Waived Telehealth Restrictions Offer Opportunity for FQHCs

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Telemedicine technology has been around for decades but never really took off. Restrictions on reimbursement and other regulatory hurdles kept many providers from offering the virtual visit as a service line.

Until now, CNBC reports a surge in virtual visits since the coronavirus hit and predicts more than 900-million COVID-19-related telehealth encounters in 2020. The Centers for Medicare and Medicaid Services (CMS) played a role in encouraging this surge, and in April, released guidelines for FQHCs and CHCs to increase their use of telehealth technology. Here are the new regulations and how they affect your practice.

CMS Waives Telehealth Restrictions

Telehealth, which allows for a video encounter between patient and doctor by using telecommunications technology, has become healthcare’s go-to tool for allowing social distancing while providing patient diagnosis and treatment. The technology allows clinicians to triage potential COVID-19 patients without exposing them to a crowded waiting room. Telehealth also protects clinicians from unnecessary exposure to the virus. Organizations like the CDC recommends telemedicine as an effective means to slow the spread of the virus while providing needed treatment to patients.

In the past, FQHCs and CHCs were limited to providing telemedicine only as an originating site. This required the patient to travel to these facilities to receive care during a video encounter. But in April, CMS released new guidelines under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, FQHCs and CHCs can provide care as a distant site provider for the duration of the COVID-19 pandemic. There are no geographic restrictions, which means providers can conduct a telehealth visit from their home to a patient in their home.  There are countless stories on how both provider and patient find this a welcome method of service while inevitably this convenience will improve overall population health statistics.

But that isn’t the only change announced by CMS, who expanded the list of services offered in a telehealth encounter to more than 180 unique categories. The healthcare organization also stated that all healthcare providers could serve patients virtually, and the amount of reimbursement will be the same as for an in-patient visit. It’s the last part of this ruling that is startling; announcing full parity for telehealth is an unusual and welcome move for CMS. According to the American Academy of Family Physicians, this means the payment rate for telemedicine services provided by an FQHC or CHC provider is $92, the average physician fee schedule amount for all services on the newly expanded telehealth list. While they must use the -95 modifier for distant site services, FQHCs will receive their Prospective Payment System (PPS) rate, and CHCs will receive their all-inclusive rate (AIR).

What the Ruling Means for Your Facility and You as a Provider

This has strong implications for telemedicine applications in your facility, of course. For clinical teams in self-quarantine, but asymptomatic, it means that they can still be utilized to provide telehealth triage to improve the efficiency of your team. It also increased reimbursement amounts for a wider variety of encounters. FQHCs and CHCs now can use telehealth technology fully, which will provide patients with the care they need while keeping everyone safe from unnecessary exposure to COVID-19.

UHC Solutions provides staffing to FQHCs and other CHCs. We are standing by to help during this time of crisis. Contact us to find out more today.