Reps. Huffman, Torres Small Call for Expanding Telephone Services Reimbursement for Community Health Centers and Rural Health Clinics

March 22, 2020

San Rafael, CA – Today, Representatives Jared Huffman (CA-02) and Xochitl Torres Small (NM-02) led 18 colleagues in sending a letter to U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma urging CMS to adjust telehealth service definitions to better meet the needs of rural health care providers during the novel coronavirus pandemic.

“Currently, medical professionals on the front lines of the COVID-19 pandemic are exercising every measure to assess and aid patients while simultaneously working to protect health care providers from the virus. Telehealth services are key to this approach,” the representatives wrote. “However, some facilities, particularly Federally Qualified Health Centers and Rural Health Centers serving disadvantaged and more rural communities, do not have video capability and as a result, are not reimbursed for this service. In this time of high demand and great need, all medical facilities, even those less resourced clinics who lack the equipment and software to meet the requirements for what is defined as telemedicine, must receive payment for telephone calls to patients in lieu of in-person office visits.”

In addition to Representatives Huffman and Torres Small, today’s letter was signed by Reps. G. K. Butterfield (NC-01); Ted Deutch (FL-22); Derek Kilmer (WA-06); Gwen Moore (WI-04); Tom O'Halleran (AZ-01); Tim Ryan (OH-13); Jackie Speier (CA-14); Norma Torres (CA-35); Nydia M. Velázquez (NY-07); Sharice L. Davids (KS-03); Angie Craig (MN-02); Sean Patrick Maloney (NY-18); Anthony G. Brown (MD-04); Joe Neguse (CO-02); James P. McGovern (MA-02); Salud O. Carbajal (CA-24); Albio Sires (NJ-08); and Debbie Wasserman Schultz (FL-23).

The full letter can be found here or below. 

Dear Administrator Verma,

We appreciate the new guidance the Centers for Medicare and Medicaid Services (CMS) has provided to expand telehealth during the coronavirus (COVID-19) public health crisis. However, many medical professionals are left out. Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHC) are not able to take advantage of the new guidance, and doctors are still unable to bill for simple phone calls that last longer than 10 minutes. We ask that CMS adjust telehealth service definitions to allow FQHCs and RHCs to include Telephone Evaluation and Management Service Medicare codes 99441, 99442, and 99443 otherwise be paid for an in- person Medicare visit.

Currently, medical professionals on the front lines of the COVID-19 pandemic are exercising every measure to assess and aid patients while simultaneously working to protect health care providers from the virus. Telehealth services are key to this approach. However, some facilities, particularly FQHCs and RHCs serving disadvantaged and more rural communities, do not have video capability and as a result, are not reimbursed for this service. In this time of high demand and great need, all medical facilities, even those less resourced clinics who lack the equipment and software to meet the requirements for what is defined as telemedicine, must receive payment for telephone calls to patients in lieu of in-person office visits.

The request to pay for telephone calls does not detract from medical facilities with telemedicine capabilities, rather, it would help those less resourced clinics who lack the AV equipment/software to meet the requirements for what is defined as telemedicine. This would allow such clinics to be paid for telephone calls to patients following Centers for Disease Control and Prevention guidance to stay home and seek care remotely, if possible.

We are grateful to our medical professional community for all the critical services they are providing to our communities during this public health crisis. Now, we must ensure they are compensated properly. Therefore, we ask that CMS allow medical professionals at FQHCs and RHCs to bill for telephone consultations. As the nation works to overcome this global pandemic, we must ensure that all medical professionals can be compensated for the work they are doing by making this urgently needed change under applicable law and policy. We thank you for your consideration of our request.

Sincerely,

--- Members of Congress ---

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