The 2026 Medicare Physician Fee Schedule made two significant changes that affect Rural Health Clinics and Federally Qualified Health Centers. First, HCPCS code G0512, which previously bundled behavioral health integration services for RHCs and FQHCs, is no longer payable as of January 1, 2026. Practices must now report the component codes (99492, 99493, 99494, plus G2214) instead. Second, telehealth billing under G2025 was extended through December 31, 2027, with a 2026 payment rate of $97.53. The National Association of Rural Health Clinics has called the package a meaningful regulatory win, but only for clinics that update their billing.
What G0512 covered and why it ended
G0512 was a single bundled code that paid RHCs and FQHCs for behavioral health integration services delivered under the Psychiatric Collaborative Care Model. It covered a month of services including care manager activity, psychiatric consultant input, and the primary care provider’s coordinating role. CMS retired the code as part of broader work to align RHC and FQHC payment with the codes used in non-RHC settings. The replacement is a set of component codes that need to be billed individually, with documentation supporting each.
The new code map
Starting January 1, 2026, RHCs and FQHCs delivering Psychiatric Collaborative Care services bill the component codes:
- CPT 99492: initial psychiatric collaborative care management, first 70 minutes in the first calendar month.
- CPT 99493: subsequent psychiatric collaborative care management, first 60 minutes in subsequent months.
- CPT 99494: each additional 30 minutes in any month.
- HCPCS G2214: psychiatric collaborative care management, first 30 minutes in a subsequent calendar month, used when work falls below the 99493 threshold.
Time tracking is now non-negotiable
Under G0512, RHCs and FQHCs received a flat monthly payment regardless of internal time distribution. The component codes pay differently based on cumulative time documented for the calendar month, which means the care manager and the billing provider need a consistent way to log minutes. The audit-ready format is a daily time log per patient that captures activities (chart review, patient phone call, psychiatric consultant correspondence, care plan documentation) with start and end times. At month end, the cumulative minutes determine which combination of 99492 or 99493 plus 99494 or G2214 applies.
G2025 telehealth through 2027
Congress extended Medicare telehealth flexibilities through December 31, 2027, including audio-only behavioral health, FQHC and RHC telehealth billing under G2025, and the in-person visit waiver for mental health telehealth (extended through January 1, 2028). The 2026 G2025 payment rate is $97.53. RHCs and FQHCs can continue to bill telehealth visits using G2025 with appropriate place-of-service and modality documentation. The two-year horizon gives clinics time to integrate telehealth into routine workflow without the constant deadline anxiety that has characterized the post-PHE period.
Care management add-ons: BHI and CoCM
Optional add-on codes G0568, G0569, and G0570 are now available for Behavioral Health Integration and Psychiatric Collaborative Care delivery in RHCs and FQHCs, paid at the national non-facility rate. These layer with primary care visits when behavioral health work is delivered by the same billing practitioner in the same month. Documentation must clearly distinguish the time and activity attributable to BHI or CoCM from the rest of the encounter, and consent must be in place for both the primary care service and the behavioral health integration.
Direct supervision via telehealth
CMS permanently adopted a definition of direct supervision that allows the supervising practitioner to provide supervision through real-time audio and visual interactive telecommunications, excluding audio-only. For RHCs and FQHCs operating multiple sites, that flexibility lets one supervising provider cover several sites simultaneously when the technology supports it. The documentation requirement is unchanged: the supervising provider must be immediately available for guidance and able to take over the encounter if needed.
How MHB helps RHCs and FQHCs
For RHCs and FQHCs that want billing partners familiar with the 2026 component-code structure, time-tracking workflows for collaborative care, and the G2025 telehealth rules, our team handles medical billing for rural and federally qualified health centers, with site-specific code mapping and monthly audit reviews on collaborative care claims.
The bottom line
The G0512 retirement is a billing change that requires a real workflow update, not a code-substitution shortcut. RHCs and FQHCs that build time-tracking and consent processes into their collaborative care programs in early 2026 capture the full revenue available. Clinics that try to handle the change inside their existing G0512 routine will see months of denials before realizing the structure broke.
