Congress and CMS have introduced changes to rural health clinic and federally qualified health center requirements and payments to ensure patients have access to services they need during the pandemic.
Here are seven things rural health clinics and FQHCs need to know about Medicare telehealth reimbursement, according to a recent CMS report:
1. Under the Coronavirus Aid, Relief and Economic Security Act, rural health clinics and FQHCs are authorized to support distant site telehealth services to Medicare beneficiaries during the pandemic.
2. CMS requires telemedicine services to include both an originating site and a distant site; the originating site is the location of the patient at the time the service is being delivered while the distant site is where the physician is located when delivering the service.
3. Rural health clinic and FQHC providers can deliver distant site telehealth services from any location, including their home, during the pandemic. Click here for a list of more than 85 service CMS is covering when delivered via telehealth.
4. CMS payment rates to rural health clinics and FQHCs for distant site telehealth services is $92.
5. For telehealth distant site services delivered between Jan. 27 and June 30, rural health clinics and FQHCs must record "Modifier 95" on the claim. Rural health clinics will be paid at their all-inclusive rate and FQHCs will be paid based on the FQHC prospective payment system rate.
6. For telehealth services delivered between July 1 and the end of the COVID-19 public health emergency, rural health clinics and FQHCs must record a "G" code on the claim.
7. During the COVID-19 public health emergency, CMS will pay all reasonable costs for any service related to COVID-19 testing, including applicable telehealth services beginning March 1. For services related to COVID-19 testing, including telehealth, rural health clinics and FQHCs must waive the collection of co-insurance from beneficiaries.