Update #15 - June 1, 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

CMS announced and update 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:
  • Bill telehealth services with G2025
  • RHCs will be paid their all-inclusive rate (AIR) until July 1
  • 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
Audio-only visits (eg, phone calls) may be billed under HCPCS G2025 as well.
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.

Supporting the lost 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 Program fund. Contact us today to determine if additional funding is available to support your RHC's during the COVID-19 PHE.

Julie Hardy
Caren Puvalowski, CHFP
Director, Revenue Integrity and Payment
Lead Consultant, Critical Access Hospitals

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