For CMS claims effective January 27, 2020 through June 30, 2020:
FQHCs/RHCs are eligible to furnish any telehealth service that is already approved as a distant site telehealth service within the 2020
Physician Fee Schedule
When billing as the telehealth distant site,
FQHCs/RHCs must use Modifier 95 on the claim, &
FQHCs/RHCs will be paid their AIR/PPS rate.
Per the MLN, FQHCs/RHCs do not need to resubmit existing claims for this payment modification; these claims will be automatically refiled in July 2020 when the Medicare claims processing system has been updated with the new payment rate.
For claims effective July 1, 2020 through the end of the PHE:
FQHCs/RHCs will use G2025 to identify services that were furnished via telehealth. Claims with the new G code will be paid at the $92 rate.
Only distant site telehealth services furnished during the PHE are authorized for payment; If the public health emergency is still in effect after December 31, 2020, the MLN states that this rate will be updated based on the 2021 Physician Fee Schedule average payment rate for these services.
Addtional CMS Guidance Covered
Along with the distant site payment directives, the new CMS MLN provides guidance for FQHCs and RHCs regarding:
- Accelerated/advanced payment structures;
- Consent Processes (Documentation and Timing), and
- Scope of home health/visiting nursing services.