The Senate Just Settled One WISeR Fight. Almost Nobody’s Watching the Code That Dies October 1.

One of the three fronts I flagged last issue just closed. On 16 July, the Senate voted 46–50 along party lines to block consideration of S.J.Res.198, the Congressional Review Act resolution that would have nullified WISeR. The GAO ruling that started this fight — that CMS should have submitted WISeR for congressional review before launch — still stands as a matter of process. It just did not matter to the outcome.

That leaves two fronts open: the House Appropriations rider that would block FY2027 funding, which still has not reached a floor vote, and the FOIA fight over the AI methodology, still working through the courts. Both can generate headlines this autumn. Neither has stopped the programme for a single day.

While that vote pulled the attention, CMS finalised something with a harder deadline and zero controversy attached to it.

The deadline that is not about WISeR at all

Starting with dates of service on or after 1 October 2026, Rural Health Clinics and Federally Qualified Health Centers can no longer bill distant-site telehealth under the single catch-all code G2025. CMS Change Request 14468 requires them to bill the individual CPT or HCPCS code that actually describes the service delivered, alongside modifier 93 for audio-only or modifier 95 for audio-visual. The flat $97.53 G2025 rate goes away. Reimbursement moves to whatever the specific code pays under the Physician Fee Schedule.

For six years, RHCs and FQHCs billed telehealth the way you would expense a business trip with one line item: “expenses, $97.53”. That worked fine until someone downstream — a payer, an auditor, an ACO — needed to know what was actually delivered. Now they will know, because the billing system will have to know first.

Here is the part that should worry billing teams more than the code change itself: this touches claim scrubbers, EHR charge masters, payer edits and denial workflows simultaneously, not sequentially. A clinic that treats this as a one-line update to its superbill is going to find out in November, when the first batch of claims comes back, that “annual wellness visit performed virtually” and “office visit, established patient” are not interchangeable line items any more.

What to actually do with this

• Pull your telehealth code inventory now. Cross-reference every CPT/HCPCS code your clinicians actually deliver via telehealth against the CMS telehealth services list published with the CY2026 Physician Fee Schedule — not against what your EHR currently has mapped to G2025.
• Model the reimbursement delta before October, not after. Some visits will pay more than $97.53 under their specific code, some less. Practices that skip this analysis in September will discover their answer in Q4 revenue, not in a spreadsheet.
• Treat this as a system change, not a code change. Charge master, scrubber logic and denial workflows all need updating together.
• Do not let the WISeR headline crowd this off your radar. WISeR affects six states and a defined service list. This affects every RHC and FQHC billing Medicare telehealth, nationwide, on a fixed date.

The 2030 view

The Senate vote makes for a cleaner story — a roll call, a party line, a winner and a loser by the end of the afternoon. The G2025 phase-out has none of that. It has a change request number, an effective date and a modifier table. But the modifier table is what will show up in a rural clinic’s October remittance advice, while the Senate vote will mostly show up in a news recap.

The practices that come out ahead in Q4 will not be the ones who called the Senate vote correctly. They will be the ones who spent September mapping their actual telehealth codes instead of waiting to see what the remit said.