NARHC Forum

Contributor: Kara Carson, Family Medical Center - Pinckneyville

Some hospitals are beginning to charge patients for provider responses to messages received via online patient portals. In an article we read, one large hospital was activating this charge when it takes providers more than 5 minutes to respond to a patient message and if the response was provided within 7 days of the patient message being created.

Is this something that RHCs can bill for? Are there any guidelines on this? Is this payable by Medicare? What about other payers - are they recognizing this as a payable service?

Any feedback is most appreciated. Thanks!

Contributor: Jackie King, ArchProCoding

Hi Kara Jo,

RHCs can bill these virtual check in visits using HCPCS II code G0071.  Payment for this code is set at the average of the national non-facility PFS
payment rates and reflects both HCPCS code G2012 (communication technology-based services) and
HCPCS code G2010 (remote evaluation services) and is updated annually based on the
PFS national non-facility payment rate for these codes.

Medicare Telehealth Codes for RHC and FQHC: https://telehealth.hhs.gov/providers/billing-and-reimbursement/billing-medicare-as-a-safety-net-provider#virtual-communication-billing-codes-for-rhcs-and-fqhcs

Virtual Communication Services in Rural Health Clinics (RHCs) and
Federally Qualified Health Centers (FQHCs)
Frequently Asked Questions: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS/Downloads/VCS-FAQs.pdf

Hope this helps,

Jackie King @ ArchProCoding