top of page

Can a FQHC Bill For Remote Patient Monitoring?

Many FQHCs have been hesitant to adopt telehealth, but recent changes to Medicare reimbursement policies have changed that. The changes to Medicare reimbursement guidelines for remote patient monitoring, for example, will make telehealth services more widely available. As a result, FQHCs are starting to accept telehealth services. This can be a valuable service for both patients and doctors. And, if they're using telehealth to improve patient care, they may be able to bill for the service.

FQHC’s can apply for federal grants for their remote patient monitoring program

Developing a remote patient monitoring system can reduce the amount of time and money a health care facility spends on patient visits. FQHCs and RHCs must present their cost estimates to MHCP. They should include updated statistical data and other information. The application process can be lengthy. However, it is worth it to get the most out of this grant program. Read on to learn more.

Remote patient monitoring can benefit a wide variety of patients. This new technology can be used for telehealth and telemedicine services. It is especially beneficial to those who are living in remote areas and lack access to high-speed internet. The technology can provide real-time data for physicians and other health care providers. It can also be useful for people with dementia and other conditions. The FQHC has recently added a benefit for patients with social isolation, which can exacerbate health conditions and result in early mortality

Telephonic encounters are considered medically necessary

Telephonic encounters are medically necessary services provided to a patient by a physician at a remote site. These visits require two-way electronic audio-only communications. The physician can bill for services rendered from the distant site to a Medicaid beneficiary. The patient can also receive other services provided by a distant practitioner. These services are covered under the All Patient Revised - Diagnosis Related Group payment.

Telephonic encounters with Medicaid patients are reimbursed in six payment pathways and under the usual provider billing structure. Telephonic encounters can be billed by FQHCs, RHCs, and managed care organizations. The table below details the applicable modifiers and payment levels for Medicaid telehealth services. For Medicare, remote patient monitoring is covered as a telehealth service, while Medicaid pays for the cost of Part B coinsurance or deductible, to the extent allowed by New York state law.

Medicaid is allowed to pay for telephonic encounters when the provider meets certain standards for medical necessity. If the provider meets the requirements for medical necessity, the FQHC can bill for remote patient monitoring in Lane 6 and receive payment for it as a telehealth service. However, the MMC plan will often have separate detailed billing guidance for telehealth services.

The telehealth bill also clarifies the billing guidelines for federally qualified health centers (FQHCs). It allows remote supervision to be billed as an encounter under HIPAA, removing restrictions on distant sites and clarifying the federal enforcement of HIPAA regulations. However, remote patient monitoring is not appropriate for all types of patients. You can submit a claim for these services if they are medically necessary, but it is better to consult with your insurance carrier to make sure you're not missing out on reimbursement.

When FQHC providers provide remote patient monitoring services, it is important to note that the originating site must bill for the remote patient monitoring services as if the originating site was the same. The remote patient monitoring service must be billed as if it were a face-to-face encounter and must include the appropriate CPT code and modifier. Additionally, the originating site may bill only the facility fee for telehealth originating-site services.

In addition to rural health clinics, federally qualified health centers and private physician practices can provide remote patient monitoring services. These services are covered under the telehealth provisions of the CARES Act. Telehealth services can be provided by any qualified practitioner within the scope of practice. There are no geographical limitations. Physicians can provide telehealth services even from their homes.

CMS may change reimbursement guidelines for telehealth

CMS is preparing to change its reimbursement guidelines for telehealth services. The new rule will allow for reimbursement for certain telehealth services, including cardiac rehabilitation. Previously, such services were only eligible for Medicare reimbursement during a public health emergency, but now they can be reimbursed in any year. The new rule will also remove geographic restrictions on telehealth services for mental health. Despite the changes, Medicare will likely continue to be the primary payer for such services.

The changes to the reimbursement guidelines will likely apply to physicians who use telehealth to provide health care services. The change will be gradual, allowing health care providers to work together to make it affordable for patients. As telehealth becomes more widely used, more payers will pay for the services, and the payment policies will change as well. This means that Medicare will likely continue to cover telehealth services, but CMS has to keep these guidelines budget neutral.

There is some uncertainty surrounding the CMS's decision, however. Its current policies are strict and only allow a limited amount of reimbursement for certain telehealth services, such as virtual visits between doctors and patients or remote patient monitoring for chronic conditions. However, CMS is now expanding the reimbursement options for telehealth, including an increase in the billable hours for certain telehealth services. As of January, CMS has added 54 new codes for audio-only delivery of healthcare services.

The new rules are designed to improve the patient-provider relationship. A telehealth provider can use its technology to improve the patient-provider relationship and provide quality care at a lower cost. In addition, the use of telehealth tools can be an ideal solution for physicians in rural areas. The benefits are significant for patients who cannot get to the hospital for treatment. The patient-provider relationship is growing and changing and the benefits of telehealth are rapidly becoming more widely available.

Another recent change to telehealth rules is an extension of the authority of administrative personnel to deny and revoke enrollment in the service. This is an important change to the rules, because it will allow providers to focus on the patient-provider relationship. Moreover, it will ensure that telehealth providers can continue to compete for patients and earn their share of the revenue. With these changes, CMS is expected to make telehealth a much more viable option for Medicare and other payers.

118 views0 comments

Recent Posts

See All


bottom of page