On October 31, CMS released the final rule for the Calendar Year (CY) 2026 Medicare Physician Fee Schedule (MPFS) that contains a number of updates related to social drivers of health (SDOH) and health-related social needs (HRSN) screening.
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What's Inside
SDOH Risk Assessment Billing Code Revision: CMS finalized a revised code descriptor for HCPCS Code G0136, replacing reference to conducting a standardized SDOH assessment with conducting a “standardized, evidence-based assessment of physical activity and nutrition.”
Health-Related Social Needs (HRSN) Screening in Ambulatory Specialty Model (ASM): The new mandatory CMMI model includes a requirement for specialists in its heart failure cohort to attest to a “Connecting to Primary Care and Ensuring Completion of Health-Related Social Needs Screening” improvement activity.