How Your Telehealth Code Now Decides the Patient's Bill

Every CMS change request carries a line labeled Policy. On Transmittal 13975, issued Tuesday, it reads in full:

"There are no policy changes associated with this instruction."

Under Provider Education, the same document says None. Under Impacted Contractors, None.

It revises two sections of one manual chapter, it has one business requirement, and its effective date was two days after it issued.

So we diffed it against the version it replaced.

What the Manual Said Until Tuesday

CR 14625 rewrites sections 80 and 40.1 of Chapter 9 of the Claims Processing Manual, the chapter 16,750 enrolled rural health clinics and federally qualified health centers bill from.

The version it overwrote was stamped Rev. 13264, issued June 9, 2025. Four things moved.

• The expiration date. The old section 80 told you twice, in one paragraph, that non-behavioral distant site telehealth ran "until December 31, 2025, or later date if extended." That sentence stayed on cms.gov for 272 days after the date in it passed. The new text says December 31, 2027.
• The deductible. Old section 40.1: "RHC services are subject to an annual deductible of twenty percent of charges for covered services." The Part B deductible is not a percentage of anything. For 2026 it is $283, a flat annual dollar amount CMS announced on November 14, 2025. The new sentence inserts two words: "an annual deductible and coinsurance of twenty percent of charges."
• The mental health start date. The old text said RHCs and FQHCs could bill mental health visits via telehealth "beginning January 1, 2023." CMS finalized that in the CY 2022 fee schedule rule and has said January 1, 2022 in its own MLN article since May 2022. The manual disclaimed a year of a benefit that existed.
• Four subheads. Section 80 had none. It now has four, and one of them scopes a sentence about the FQHC deductible to the originating site facility fee, where it belongs.

Here is the part that is hard to read as housekeeping.

On December 18, 2025, thirteen days before the date in section 80 expired, CMS issued Transmittal 13547 and revised three other Chapter 9 sections. The word "telehealth" appears zero times in it.