Lifestyle medicine is moving from the margins of the payment system into the mainstream architecture of federal healthcare transformation.
The 2026 payment environment is shaping up to be one of the most consequential in the history of lifestyle medicine. Across fee-for-service (FFS) and value-based care (VBC), the Centers for Medicare and Medicaid Services (CMS) is signaling a clear and growing interest in prevention, nutrition, physical activity, upstream drivers of health, and addressing the root causes of chronic disease. These shifts reflect an accelerating alignment between federal policy and the core tenets of lifestyle medicine (LM). Below is a comprehensive look at the landscape and what it means for clinicians, health systems, and advocates advancing lifestyle medicine care.
I. Advancements in the 2026 Physician Fee Schedule (PFS)
The proposed and final 2026 PFS rule contains several landmark updates for LM, including new billable services, supportive cross-setting policies, and requests for information that could shape future rulemaking.
A new Gcode for nutrition and physical activity assessment (G0136)
Perhaps the most significant advancement is the refinement of the G0136 code, now formally defined as the Administration of a standardized, evidence-based assessment of physical activity and nutrition (5–15 minutes, not more often than every six months).
This is a major step forward. For the first time, lifestyle-related risk screening can be captured in a standardized, validated, repeatable, and billable manner. This measure lays the groundwork for routine, reproducible assessment of two of the most powerful and modifiable predictors of (and interventions for) chronic disease. It also gives clinicians a way to integrate lifestyle assessment into clinical workflows with real payment support—an essential milestone for scaling LM in traditional care environments.
Check out ACLM’s free downloadable lifestyle medicine assessment tool to seamlessly integrate this service into your workflow. Epic users may also be able to access lifestyle medicine assessment tools in their foundational build.
New advanced primary care management (APCM) addon codes
CMS finalized three new G-codes to expand the APCM suite (G0556, G0557, G0558). These add-on codes support the monthly work required to manage complex chronic illness, including behavioral health integration and care coordination. This is particularly important for LM because comprehensive lifestyle intervention often involves interprofessional touchpoints, team-based care, and frequent follow-up—activities traditionally under-reimbursed.
Digital mental health treatment expansion
CMS finalized expanded payment for digital mental health treatment devices (e.g., for insomnia, depression, anxiety, and substance use), acknowledging the growing role of software-based, evidence-based behavioral tools. This is encouraging for LM models that integrate digital tools as core components of chronic disease care.
Check out ACLM’s growing list of evidence-based certified programs for turnkey digital solutions.
Medicare Diabetes Prevention Program (MDPP) new online delivery option
CMS is introducing a new asynchronous online delivery modality for the MDPP, available through December 31, 2029. To support this expansion, CMS is creating a new Healthcare Common Procedure Coding System (HCPCS) code—G9871, covering 60 minutes of online behavioral counseling for diabetes prevention. During this online delivery period, CMS will also establish a payment rate of $18 for each core or core maintenance session delivered asynchronously.
2026 RFIs reveal how CMS is thinking about the next generation of payment innovation, many of which directly relate to LM. They include questions about:
- Intensive therapeutic lifestyle change (ITLC)
- Health and wellness coaching
- Physical activity interventions
- Motivational interviewing
- Care models supporting chronic disease prevention and remission
These RFIs are an invitation for LM clinicians, researchers, and health systems to shape future policy and help CMS build a payment system that more accurately reflects the evidence base for lifestyle change.
II. CMMI’s Newly Launched MAHA-Aligned Models: A Turning Point for Lifestyle Medicine and Technology Integration
CMS’s Innovation Center (CMMI) is operationalizing the Making America Healthy Again (MAHA) strategy through a series of bold, prevention-aligned innovation models
MAHA ELEVATE and ACCESS
The flagship models Make America Healthy Again: Enhancing Lifestyle and Evaluating Value-based Approaches Through Evidence (MAHA Elevate) and Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) embed the MAHA pillars—evidence-based prevention, patient empowerment, and choice/competition—into redesigned payment and care delivery structures. Each model explicitly calls out exercise, nutrition, and sustained healthy behaviors as target levers. These models signal that CMMI is preparing to test lifestyle medicine at scale, not as an adjunct but as a core clinical strategy.
Check out our webinar series on these models: https://portal.lifestylemedicine.org/ACLM/Advocacy/January-Briefings.aspx?_zs=JlBPp&_zl=mRoc3v
Ambulatory specialty model (ASM)
Finalized for testing in chronic low back pain and congestive heart failure, ASM evaluates whether specialists can improve quality and reduce costs through upstream chronic disease management. For LM, this opens the door for specialists to integrate evidence-based exercise therapy, optimal nutrition, stress reduction, substance use reduction, connectedness and sleep interventions in episodic and longitudinal care models.
TEAM and BALANCE
Additional innovation models—Transforming Episode Accountability Model (TEAM) andBetter Approaches to Lifestyle And Nutrition for Comprehensive Health (BALANCE)—also present opportunities for lifestyle medicine integration. Each model aims to address root causes, reduce fragmentation, and center longitudinal, proactive care—exactly where LM excels.
Taken together, the 2026 PFS and CMMI portfolio represent a broader philosophical shift: CMS is increasingly treating lifestyle-related risk factors and outcomes measurement as necessary in clinical care delivery. The cross-model emphasis on nutrition, physical activity, mental health, and prevention underscores that the next era of payment policy will reward health creation and restoration, not just disease management.
Conclusion and future direction
In many ways, 2025 was a year that set the stage for the increased interest in lifestyle medicine at a federal policy and payment level. Signals of this shift include:
- CMS openly signaled interest in well-being, nutrition, physical activity, and prevention during multiple listening sessions and quality-measurement discussions.
- The CMS Quality Measure team explicitly requested information on new measures that promote well-being, happiness, emotional health, purpose, and social connection.
- MAHA’s national strategy called for nutrition education reform, food-is-medicine research, and chronic disease reversal frameworks, aligning federal priorities directly with LM principles
- Procurement Technical Assistance Centers (PTAC) RFIs centered on patient empowerment, shared decision-making, and models that support healthy behavior change.
By the end of 2025, LM was no longer peripheral—it was showing up across CMS, CMMI, PTAC, MAHA, NIH, and CQI discussions. The 2026 rulemaking cycle reflects that momentum.
The convergence of policy signals, payment updates, new G-codes, and MAHA-aligned models paints an exceptionally hopeful picture: Lifestyle medicine is moving from the margins of the payment system into the mainstream architecture of federal healthcare transformation.
The next step is not to be a bystander but to participate in shaping the future by commenting on RFIs, engaging in model testing, sharing real-world LM outcomes, supporting measure development, and advocating for system-wide LM training for clinical care teams. And, by continuing to advocate for a system in which the most powerful tools for treating, reversing and preventing chronic disease are fully recognized, measured, and reimbursed.
Turn policy momentum into practice
2026 marks a breakthrough year for lifestyle medicine reimbursement. The opportunity is here—now it’s time to put it into action.
The Lifestyle Medicine Payment Summit showcases pioneering care models, sustainable financing strategies, and cross-sector partnerships making lifestyle medicine viable and scalable across diverse practice settings.
Access is free for ACLM members and $99 for non-members.