- It is for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) who are billing Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.
- CR10843 provides instructions for payment to RHCs and FQHCs billing for communication technology-based services for dates of service on or after January 1, 2019. Make sure your billing staffs are aware of these instructions.
- CR10843 provides instructions for payment to RHCs and FQHCs furnishing General Care Management (HCPCS code G0511), Psychiatric Collaborative Care Model (CoCM) (HCPCS code G0512), and Virtual Communications (HCPCS code G0071).
- MACs shall generally pay 80 percent of the lesser of the RHC or FQHC’s charge for HCPCS codes G0511, G0512, and G0071, or the corresponding rate. CMS updates the rates annually based on the PFS and the rates for the codes.
- Medicare waives the RHC and FQHC face-to-face requirements when an RHC or FQHC furnishes these services to an RHC or FQHC patient. RHCs and FQHCs receive payment for communication technology-based services or remote evaluation services when an RHC or FQHC practitioner provides at least 5 minutes of communications-based technology or remote evaluation services to a patient who has been seen in the RHC or FQHC within the previous year.