Next Event: 2026 Outpatient Therapy Regulatory and Payment Updates
Date: November 19,2025
CMS Releases CY 2026 Medicare Physician Fee Schedule Final Rule
On October 31, 2025, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2026 Medicare Physician Fee Schedule (MPFS) final rule. This final rule does have regulatory and reimbursement implications for outpatient physical, occupational, and speech therapy provided in all outpatient therapy settings.
Does this final rule have tricks, treats, or both for outpatient therapy services. In this article, I will inform you of what CMS is finalizing on the following topics:
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Hi Rick – Does this language in the final rule indicate that 98975 can now be billed 1x per episode when monitoring is evidenced either 2-15 or 16-30 times in a 30 day period?
“We will be adopting all descriptors, guidelines, prefatory language, and parenthetical changes made to the Remote Monitoring section of the 2026 edition of the CPT codebook, including for CPT code 98975.”
This is the language that should appear in the 2026 CPT code for 98975:
(Do not report 98975 for less than 2 days of cumulative monitoring during the 30-day period)
In 2026, do we still apply the KX modifier above the 2480 threshold?
Yes