CMS Releases Guidance on Telehealth Billing for RHCs

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:

1. Medicare claims for RHC telehealth visits occurring since January 27^th will be paid by Medicare. If you have been holding these telehealth claims, you can submit them and they will be paid.
2. 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.
3. 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.
4. In order to expedite adoption of this policy, CMS will INITIALLY pay the RHC’s all-inclusive rate for this visit.
5. 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.
6. 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.
7. 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!