CMS Releases Virtual Communication FAQs & MLN Matters Guidance for RHCs and FQHCs
Beginning January 2019, the Centers for Medicare and Medicaid Services
(CMS) began reimbursing for certain kinds of services furnished remotely using communications technology that are not considered “Medicare telehealth services.” Because they are not defined specifically as telehealth, the limitations and restrictions generally applicable to telehealth in Medicare do not apply. These services include “virtual communication services” including communication technology-based services (HCPCS code G2012) and remote evaluation services (HCPCS code G2010). However, due to the unique rules that apply to federally qualified health centers (FQHCs) and rural health clinics (RHCs), CMS has assigned a new code (G0071) specifically for these safety-net clinics to utilize for virtual communication services as they are not eligible to bill G2010 or G2012. As a result of this policy change, CMS has released an FAQ document
on the topic to help clarify any confusion around the use of the new code for FQHCs and RHCs. View the FAQs for the full scope of the questions and concerns
answered through the document.
Additionally, a Medicare Learning Network (MLN) Matters document was also released with instructions for FQHCs and RHCs billing Medicare Administrative Contractors (MACs) for communication technology-based services. The document stipulates that the payment rate for G0071 is set at the average of the Physician Fee Schedule (PFS) non-facility payment rate for communication technology-based services and remote evaluation services, and that the face-to-face requirement that normally applies to RHCs and FQHCs is waived for these services. For more information on the requirements, see the full MLN Mattersdocument.