Comment on CMS-2026-1916-0001

Nearly three in four American adults live with a chronic disease. As some of the most frequent users of the healthcare system, they have a clear view of where it succeeds and where critical gaps remain. A recent national poll found that patients across political affiliations report many of the same challenges in accessing, coordinating, and managing their care. Health coaching can help address these challenges, ease the growing burden on patients and the healthcare system, and improve health outcomes. The proposed reimbursement is a critical step toward making this essential support accessible to those who need it most. For these reasons, we strongly support CMS’s proposal to establish national payment for CPT codes 0591T, 0592T, and 0593T for individual and group health and well-being coaching services. Health coaching, particularly when provided by Nurse Coaches, empowers patients by providing personalized support, knowledge, and confidence needed to make sustainable behavioral and lifestyle changes, manage chronic conditions, and improve their overall well-being. Establishing national payment for these services appropriately recognizes the time, expertise, and resources required to deliver effective coaching outcomes. The education and certification standards identified in the proposed rule will help ensure that patients receive consistent, high-quality, evidence-informed services from appropriately qualified professionals. We also support the proposed work RVUs and CMS’s decision not to impose frequency limitations when services are reasonable and medically necessary. Effective health coaching cannot be delivered through a one-size-fits-all approach. The frequency and duration of services must remain sufficiently flexible to address each patient’s unique conditions, needs, goals, and progress. We urge CMS to finalize these proposals. Establishing national payment for health and well-being coaching is an important step toward expanding access to preventive support, strengthening chronic disease self-management, reducing avoidable strain on the healthcare system, and improving long-term outcomes for Medicare beneficiaries.