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Update #6 - April 20, 2020

The Rybar Group, Inc. is committed to providing you with timely, ongoing communication regarding reimbursement and payment related regulations and opportunities as they become available. 

How to Bill Telehealth in Your RHC

On Friday, CMS announced how Rural Health Clinics (RHCs) will be reimbursed for telehealth services during the COVID-19 public health emergency (PHE). Payment to RHCs for telehealth services is set at $92, which is the average amount for all PFS telehealth services on the telehealth list, weighted by volume.

For telehealth services provided by an RHC between January 27, 2020 and June 30, 2020:
  • Append modifier -95 to services billed (synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system).
  • RHCs will be paid their all-inclusive rate (AIR)
  • These claims will automatically be re-processed in July when the Medicare claims processing system is updated with the new payment rate
For telehealth services provided between July 1, 2020 and the end of the COVID-19 PHE:
  • Bill telehealth services with HCPCS G2025
  • These services will be paid at $92
If the COVID-19 PHE is in effect after December 31, 2020, this rate will be updated based on the 2021 PFS average payment rate, weighted by volume.

Costs for the provision of telehealth services will not be used to determine the RHC AIR but must be reported on the appropriate cost report form.

Supporting the loss reimbursement and all COVID-19 related expenses with auditable documentation is the key to qualifying for the federal and state relief payments now and in the future. 

Expenses such as equipment to provide telehealth services, or an increase in broadband internet, may be covered under an FCC Telehealth grant. Contact Julie Hardy at jhardy@therybargroup.com to determine if additional funding is available to support your RHC's during the COVID-19 PHE.

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