{"id":27795,"date":"2020-06-11T19:02:32","date_gmt":"2020-06-11T19:02:32","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27795"},"modified":"2020-06-11T19:02:32","modified_gmt":"2020-06-11T19:02:32","slug":"covid-19-prompts-expanded-telehealth-reimbursement-for-fqhcs-and-rhcs","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/covid-19-prompts-expanded-telehealth-reimbursement-for-fqhcs-and-rhcs\/","title":{"rendered":"COVID-19 Prompts Expanded Telehealth Reimbursement for FQHCs and RHCs"},"content":{"rendered":"\n

As the COVID-19 pandemic continues to create barriers to in-person care, there has been increased focus on enabling the delivery of healthcare services through telehealth. Congress, the Centers for Medicare and Medicaid Services (CMS), and state Medicaid programs have identified reimbursement for telehealth and telephonic services provided by federally qualified health centers (FQHCs) and rural health clinics (RHCs) as a high priority, recognizing that FQHCs and RHCs are critical providers for vulnerable populations.1<\/sup> As a result, since March, there has been substantial new flexibility in Medicare and state Medicaid policy related to telehealth and telephonic services at FQHCs and RHCs, promoting continued access to an important source of care during the COVID-19 Public Health Emergency (PHE). Concurrently, increased access to telehealth and telephonic services among Medicare and Medicaid beneficiaries has provided critical reimbursement to FQHCs and RHCs during the pandemic, helping them remain sustainable as in-person visits have been curtailed.<\/p>\n\n\n\n

Medicare<\/strong><\/p>\n\n\n\n

Three major changes in Medicare policy have expanded telehealth options for FQHCs and RHCs in recent months. First, Congress temporarily eliminated a long-standing federal statutory prohibition on FQHCs and RHCs acting as telehealth distant sites2<\/sup> for Medicare beneficiaries.3<\/sup><\/strong> Previously, an FQHC or RHC could not bill if it provided services to a patient who was not physically present at the facility. With this temporary change, codified in Section 3704<\/a> of the Coronavirus Aid, Relief, and Economic Security (CARES) Act, FQHCs and RHCs can serve as distant sites for the duration of the PHE, meaning that they can bill for telehealth services\u2014provided through two-way, real-time video communications\u2014permitted under the Medicare Physician Fee Schedule<\/a>.<\/p>\n\n\n\n

Second, under Section 1135 authority,4<\/sup> CMS has t<\/strong>emporarily permitted<\/a><\/strong> a broad range of providers, including FQHCs and RHCs, to obtain Medicare reimbursement for certain services described under the Medicare Physician Fee Schedule that are delivered telephonically <\/strong>(i.e., not delivered by two-way, real-time video communications).5<\/sup> Previously, FQHCs and RHCs could not bill for telephonic visits and could only obtain Medicare reimbursement for virtual communication services, defined<\/a> as \u201cbrief discussions with the RHC or FQHC practitioner to determine if a visit is necessary\u201d\u2014services that would not take the place of a regular, in-person visit.6<\/sup><\/p>\n\n\n\n

Finally, CMS provided new guidance on how FQHCs and RHCs will be paid for telehealth, telephonic and virtual communication services <\/strong>during the PHE.<\/p>\n\n\n\n