CMS Announces MAHA Elevate: A Grant-Based Opportunity Clinics Should Pay Attention To

CMS just announced a new innovation model called MAHA Elevate.

And importantly, this one is not a reimbursement cut.
It’s not a rule change.
And it’s not a new hoop clinics are required to jump through.

It’s a grant-based opportunity.

That alone makes it worth slowing down and paying attention.

The Plain-English Version

Here’s what CMS is proposing:

• $100 million has been set aside
• Up to 30 grants will be awarded
• The model is designed to test lifestyle and functional medicine approaches to chronic disease
• These services are not traditionally reimbursable under Medicare today

In other words, CMS is explicitly funding care models that currently live outside standard billing pathways.

What CMS Is Actually Testing

The focus of MAHA Elevate is not volume or utilization.
It’s evidence.

Specifically, CMS wants to evaluate whether non-traditional, upstream approaches can:

• Improve patient outcomes
• Reduce downstream medical spend
• Deliver value at a lower total cost of care

If organizations can demonstrate those outcomes, CMS can use the data to justify future reimbursement pathways.

This is how “non-billable” services become billable.

Not through lobbying alone.
Through proof.

Why This Matters for Physical Therapy

Many of the care models CMS is trying to evaluate already sit naturally within the PT ecosystem.

Think:

• PT + nutrition
• PT + health or behavior coaching
• PT + wellness programs that address root causes, not just symptoms
• PT partnered with other providers delivering lifestyle or functional interventions

These approaches often fall outside what Medicare reimburses today, even when they meaningfully improve outcomes.

MAHA Elevate is an attempt to test whether that gap should exist at all.

What This Means for Smaller Practices

For independent or smaller practices, this does not mean going it alone.

In fact, the structure of the model makes partnership essential.

That could mean collaborating:

• With other PT groups
• With nutrition, wellness, or coaching providers
• With primary care organizations or ACO-aligned groups

The opportunity isn’t just about grant dollars.
It’s about positioning.

The Bigger Signal

At a systems level, MAHA Elevate sends a clear message.

CMS is actively looking for alternatives to high-cost, specialty-driven medicine.
And it is willing to fund experiments that test preventative, functional, and lifestyle-based care.

For physical therapy, that’s meaningful.

It positions PT not just as downstream rehab, but as primary, preventative, functional care within a system that is increasingly focused on cost, outcomes, and long-term value.

This model won’t change Medicare overnight.

But it is exactly how future billing pathways get built.

More to come.
This one is worth watching.

Hat tip to Dana Strauss for flagging this early.