On April 17, 2020, the Centers for Medicare and Medicaid Services (CMS) issued an MLN Matters Special Edition Article with additional guidance for rural health clinics (RHCs) and federally qualified health centers (FQHCs) during the COVID-19 public health emergency (COVID-19 PHE).

The Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which was signed into law on March 27, 2020, permits RHCs and FQHCs to furnish distant site telehealth services to Medicare beneficiaries during the COVID-19 PHE. Prior to the CARES Act, Medicare would reimburse RHCs and FQHCs for telehealth services when the patient was located at the RHC or FQHC. Now, any RHC or FQHC practitioner may provide telehealth services (within the practitioner’s scope of practice) during the COVID-19 PHE from wherever the practitioner is located to a patient of the RHC or FQHC wherever the patient is located, including the home. A list of approved distance site telehealth services is available here.

CMS announced that the new payment rate for distant site telehealth services will be $92, and beginning in July, when the Medicare claims processing system is updated, all distance site provider telehealth claims will be reprocessed and RHCs and FQHCs will be paid based on the $92 rate for telehealth services provided since January 27, 2020.

Additionally, CMS made the following announcements:

• The online digital evaluation and management CPT codes 99421, 99422 and 99423 are billable during the COVID-19 PHE;
• Effective March 1, 2020, and for the duration of the COVID-19 PHE, the area typically served by the RHC and the area included in the FQHC service area plan is determined to have a shortage of home health agencies, meaning the RHC or FQHC is not required to request such a determination before billing for visiting nursing services furnished to homebound individuals; and 
• The RHC or FQHC may obtain patient consent at the same time services are initially furnished, and patient consent may be obtained by auxiliary personnel under the general supervision of the RHC or FQHC practitioner.

CMS has issued additional guidance documents for RHCs and FQHCs, which can be found here and here. For additional web-based resources regarding evolving changes to Medicare policies, visit Medicare’s current emergencies webpage.

This alert was written by Christopher Dean and Leslie Cumber, lawyers in the Health Care practice group at Miles & Stockbridge.

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