar this fall.
Beginning October 1, 2026, CMS will require federally qualified health centers (FQHCs) and rural health clinics (RHCs) to bill Medicare using the individual CPT or HCPCS code that describes the telehealth service provided, rather than HCPCS code G2025.
While this isn’t expected to significantly change how telehealth services are delivered, it does require updates to billing processes and systems.
What’s Changing?
For dates of service on or after October 1, 2026, Medicare telehealth claims should include:
- The individual CPT or HCPCS code that describes the service
- The appropriate revenue code
- Modifier 93 for audio-only telehealth, when applicable
- Modifier 95 for audio and video telehealth services
FQHCs may continue to use G2025 for eligible nonbehavioral health distant-site telehealth services through September 30, 2026.
What Should Health Centers Do Now?
Although the change is relatively straightforward, it’s worth checking that your organization is ready before October.
A few items to review include:
- Billing software and EHR configuration
- Charge capture workflows
- CPT and HCPCS code setup
- Revenue code mapping
- Staff awareness and training
If you work with a clearinghouse or third-party billing partner, now is also a good time to confirm they’ll be ready for the transition.
A Good Reminder to Review Billing Workflows
CMS billing requirements continue to evolve, and even smaller operational updates can create unnecessary claim issues if they’re overlooked.
Taking a few minutes now to review your telehealth billing process can help ensure claims continue to move through cleanly after October 1.
At Medcor, we closely monitor Medicare and Medicaid billing changes so our FQHC partners can stay focused on patient care while maintaining a healthy revenue cycle.