CMS has released the long-awaited guidance on telehealth billing for RHCs. The full MLN document, New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency (PHE), is available.
Here are key points on what CMS is adopting:
- Medicare claims for RHC telehealth visits occurring since January 27th will be paid by Medicare. If you have been holding these telehealth claims, you can submit them and they will be paid.
- CMS has established a uniform RHC telehealth payment rate of $92.00 per visit. This rate will apply to telehealth visits performed by independent or provider-based RHCs.
- All RHCs will bill for telehealth visits the same as you would bill for an in-person visit and use the 95 modifier on the claim line to signify that the visit was via telehealth rather than in-person.
- In order to expedite adoption of this policy, CMS will INITIALLY pay the RHC’s all-inclusive rate for this visit.
- Beginning in July, CMS will automatically adjust ALL RHC telehealth claims to reflect the $92 telehealth per visit rate that were submitted between now and July 1, 2020. RHCs with a per-visit rate below $92.00 will receive an additional payment reflecting the difference between their AIR and $92.00. For RHCs with an AIR above $92.00, CMS will RECOUP the difference.
- After July 1, 2020, through end of the COVID-19 Emergency RHCs will use G Code G2025 to identify distant site telehealth visit services. This code will reimburse $92.00 and no recoupment will be necessary.
- Costs associated with the delivery of a telehealth visit will be reported on the RHC cost report however, they will be included in line 79 of the cost report, non-reimbursable RHC costs. This is so that RHC telehealth costs and telehealth visits will not be counted when determining the RHCs cost-per visit.
NARHC presents Telehealth Visit Guidance + Other Covid-19 Updates
NARHC is hosting a free webinar on Monday April 20th at 2 PM Eastern regarding the latest guidance from CMS on billing telehealth visits as the distant site provider in a rural health clinic. They will also provide an update on other COVID-19 related topics such as the Paycheck Protection Program and the Provider Relief Fund. Registration is free!