2026 Medicare Fee Schedule: Big Wins & Big Questions for Virtual Care Providers

🚨 CMS proposes major overhaul to remote & chronic care billing in 2026

Centers for Medicare & Medicaid Services just released the 2026 Proposed Physician Fee Schedule, and the updates are highly relevant to Vironix Health’s mission to make virtual care scalable, sustainable, and patient-centered.

Here’s what providers need to know: ✅ New RPM/RTM codes for shorter durations: <20 mins and <16 days of data ✅ Advanced Primary Care Management (APCM) codes to streamline CCM, PCM, BHI, and peer support ✅ Expanded reimbursement for Digital Mental Health Treatment ✅ Simplified Behavioral Health Integration (BHI) under a modular model ✅ Shifting valuation for certain codes to reduce burden on clinicians/staff

These changes create new opportunities to increase revenue, simplify billing, and expand access to care, but they also raise important questions about implementation and compliance.

We’ve summarized the changes in a side-by-side comparison of current vs. proposed codes, and we’re here to help you understand what it means for your virtual care program.

👉 Reach out to the Vironix team if you’d like support navigating this shift and maximizing the impact of your care management services.

Sources: ▪️ https://lnkd.in/gZvyw5hq