CMS released several updated MLN Matters® articles outlining important billing, payment, and coverage changes taking effect in 2026. These updates impact ESRD facilities, ambulatory surgical centers, rural health clinics, and preventive services.
Acute Kidney Injury & ESRD Billing Updates
Beginning July 1, 2026, ESRD facilities will no longer be required to submit the AX modifier on certain ESRD PPS claims eligible for add-on payment adjustments. CMS also issued new billing instructions for hemodiafiltration and acute kidney injury claims.
Ambulatory Surgical Center Payment Update
Effective January 1, 2026, CMS updated ASC payment policies to reflect new device categories, CPT and HCPCS codes, covered drugs and biologicals, skin substitutes, and expanded non-opioid pain management treatments.
Behavioral Health Integration Services Revisions
CMS added three new optional add-on HCPCS codes for general behavioral health integration and psychiatric collaborative care model services when advanced primary care management services are provided.
Rural Health Clinic Updates
CMS permanently adopted the definition of direct supervision to include audio-visual telecommunications, updated 2026 payment rates and telehealth fees, added new behavioral health integration codes, discontinued select virtual care HCPCS codes, and confirmed that RHCs may continue billing medical telehealth services and serving as distant site providers through December 31, 2026.
Medicare Preventive Services Revisions
Updates include revised annual wellness visit coding, new Medicare Diabetes Prevention Program HCPCS codes, extended virtual and online session flexibilities through 2029, and expanded guidance on billing add-on code G2211 with home or residence E/M visits starting January 1, 2026.