Federally Qualified Health Centers (FQHCs)

CMS’ Proposed Medicare Physician Fee Schedule Provokes Strong Reactions

14 Aug 2024

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Federally Qualified Health Centers (FQHCs), Medicare Physician Fee Schedule (MPFS), Medicare Physician Fee Schedule (PFS), Physician Fee Schedule, Rural Health Clinics (RHCs), Telehealth, Telemedicine 0 comments

Proposed Medicare Physician Fee Schedule Would Extend Telehealth Flexibilities and Add New Coverage

Summary PointsThe Centers for Medicare & Medicaid Services (CMS) released its annual proposed rule updating the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2025.1The proposed rule includes various provisions related to telehealth service delivery and other virtual care modalities. Similar to recent proposed rules, many of the provisions seek to extend temporary telehealth and virtual care flexibilities […]

CMS proposes new payments for digital health under CY2025 PFS draft rule

5 Aug 2024

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Federally Qualified Health Centers (FQHCs), Legislation, Remote Physiological Monitoring (RPM), Rural Health Clinics (RHCs) 0 comments

CMS proposes new payments for digital health under CY2025 PFS draft rule

Bipartisan bill would ensure continued access to telehealth services

4 Mar 2024

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Current Procedural Terminology (CPT®) code set, Federally Qualified Health Centers (FQHCs), Public Health Emergency (PHE), Remote Patient Monitoring, Remote Therapeutic Monitoring (RTM), Rural Health Clinics (RHCs), Telehealth 0 comments

2024 Telehealth Reimbursement Updates: Expanding Access and Optimizing Care

As the adoption of telehealth, remote monitoring, and connected care technologies continues to increase, it’s important for healthcare leaders to stay on top of the latest updates in telehealth reimbursement. Some of the most significant updates come from the Centers for Medicare & Medicaid Services (CMS), which released its final rule for Medicare payments under the Physician Fee […]

RTM vs. RPM CPT Codes 2024 Takeways and Rates

6 Dec 2023

American Medical Association (AMA), Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Current Procedural Terminology (CPT®) code set, Federally Qualified Health Centers (FQHCs), Physician Fee Schedule, Remote Patient Monitoring, Remote Therapeutic Monitoring (RTM), Rural Health Clinics (RHCs) 0 comments

RTM vs. RPM CPT Codes 2024: Takeways and Rates

In this article, you’ll learn the differences and rates between RTM billing codes and RPM billing codes for 2024. CMS released the CY 2024 Physician Fee Schedule Final Rule in November 2024. The final rule includes 3,000 pages of detailed policy changes related to remote therapeutic monitoring (RTM) and remote patient monitoring (RPM) Medicare reimbursement. This article breaks down the […]

Papers about types of medicare insurance and a stethoscope.

22 Nov 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Federally Qualified Health Centers (FQHCs), Public Health Emergency (PHE), Remote Patient Monitoring, Remote Therapeutic Monitoring (RTM), Rural Health Clinics (RHCs) 0 comments

Medicare Final Rule 2024: Key Takeaways for RPM and RTM

On November 2, 2023, in the 2024 final rule for the physician fee schedule, the Centers for Medicare & Medicaid Services (CMS) finalized crucial policies impacting remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services reimbursed under the Medicare program. This article breaks down the key takeaways of the Medicare final rule 2024 to guide […]

21 Nov 2023

Blog, COVID-19 - Coronavirus, Federally Qualified Health Centers (FQHCs), Health Resources and Services Administration (HRSA), Telehealth 0 comments

Data Element Identification and Data Collection Procedures for the HRSA Direct-to-Consumer Evidence Based Telehealth Network Program

FQHCs must get creative with building and sustaining remote patient monitoring programs

18 Oct 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, COVID-19 - Coronavirus, Federally Qualified Health Centers (FQHCs), Remote Patient Monitoring 0 comments

FQHCs Must Get Creative with Building and Sustaining Remote Patient Monitoring Programs

Federally qualified health centers (FQHCs) are an important safety net for individuals who often do not have easy access to primary and preventive care. With a mission to ensure the delivery of high-quality, comprehensive health care services to these underserved communities, many FQHCs are now choosing to leverage technology – like remote patient monitoring (RPM) […]

AHA-supported bill would expand access to telehealth services

10 Oct 2023

American Hospital Association (AHA), Blog, CONNECT Act, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Telehealth 0 comments

AHA-Supported Bill Would Expand Access to Telehealth Services

AHA on Oct. 10 voiced support for the CONNECT for Health Act (S. 2016/H.R. 4189), legislation that would increase patient access to telehealth services while removing barriers to adoption. The bill would permanently remove geographic restrictions that limit where patients can access telehealth, add homes and other clinically appropriate originating sites, and allow rural health […]

Key remote patient monitoring takeaways from the 2024 PFS proposed rule

17 Aug 2023

Behavioral Health Integration (BHI), Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Federally Qualified Health Centers (FQHCs), Physician Fee Schedule, Remote Patient Monitoring, Rural Health Clinics (RHCs) 0 comments

Key Remote Patient Monitoring Takeaways from the 2024 PFS Proposed Rule

Aug 17, 2023 Daniel Tashnek, JD In the proposed role, CMS proposed to clarify that it is permissible to bill for RPM or remote therapeutic monitoring services, but not both at the same time. The Centers for Medicare & Medicaid Service (CMS) recently published its 2024 physician fee schedule (PFS) proposed rule. One subject receiving a fair […]

7 Aug 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, COVID-19 - Coronavirus, Critical Access Hospital (CAH), Current Procedural Terminology (CPT®) code set, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Skilled Nursing Facilities (SNFs) 0 comments

42 CFR § 411.15 – Particular Services Excluded from Coverage.

§ 411.15 Particular services excluded from coverage. Link to an amendment published at 88 FR 53345, Aug. 7, 2023. The following services are excluded from coverage: (a) Routine physical checkups such as: (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening […]

Executive Summary Tracking Telehealth Changes State-by-State in Response to COVID-19

31 Jul 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, COVID-19 - Coronavirus, Current Procedural Terminology (CPT®) code set, Drug Enforcement Agency (DEA), Federally Qualified Health Centers (FQHCs), Office of Inspector General (OIG), Physician Fee Schedule, Public Health Emergency (PHE), Rural Health Clinics (RHCs) 0 comments

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19

2023: New Federal Developments There were no new federal developments in the last month. 2023: New State-Level Developments State Activity Illinois Illinois passed S.B. 1913, which requires Medicaid FFS and Medicaid managed care plans to provide coverage of mental health services, substance use disorder treatment, and ‘behavioral telehealth services’. Requires Medicaid FFS and Medicaid managed care plans […]

28 Jul 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, COVID-19 - Coronavirus, Federally Qualified Health Centers (FQHCs), Physician Fee Schedule, Public Health Emergency (PHE), Remote Patient Monitoring, Remote Therapeutic Monitoring (RTM), Rural Health Clinics (RHCs), Telehealth 0 comments

CMS Annual Physician Fee Schedule Updates: Effects on Telehealth Services

At a Glance The annual Medicare physician payment rule is upon us, proposed July 13, 2023, for calendar year (CY) 2024 and open for public comment through September 11. Each year, the couple-of-thousand-page rule makes modifications to how Medicare pays physician and nonphysician providers for their services, including for telehealth services. In recent years, the physician […]

21 Jul 2023

Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Federally Qualified Health Centers (FQHCs), Physician Fee Schedule, Remote Physiological Monitoring (RPM), Remote Therapeutic Monitoring (RTM), Rural Health Clinics (RHCs) 0 comments

Remote Monitoring: CMS Clarifies Guidance, Proposes Rural Provider Payment, Requests Information on Digital Therapeutics

Over the past several years, the Centers for Medicare and Medicaid Services (CMS) has expanded payment for care management and remote monitoring services in an effort to recognize and pay for non-face-to-face services that improve care coordination for Medicare beneficiaries. In connection with the calendar year 2024 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS […]

Legislation Aims to Support Telehealth Access in Rural Areas

24 May 2023

Blog, COVID-19 - Coronavirus, Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Telehealth 0 comments

Legislation Aims to Support Telehealth Access in Rural Areas

May 24, 2023 – Earlier this month, a group of six United States House representatives introduced the Protecting Rural Telehealth Access Act, which intends to maintain regional telehealth access and Medicare coverage flexibilities enacted during the COVID-19 pandemic. The expansion of telehealth that took place during the COVID-19 pandemic helped boost access to care, including in rural areas. […]

CCHP Telehealth Flexibilities Continued in the Spring of 2023

22 May 2023

Blog, Center for Connected Health Policy (CCHP), Federally Qualified Health Centers (FQHCs), Public Health Emergency (PHE), Rural Health Clinics (RHCs), Telehealth 0 comments

CCHP: Telehealth Flexibilities Continued in the Spring of 2023

May 22, 2023 – A new report from the Center for Connected Health Policy (CCHP) found that various changes in telehealth policies related to Medicaid reimbursement, private-payer laws, and professional requirements occurred at the state level in 2023. Encompassing the period of January to March 2023, this spring report followed the standard process of organizing information under three headings: […]

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