Sources & updates
Sources, change log and open questions
Every rule claim on Health Coach Codes traces back to a primary source listed here. Page numbers refer to the public-inspection display copy of the final rule until the Federal Register version is published.
Primary sources
| Source | What it supports |
|---|---|
| CMS-1848-F, CY 2027 PFS Final Rule (CMS landing page) | Rule documents, addenda and telehealth list. Released Nov 4, 2026; effective Jan 1, 2027. |
| Federal Register public-inspection copy 2026-22743 | Health coaching discussion, section (56), pp. 374–387; Table A-D9, p. 436; 42 CFR 410.26(b)(5), pp. 2059–2060. |
| 42 CFR 410.26(b)(5)(iii)–(v), as amended | Health coaching may be furnished by auxiliary personnel under general supervision; only the supervising practitioner bills. |
| Addendum B, CY 2027 PFS Final Rule (updated Nov 5, 2026) | Status A for 0591T–0593T; work RVUs 1.81 / 1.00 / 0.23; 0592T global indicator ZZZ. |
| CY 2027 PFS Final List of Medicare Telehealth Services | 0591T, 0592T and 0593T: finalized action "Maintain". |
| NCHEC announcement on national payment | CHES®/MCHES® holders are not independent billers; avoid assumptions about individual eligibility. |
| ACL evidence-based programs list | The Older Americans Act program-training pathway referenced in the rule (p. 383). |
What the final rule does not address
- Coaching-specific documentation, referral, plan-of-care or consent requirements (none found in pp. 374–387).
- Beneficiary cost sharing for these codes.
- Contracting arrangements between community-based organizations and billing practitioners.
Open questions we are tracking
- 0592T add-on indicator. Addendum B lists 0592T with global "ZZZ" (add-on). How MACs will process a follow-up session billed without 0591T is unresolved.
- CHES eligibility versus active certification. The rule names "eligibility for Certified Health Education Specialists" and does not say whether active CHES®/MCHES® certification or eligibility is what satisfies the pathway.
- MAC guidance. No Medicare Administrative Contractor articles for these codes had been published as of the last-verified date.
- Federal Register citation. Page citations will be updated to the final Federal Register version after publication (scheduled Nov 9, 2026).
Change log
- Nov 5, 2026. Added the help center, the blog, and guides on SOAP notes, general supervision, CHES® and MCHES®, coaches, practices and veteran coaching.
- Nov 5, 2026. Added code guides for 0591T, 0592T and 0593T, and the 2027 final rule explainer.
- Nov 5, 2026. Site launched. Content verified against the CMS-1848-F display copy and the Addendum B file updated Nov 5, 2026. The 0591T time reference was corrected to follow the CMS table, which lists no time for 0591T.
Spotted an error or a newer source? Email Angel@subthesis.com with the page and source. CPT® is a registered trademark of the American Medical Association.