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) as amended by HR 2617 (2022 Session). (Accessed Feb. 2023).
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.
SOURCE: Mental Health Visits via Telecommunications for Rural Health Clinics and Federally Qualified Health Centers, MLN Matters SE22001, (June 6, 2022), (Accessed Feb. 2023).
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.
SOURCE: CMS, Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) Medicare Benefit Policy Manual Chapter 13 Update, Jan. 26, 2023, pg. 20 (Accessed Feb. 2023).
FQHCs provide: …
- Virtual communication services like communication-based technology and remote evaluation services.
- Mental health services using telecommunications (starting January 1, 2022).
We pay for virtual communication services when an FQHC practitioner meets certain requirements, including:
- Practitioner provides at least 5 minutes of billable FQHC virtual communications, either through communication-based technology or remote evaluation services
- Patient had at least 1 face-to-face billable visit within previous year
- Virtual visit isn’t related to services provided within last 7 days
- Virtual visit doesn’t lead to in-person FQHC service within the next 24 hours or at next appointment
When the virtual communication HCPCS code G0071 is on an FQHC claim alone or with other payable services, we require FQHCs to submit HCPCS code G2012 (communication technology based services) or HCPCS code G2010 (remote evaluation services).
When an FQHC practitioner provides virtual communication services, they don’t need to meet face-to-face, so the coinsurance doesn’t apply.
SOURCE: CMS MLN Booklet, Federally Qualified Health Center, October 2022 (Accessed Feb. 2023).
See: Federal Medicare Live Video Distant Site