Billing Medicare as a safety-net provider
Find out what Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are able to bill Medicare for when it comes to telehealth.
Telehealth policy updates for RHCs and FQHCs
Telehealth can increase access to health care in rural and underserved communities. To support access to care, telehealth policies allow:
- FQHCs and RHCs can serve as Medicare distant site providers for non-behavioral/mental telehealth services through March 31, 2025. For an encounter furnished using interactive, real-time, audio and video telecommunications technology or for certain audio-only interactions in cases where the patient is not capable of, or does not consent to, the use of video technology services, payment to RHCs and FQHCs are subject to the national average payment rates for comparable services under the physician fee schedule (PFS) through December 31, 2025.
- Non-behavioral/mental telehealth services in Medicare can be delivered using audio-only communication platforms through March 31, 2025. Interactive telecommunications system may also permanently include two-way, real-time audio-only communication technology for any telehealth service furnished to a patient in their home if the distant site physician or practitioner is technically capable of using an interactive telecommunications, but the patient is not capable of, or does not consent to, the use of video technology.
- FQHCs and RHCs can permanently serve as a Medicare distant site provider for behavioral/mental telehealth services. Medicare patients can permanently receive telehealth services for behavioral/mental health care in their home. There are no geographic restrictions for originating site for Medicare behavioral/mental telehealth services on a permanent basis. Behavioral/mental telehealth services in Medicare can permanently be delivered using audio-only communication platforms. For FQHCs and RHCs, the in-person visit requirement for mental health services furnished via communication technology to beneficiaries in their homes is not required until January 1, 2026.
Telehealth codes for RHCs and FQHCs
Use the following Healthcare Common Procedure Coding System (HCPCS) codes and Current Procedural Terminology (CPT) codes:
| HCPCS code | G2025 |
|---|---|
| Revenue code | 052X |
| Reimbursement rate | $96.87 for claims submitted between January 1, 2025 – December 31, 2025 $95.27 for claims submitted between January 1, 2024- December 31, 2024 $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 |
Remote Patient Monitoring services
Remote patient monitoring (RPM) services are billable. RHCs and FQHCs can receive a separate payment for these services.
Requirements include:
- An established patient relationship
- Patient consent at the time RPM is furnished
- Must be medically reasonable and necessary
- Must not be duplicative
More information:
Telehealth policy updates — Health Resources and Services Administration
Calendar Year 2025 Medicare Physician Fee Schedule — Centers for Medicare & Medicaid Services
Federally Qualified Health Center (PDF) — Centers for Medicare & Medicaid Services
Information for Rural Clinics (PDF) — Centers for Medicare & Medicaid Services
List of telehealth services — Centers for Medicare & Medicaid Services
Mental Health Visits via Telecommunications for Rural Health Clinics & Federally Qualified Health Centers — Centers for Medicare & Medicaid Services
Understanding telehealth policy — National Policy Telehealth Resource Center