CMS to begin covering some GLP1 drugs through the Part D Bridge program July 1, 2026

Ask your RHC consultant how your clinic can help patients particpate this program while also maximizing the RHC preventive service benefit for Intensive Behavioral Therapy for Obesity. CMS is expanding access to certain GLP-1 medications for Medicare Part D beneficiaries through a short-term demonstration starting July 1, 2026. The Medicare GLP-1 Bridge will operate outside of a beneficiary’s Medicare Part D plan coverage and use a central processor for managing prior authorization, claims processing, and pharmacy payment. Eligible beneficiaries will pay $50 for drugs furnished under the Medicare GLP-1 Bridge. For a patient to access GLP-1 medications via the Medicare GLP-1 Bridge, a medical provider must submit a prior authorization request and a prescription for an eligible GLP-1 drug for a use covered under the demonstration. Prior authorization requests will not be processed before July. Call us for more details.

RHC Telehealth Change: Patient Homes are Originating Sites through 2027

CMS has clarified that patients may be in their homes as a qualified originating site for medical telehealth through December 31, 2027. This changes an earlier determination that the home location would not qualify after January 30, 2026. Now, the RHC patient may be in their own home. The RHC provider is located either in the RHC or at their personal residence. These services are reported with G2025 with NO CG modifier. The reimbursement is $97.53. Mental telehealth continues to be a permanent RHC encounter and is reported with the appropriate mental health service CPT, the CG modifier and the appropriate modifier for the modality used. Contact your RHC consultant for more details.

RHC: NEW LIBRARY ITEMS: AUTOCLAVE LOGS 238-D & 238-E

Two new library items have been created for those RHCs using autoclaves. Surveyors are validating that autoclave logs are being kept, especially cleaning logs which align with manufacturers guidelines. Don't receive a deficiency because of a missing log. We have added 238-D which is for monthly autoclave cleaning and spore counts and 238-E which is a log which can be used daily, weekly and monthly according to the manufacturer's guidelines.