Medicare Payment Rules Signal Opportunity for Telehealth, Digital Therapeutics and Software Solutions: Updates from the CY 2026 Hospital Outpatient Prospective Payment System and Physician Fee Schedule Proposed Rules - orrick.com
Medicare's CY 2026 proposed rules expand telehealth coverage and payment for digital therapeutics, including audio-only services and remote monitoring, effective January 1, 2026.
Aforeworn detected this change in the Telehealth Cross-State Licensing space on July 6, 2026 and published this briefing so affected operators are forewarned rather than caught off guard. It is rated High urgency. Telehealth platforms, virtual specialty clinics, behavioral-health providers, e-prescribers should confirm how it applies to their specific situation before acting. There is a time constraint attached: 2025-09-09 (comment deadline); 2026-01-01 (effective date). Acting after that point can mean penalties, a lapsed licence, or lost eligibility — exactly the kind of surprise Aforeworn exists to prevent. Aforeworn monitors Telehealth Cross-State Licensing continuously and turns every detected change into a plain-English briefing like this one, so you always know first. Forewarned is forearmed.
What changed
Medicare proposes to permanently cover audio-only telehealth, add digital therapeutics to outpatient payment, and extend originating site flexibilities.
Who it affects
Telehealth platforms, virtual specialty clinics, behavioral-health providers, e-prescribers
What you must do
Review proposed rules and submit comments by September 9, 2025; update billing and compliance protocols for new codes.
Deadline
2025-09-09 (comment deadline); 2026-01-01 (effective date)
Never miss a change like this again
Aforeworn watches Telehealth Cross-State Licensing around the clock and alerts you the moment a rule moves — with a plain-English brief on what to do.
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