← Back to list
2026-10-01 - Acute Hospital Care at Home: Code Correctly for Telehealth Place of Service
Act
by Oct 1, 2026
Effective date
Oct 1, 2026
Identified
Oct 1, 2026
Summary
Medicare now requires telehealth services provided to Acute Hospital Care at Home (AHCAH) patients to be billed with POS code 21 (inpatient hospital) rather than a home-based POS code, combined with Modifier 95 (synchronous telemedicine). This reflects that Medicare treats AHCAH patients as inpatients regardless of the delivery location.
Get alerts when payers change rules like this one
We check Medicare/CMS and other payers every day and email you when a change matches your specialty and state.
Get Medicare/CMS alertsPolicy Monitoring is free. No card required.
What to do
by Oct 1, 2026 · 5 steps
01Billing team must update billing software and claim submission processes to automatically apply POS 21 with Modifier 95 for all telehealth services delivered to AHCAH-enrolled patients.
02Providers must verify patient AHCAH enrollment status at check-in.
03Update encounter forms and EMR templates to flag AHCAH patients so coders apply correct POS/modifier combination.
04Train all billing and clinical staff on this requirement.
05Claims submitted with incorrect POS codes (e.g., POS 02 for home) for AHCAH telehealth will be denied or require correction.
Codes mentioned
2195
Original notice
2026-10-01 - Acute Hospital Care at Home: Code Correctly for Telehealth Place of Service
cms.gov · Always check the source before changing claims.