New billing guidance for RHC and FQHC distant site telehealth services

CMS released new billing instructions for rural health clinics (RHC) and federally qualified health centers (FQHC) that provide distant site telehealth services.

RHCs and FQHCs were first authorized to serve as distant site telehealth providers during the COVID-19 pandemic, and lawmakers have since extended their authority to continue furnishing these services through January 1, 2028. Currently, these facilities generally report distant site telehealth services using Healthcare Common Procedure Coding System (HCPCS) code G2025.

Beginning October 1, 2026, RHCs and FQHCs will no longer bill G2025 for distant site telehealth services. Instead, they must bill the specific Current Procedural Terminology (CPT®) or HCPCS code that describes the service furnished. CMS posts the applicable codes annually on its telehealth services web page and includes them in the Medicare Physician Fee Schedule (MPFS) final rule.

RHCs and FQHCs must also report one of the following modifiers:

• -93: Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system
• -95: Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system

CMS will continue to pay these facilities for distant site telehealth services using a rate that is updated annually, based on the average amount for all MPFS telehealth services (weighted by volume), and not adjusted for geographic locality.

Revenue integrity professionals can read One-Time Notification Transmittal 13776 for more information.