Medicare Claims Processing Manual (Pub. 100-04), Ch. 9 § 70.6

Virtual Communication Services

Last amended: 2025Year: 2025Length: 202 wordsOfficial source
70.6 - Virtual Communication Services (Rev. 13264, Issued:06-09-25; Effective: 06-02-25; Implementation: 06-02-25) In the CY 2019 PFS final rule, CMS finalized a policy for payment to RHCs and FQHCs for communication technology-based services (“virtual check-in”) or remote evaluation services, effective January 1, 2019. CMS created a new Virtual Communications G Code, G0071 for use by RHCs and FQHCs only, with the payment rate set at the average of the PFS non-facility payment rate for communication technology-based services and remote evaluation services. RHCs and FQHCs receive an additional payment for the costs of communication technology-based services or remote evaluation services that are not already captured in the RHC AIR or the FQHC PPS payment when the requirements for these services are met. Coinsurance and deductibles apply to RHC claims, and coinsurance applies to FQHC claims for these services. RHCs and FQHCs can bill HCPCS code G0071 alone or with other payable services on an RHC or FQHC claim. The services should be billed with a revenue code 052x and should not be billed with modifier CG for payment on RHC claims. HCPCS codes G0071 are paid based on the lesser of the charges or the rate from the Medicare Physician Fee Schedule (MPFS).
Medicare Claims Processing Manual (Pub. 100-04), Ch. 9 § 70.6: Virtual Communication Services | Justis AI