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Rural Health Clinic Payment for Mental Health Visits Furnished via Telecommunications

Effective January 1, 2022, Rural Health Clinics (RHCs) mental health visits will include visits furnished using interactive, real-time telecommunications technology. This allows RHCs to report and receive payment for mental health visits furnished via real-time telecommunication technology in the same way they do when visits take place in-person, including audio-only visits when the beneficiary is not capable of, or does not consent to, the use of video technology. 

Effective January 1, 2025, there must be an in-person mental health service furnished within 6 months prior to the furnishing of the telecommunications service and that in general, there must be an in-person mental health service without the use of telecommunications technology must be provided at least every 12 months while the beneficiary is receiving services furnished via telecommunications technology for diagnosis, evaluation, or treatment of mental health disorders. 

Exceptions to the in-person visit requirement may be made based on beneficiary circumstances (with the reason documented in the patient’s medical record) and more frequent visits are also allowed under our policy, as driven by clinical needs on a case-by-case basis.

Billing information

  • Date of service: On or after January 1
  • Revenue code: 0900
  • Use the appropriate qualifying payment code (HCPCS) for mental health visit
  • Modifier CG - policy criteria applied 
  • Modifier 95 - for services furnished via audio and video telecommunications or 
  • Modifier FQ or 93 - for services that were furnished audio-only

 

References