Last week, CMS released the CY 2026 Medicare Physician Fee Schedule (MPFS) Proposed Rule — and with it, a long-sought advancement for our field.

For the first time, CMS proposes allowing HCPCS code G2211 — the complexity add-on code — to be billed during home and assisted living visits.

This is a transformative step toward payment equity for home-based primary care (HBPC) providers. G2211 recognizes the inherent complexity and continuity of care delivered over time — exactly the kind of care our members provide every day, often to the highest-need populations in the health system.

We are deeply grateful to CMS for considering this policy expansion and for acknowledging the voices of our clinicians, patients, and advocates.

And we are proud to share that AAHCM’s policy and advocacy efforts directly contributed to this change. Over the past year, we’ve submitted formal comments, met with CMS officials, and mobilized stakeholder support to ensure that home-based clinicians were not left out of this important payment reform.

What This Means:

• New revenue opportunity for longitudinal care delivered in the home and ALF settings
• Recognition of complex, high-value work often delivered outside the clinic
• Momentum toward more equitable, sustainable Medicare payment policy for HBPC

We know this is a proposal — not yet final — and we will continue our advocacy to ensure this becomes permanent policy. In the coming weeks, AAHCM will publish additional guidance and analysis to help you understand how this could affect your practice and patients.

Thank you for being a part of this progress. This is a shared win — and a clear example of what our collective voice can achieve.