CMS Issues Change Request to Allow Category II Codes to Be Submitted on RHC Claims in 2025

Dear RHC Community,

NARHC has been engaging with CMS over the last year in an attempt to resolve the CPT Category II code issue for RHCs, including through a letter to the CMS Administrator.

We are very pleased to report that CMS recently issued a CMS Change Request to allow Category II codes to be submitted on RHC claims beginning April 7, 2025.

This has historically been a significant barrier to RHC participation in a variety of value-based care models. We hope that this change will now allow RHCs to easily report through CPT Category II in line with how other providers participate in value-based care models.

We thank CMS for their attention to this issue and for the RHCs who initially raised it for NARHC to advocate on behalf of!

With any questions, please contact Nathan.Baugh@narhc.org or Sarah.Hohman@narhc.org.

Sincerely,
National Association of Rural Health Clinics