CMS Takes a Historic Step Toward Recognizing Health & Wellness Coaching
On November 4, 2026, the Centers for Medicare & Medicaid Services (CMS) finalized the CMS CY 2027 Medicare Physician Fee Schedule (PFS), which has established new pathways to reimbursement for health and wellness coaching. This ruling marks an exciting next chapter for the profession, creating more opportunities for coaches to work alongside healthcare providers and employers to support evidence-based, whole-person care.
These updates in national Medicare policy represent significant steps forward and reflect years of work led by NBHWC in collaboration with our profession: building standards, strengthening evidence, demonstrating health and wellness coaching in practice, and advocating for sustainable pathways that can expand access.
NBHWC is dedicated to defining the path forward. We remain committed to helping coaches, healthcare organizations, and partners understand the final policy, navigate its requirements responsibly, and continue strengthening the pathways through which qualified health and wellness coaches can contribute.
CMS CY27 Policy Updates
The final Physician Fee Schedule (PFS) CY 2027 includes several important provisions where CMS has:
- Finalized national valuation/pricing for the existing Category III CPT codes 0591T, 0592T, and 0593T;
- Finalized that health and well-being coaching* services require general supervision by an eligible Medicare billing practitioner, rather than the direct supervision originally proposed;
- Improved the valuation of the individual coaching services, 0591T and 0592T;
- Explicitly included the National Standards of the National Board for Health & Wellness Coaching (NBHWC) among the pathways that may satisfy CMS’ appropriate training and certification requirements; and
- Finalized no specific frequency limitations, provided services are reasonable and necessary.
NBHWC actively reviews proposed federal policies and collaborates with policy experts, healthcare organizations, and other key stakeholders to evaluate their potential impact on the health and wellness coaching profession. We are carefully reviewing the final rules and will share additional guidance on eligibility, implementation, billing, and what this means for NBC-HWCs, healthcare organizations, training programs, and our broader community.
Live webinar series
The CMS rule, explained
Three live sessions on what the final rule means for NBC-HWCs and how to put it into practice.
Why This Matters
Recognizes the Importance of Behavior Change
Recognizes the Importance of Behavior Change: The final rule recognizes the value of health and wellness coaching in supporting behavior change, helping individuals improve health outcomes, manage chronic conditions, and adopt sustainable lifestyle habits. It reinforces the important role of behavior change in prevention and ongoing clinical care.
Expands Potential Access to Care
Expands Access to Care: The establishment of a national Medicare payment pathway creates new opportunities to expand access to health and wellness coaching services for eligible Medicare beneficiaries. This represents an important step toward making evidence-based, personalized support more accessible as part of healthcare delivery.
Advances Integration in Healthcare
Advances Integration in Healthcare: The final rule represents a significant step toward integrating health and wellness coaching into the healthcare system. By establishing a national payment pathway for these services, it supports collaborative, person-centered approaches to improving health outcomes and reinforces the role of qualified health and wellness coaches within clinical care teams.
Our History of Advocacy
2018 - 2019
The AMA CPT Editorial Panel approved Category III CPT codes (0591T–0593T) in May 2019, effective January 1, 2020. (PMC)
First nationally recognized CPT codes specifically for Health & Wellness Coaching. Created a standardized way to report coaching services.
2020
0591T (initial assessment), 0592T (follow-up), 0593T (group coaching)
Allowed organizations to begin tracking utilization and, in some cases, seek payment where payers allowed.
2020
NBHWC, NCHEC, UC San Diego and numerous healthcare organizations launched a national utilization data project to collect coaching use and reimbursement data needed for eventual Category I CPT application. Category III codes exist primarily to collect utilization evidence required for eventual Category I consideration.
2021-2023
(PMC)
Strengthened the evidence required by both AMA and CMS.
Late 2023
(PMC)
First formal Medicare recognition pathway for the coaching CPT codes, although temporary and limited to telehealth policy.
2024
(PMC)
Summarized years of advocacy, evidence, implementation experience, and reimbursement strategy into a single reference document.
2025
NBHWC increased direct engagement with CMS, including meetings, executive summaries, and formal submissions describing reimbursement and implementation pathways. Submission of multiple formal letters and publication of CMS Advocacy FAQs.
April 2026
NBHWC continued to advance the profession through sustained engagement with CMS, including leadership meetings, formal policy submissions, and advocacy communications that support the future of health and wellness coaching.
July 2026
This includes a proposed national payment pathway for Health & Wellness Coaching services (proposal only at this stage). NBHWC is coordinating its response.
Potentially the largest reimbursement milestone to date, pending final rulemaking.
