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For providers Billing for telehealth during COVID-19

Billing Medicare as a safety-net provider

Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can bill Medicare for telehealth services through December 31, 2024 under the Consolidated Appropriations Act of 2023.

Reimbursement policies for RHCs and FQHCs

RHCs and FQHCs can provide services as a distant site provider using telehealth. Based on recent legislation, any service that Medicare has approved to be furnished via telehealth can be provided by an FQHC or RHC through December 31, 2024. Please check with the Centers for Medicare and Medicaid for any updates.

Services include:

  • RHCs and FQHCs can bill Medicare for telehealth services as distant site providers, at a reimbursement rate of $97.24 for claims submitted until December 31, 2023.
  • Patients can receive telehealth services in their home.
  • Virtual communication services are covered, including online digital evaluation and management, which are broadly defined as digital communications that are patient-initiated using a secure patient portal. Note, virtual communication services are reimbursed at a different rate since they are not defined as telehealth services by the Centers for Medicare & Medicaid Services. See virtual communication billing codes for RHCs and FQHCs below for more details.

Did you know?

Audio-only visits for telebehavioral and telemental health services in Rural Health Clinics and Federally Qualified Health Centers have been codified into the Medicare Physician Fee Schedule as of January 1, 2022. You may use audio-only for telebehavioral and telemental health in situations where your patient cannot access or does not consent to an audio-visual visit. You can bill and receive reimbursement in the same way as in-person visits. Learn more about flexibility for Rural Health Clinics and Federally Qualified Health Centers during the COVID-19 PHE (PDF).

Telehealth codes for RHCs and FQHCs

For RHC and FQHC telehealth services provided on or after July 1, 2020, through December 31, 2024, use the following Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes:

Billing codes
HCPCS code G2025
Revenue code 052X
Reimbursement rate

$98.27 for claims submitted between January 1, 2023-December 31, 2023.

$97.24 for claims submitted between January 1, 2022-December 31, 2022.

$99.45 for claims submitted from January 1, 2021-December 31, 2021.

$92.03 for claims submitted from January 27, 2020-December 31, 2020.

Modifiers

CS: Cost-Sharing waived for certain services (e.g., COVID-19 testing-related services or preventive services provided via telehealth).

Beginning July 1, 2020, you should no longer put the CG modifier on claims with HCPCS code G2025.

Audio-only services G2025
HCPCS code and CPT codes 99441, 99442, or 99443

For the full list of telehealth services, including which services can be provided as audio-only visits, see this list of telehealth services from the Centers for Medicare & Medicaid Services.

Virtual communication billing codes for RHCs and FQHCs

RHCs and FQHCs can bill for digital evaluation and management services through December 31, 2024. To do so, providers must submit an RHC or FQHC claim with HCPCS code G0071 (Virtual Communication Services) either alone or with other payable services. The codes are listed below for other payable services:

Billing codes
HCPCS code for virtual check-in G2012
HCPCS code for remote evaluation of recorded videos or images G2010
CPT codes for online digital evaluation and management

99421 (5-10 minutes over a 7-day period)

99422 (11-20 minutes over a 7-day period)

99423 (21 minutes or more over a 7-day period)

Reimbursement rate

$23.72 for claims submitted between January 1, 2023-December 31, 2023

$23.88 for claims submitted between January 1, 2022-December 31, 2022

$24.76 for claims submitted between January 1, 2021-December 31, 2021

More information about safety-net provider billing

For more details about billing as an RHC or FQHC:

Last updated: January 23, 2023

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