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Behavioral Health via Telehealth
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5/19/2021 @ 2:25:00 PM
Post 1 of 4

Contributor: Sarah Cole, Ohio County Healthcare RHCs

Are there any updates to the AIR payment, cost inclusion on the cost report and RHC encounter inclusion for Telehealth in an RHC and/or is there any exceptions regarding Behavioral Health Services via telehealth?

All information is most appreciated.

Thanks

Sarah Beth Cole

5/19/2021 @ 2:26:00 PM
Post 2 of 4

Contributor: Gary Lucas, ArchProCoding

Hello ,
I am currently teaching a 2-day certification Bootcamp to folks in 24
states from 10am-5pm ET on May 19-20, 2021.

* Please allow additional time for a reply - but know that I will be
able to check emails periodically throughout the day but I may not be
able to reply as per normal.

Should you need immediate assistance please reach to Julia Scott, our Member
Services Director, at Julia@ArchProCoding.com or call 404-937-6633 option #1..


Thank you!

Gary Lucas
VP - Education
Arch Pro Coding

--

Gary Lucas
Vice President - Education

Association for Rural and Community Health Professional Coding
*(ArchProCoding)*

www.ArchProCoding.com
5/20/2021 @ 11:22:00 AM
Post 3 of 4

Contributor: Nathan Baugh, National Association of Rural Health Clinics

Sarah,

We cannot use this forum to advocate but NARHC is pursuing a legislative policy change that would allow telehealth to be paid through the AIR with those costs included on the cost report. However, that is not the current policy.

There are no exceptions regarding behavioral health services furnished via telehealth either. 

The main policy document for us on telehealth policy during the PHE remains MLN SE20016: https://www.cms.gov/files/document/se20016.pdf 

Here is the key section:

We won’t use costs for furnishing distant site telehealth services to decide the RHC AIR or the FQHC PPS rate, but these costs must be reported on the proper cost report form. RHCs must report both originating and distant site telehealth costs on Form CMS-222-17 on line 79 of the Worksheet A, in the section titled “Cost Other Than RHC Services.” FQHCs must report both originating and distant site telehealth costs on Form CMS-224-14, the Federally Qualified Health Center Cost Report, on line 66 of the Worksheet A, in the section titled “Other FQHC Services”.

Medicare Advantage Wrap-Around

Since telehealth distant site services aren’t paid under the RHC AIR or the FQHC PPS, the Medicare Advantage (MA) wrap-around payment doesn’t apply to these services. MA plans will adjust wrap- around payment for distant site telehealth services.

I hope that helps.

5/20/2021 @ 5:06:00 PM
Post 4 of 4

Contributor: Sarah Cole, Ohio County Healthcare RHCs

Thank you for the clarification. 

 


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