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26-1243 FQHCs and RHCs Must Use New Telehealth Billing Codes Beginning October 1, 2026
Effective date
Oct 1, 2026
Identified
Oct 23, 2026
Summary
Effective October 1, 2026, FQHCs and RHCs must discontinue billing HCPCS code G2025 for distant-site telehealth services and instead bill the appropriate procedure code with telehealth modifier 93 (audio-only) or 95 (audio/video). This change does not affect reimbursement rates but requires immediate billing workflow updates for practices treating Medicare and commercial telehealth patients.
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What to do
Action · 4 steps
01On or after October 1, 2026: Billing team must update billing software and encounter workflows to (1) stop billing HCPCS code G2025 for all distant-site telehealth services provided by FQHCs and RHCs, (2) require use of the specific procedure code describing the telehealth service provided, and (3) append modifier 93 for audio-only telehealth services or modifier 95 for audio/video telehealth services.
02Verify all telehealth service codes against the CMS Telehealth Services List at https://www.cms.gov/telehealth-services-list.
03Contact the Provider Services Center at 800-929-9224 (Individual and Employer Group plans) or 800-641-7761 (Medicare Supplement plans) with questions.
04Note: This change is already effective as of the analysis date (2026-10-23); verify whether your practice has completed implementation and confirm current billing procedures reflect the new code requirements.
Codes mentioned
G2025
Original notice
26-1243 FQHCs and RHCs Must Use New Telehealth Billing Codes Beginning October 1, 2026
providerlibrary.healthnetcalifornia.com · Always check the source before changing claims.