The 2026 Physician Fee Schedule (PFS) final rule was released late last week by the Centers for Medicare and Medicaid (CMS). The rule makes direct supervision via telehealth permanent for many services. Additionally, it extends audio-only flexibilities for certain non-behavioral health visits through December 31, 2026. It also proposes new add-on codes for behavioral health integration services within Advanced Primary Care Management (APCM) programs. Please note that the rule does retains some COVID-19-era telehealth restrictions, such as the originating site requirement for certain services. We are pleased that these final provisions overall reflect AAPP’s comments to strengthen behavioral health integration in primary care and expand telehealth flexibilities.
Additionally, CMS finalized a new claims-based methodology to remove units of drugs purchased under the 340B Drug Pricing Program for the purposes of calculating Medicare drug inflation rebates. The agency also finalized its proposal to create a 340B claims data repository, allowing voluntary data submission by 340B providers to potentially use for the same purpose.