Eligible Distant Site
Temporary Policy – Ends Dec. 31, 2024
In the case that such emergency period ends before December 31, 2024, during the period beginning on the first day after the end of such emergency period and ending on December 31, 2024—
- the Secretary shall pay for telehealth services that are furnished via a telecommunications system by a Federally qualified health center or a rural health clinic to an eligible telehealth individual enrolled under this part notwithstanding that the Federally qualified health center or rural clinic providing the telehealth service is not at the same location as the beneficiary;
- the amount of payment to a Federally qualified health center or rural health clinic that serves as a distant site for such a telehealth service shall be determined under subparagraph (B); and
- for purposes of this subsection—
- the term “distant site” includes a Federally qualified health center or rural health clinic that furnishes a telehealth service to an eligible telehealth individual; and
- the term “telehealth services” includes a rural health clinic service or Federally qualified health center service that is furnished using telehealth to the extent that payment codes corresponding to services identified by the Secretary under clause (i) or (ii) of paragraph (4)(F) are listed on the corresponding claim for such rural health clinic service or Federally qualified health center service.
SOURCE: Social Security Act, Sec. 1834(m) (Title 42, Sec. 1395m). (Accessed Mar. 2024).
Payment for Medicare Telehealth Services: Section 3704 of the CARES Act authorized RHCs and FQHCs to furnish distant site telehealth services to Medicare beneficiaries during the COVID-19 PHE. Medicare telehealth services generally require an interactive audio and video telecommunications system that permits real-time communication between the practitioner and the patient. (Some telehealth services can be furnished using audio-only technology.) RHCs and FQHCs with this capability could provide and be paid for telehealth services furnished to Medicare patients located at any site, including the patient’s home, through December 31,
2024. Telehealth services could be furnished by any health care practitioner working for the RHC or the FQHC within their scope of practice. Practitioners could furnish telehealth services from any distant site location, including their home, during the time that they are working for the RHC or FQHC, and could furnish any telehealth service that is included on the list of Medicare telehealth services under the Physician Fee Schedule (PFS), including those that have been added on an interim basis during the PHE. A list of these services, including which could be furnished via audio-only technology, is available at https://www.cms.gov/Medicare/Medicare-General-Information/Telehealth/Telehealth-Codes.
Beginning on or after January 1, 2022, RHCs and FQHCs can report and receive payment for mental health visits furnished via real-time telecommunication technology in the same way in-person visits are reported and reimbursed, including audio-only visits when the beneficiary is not capable of or does not consent to, the use of video technology. Payment under HCPCS code G2025 will no longer apply to mental health visits furnished via telehealth. This payment policy for mental health visits was made permanent for RHCs and FQHCs in the CY 2022 PFS final rule.
Security Act (CARES Act). Section 3704 of the CARES Act authorized RHCs and FQHCs to provide distant site telehealth services to Medicare patients during the COVID-19 PHE. Section 4113 of the Consolidated Appropriations Act, 2023, extended this authority through December 31, 2024.
Any health care practitioner working for you within your scope of practice can provide distant site telehealth services. Practitioners can provide distant site telehealth services – approved by Medicare as a distant site telehealth service under the physician fee schedule (PFS) – from any location, including their home, during the time that they’re working for you.
FQHCs are not listed as an eligible distant site provider that can deliver services via telehealth. However, FQHCs can provide telecommunications for mental health visits using audio-video technology and audio-only technology. See MLN Guidance for requirements.
Medicare-covered mental health services furnished incident to an RHC or FQHC visit are included in the payment for a medically necessary mental health visit when an RHC or FQHC practitioner furnishes a mental health visit. Group mental health services do not meet the criteria for a one-one-one, face-to-face encounter in an FQHC or RHC.
A distant site is the location where a physician or practitioner provides telehealth. Before the COVID-19 PHE, only certain types of distant site providers could provide and get paid for telehealth. Through December 31, 2024, all providers who are eligible to bill Medicare for professional services, including FQHCs/RHCs, can provide distant site telehealth.
Practitioners can provide telehealth from any distant site location, including their home, during the time they’re working for the FQHC/RHC, and they can provide any distant site-approved telehealth under the PFS. You can’t bill the visit’s cost or include it on the cost report.
SOURCE: Centers for Medicaid and Medicare Services, Medicare Learning Network Booklet 6397, Federally Qualified Health Centers, Jan. 2024, & MLN Booklet 6398, Rural Health Clinics, Mar. 2024, (Accessed Mar. 2024).
* The US Health and Human Services Administration maintains a website that summarizes information for Billing Medicare as a safety-net provider.
See: Federal Medicare Live Video Distant Site
< BACK TO RESOURCES