Facility Fee

FQHCs are authorized to serve as an originating site for telemedicine services. An originating site is the location of a client at the time the telemedicine service is being furnished through a telecommunications system. FQHCs that serve as an originating site for telemedicine services are eligible to receive an originating site facility fee if they meet the criteria found in HCA’s Telemedicine clinical policy and billing (see below). Originating site facility fees are not encounter eligible. Charges for the originating site facility fee may be included on a claim, but the originating site facility fee may not be included on the cost report.

SOURCE: WA HCA Medicaid Provider Guide, Federally Qualified Health Centers, p. 63 (Apr. 2025). (Accessed May 2025).

FQHCs are explicitly listed as an eligible originating site for the facility fee.

SOURCE: RCW 74.09.325; WA State Health Care Authority. Medicaid Provider Guide, Telemedicine Policy and Billing, p. 19 (Jan. 2025). (Accessed May 2025).

Originating sites that are enrolled with HCA to provide services to HCA clients and bill HCA may be paid a facility fee for infrastructure and client preparation. HCA does not pay an originating site facility fee to the client in any setting. Additionally, HCA does not pay an originating site facility fee in the following situations:

• Audio-only telemedicine
• Store and forward
• If the originating site is:
  • The client’s home
  • A hospital (inpatient services)
  • A skilled nursing facility o Any location receiving payment for the client’s room and board
  • The same entity as the distant site or if the provider is employed by the same entity as the distant site

FQHCs are instructed to bill for the fee using HCPCS code Q3014.

SOURCE: WA State Health Care Authority. Medicaid Provider Guide, Telemedicine Policy and Billing, p. 18-19 (Jan. 2025). (Accessed May 2025).