Medicare AdvantageBilling CodesHigh impact
CMS Telehealth Billing Change for RHCs and FQHCs Preheader: Effective Oct. 1 for MA members
Blue Cross Blue Shield of Kansas·Coding
Effective date
Oct 1, 2026
We identified it
Sep 5, 2026
Summary
Effective October 1, 2026, CMS is discontinuing the use of HCPCS code G2025 for distant-site telehealth services billed by RHCs and FQHCs to Medicare Advantage members. Billing teams must transition to submitting the appropriate CPT or HCPCS code describing the actual service furnished, along with the applicable telehealth modifier and revenue code.
Action Required
By September 30, 2026: Billing team must update billing software and system rules to stop accepting HCPCS code G2025 for RHC and FQHC distant-site telehealth claims for Medicare Advantage members. Implement mandatory validation to require providers to submit the specific CPT/HCPCS code for the actual telehealth service furnished, along with the appropriate telehealth modifier and revenue code. Update provider documentation and training materials explaining the new billing requirements. Contact your CMS provider representative at [email protected] if clarification is needed on which codes to use for specific telehealth services. Claims submitted with G2025 on or after October 1, 2026 for MA members will likely be rejected or denied.