{"id":2832,"date":"2026-09-23T06:32:54","date_gmt":"2026-09-23T06:32:54","guid":{"rendered":"https:\/\/www.ecareindia.com\/blog\/?p=2832"},"modified":"2026-09-23T07:03:19","modified_gmt":"2026-09-23T07:03:19","slug":"rhc-and-fqhc-telehealth-billing-2026","status":"publish","type":"post","link":"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/","title":{"rendered":"CMS Updates Telehealth Billing Requirements for RHCs and FQHCs Effective October 1, 2026"},"content":{"rendered":"<div class=\"wp_plus_one_button\" style=\"margin: 0 8px 8px 0; float:left; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div>\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2832\" class=\"elementor elementor-2832\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7c52ac01 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"7c52ac01\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-394ef1fc elementor-widget elementor-widget-heading\" data-id=\"394ef1fc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">CMS Updates Telehealth Billing Requirements for RHCs and FQHCs Effective October 1, 2026\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-48038c03 e-flex e-con-boxed wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-column-slider-no wpr-equal-height-no e-con e-parent\" data-id=\"48038c03\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-328db87d e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"328db87d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div data-wpr-sticky-section=\"yes\" data-wpr-position-type=\"sticky\" data-wpr-position-offset=\"1\" data-wpr-position-location=\"top\" data-wpr-sticky-devices=\"desktop_sticky\" data-wpr-custom-breakpoints=\"\" data-wpr-active-breakpoints=\"mobile_sticky tablet_sticky desktop_sticky\" data-wpr-z-index=\"10\" data-wpr-sticky-hide=\"\" data-wpr-replace-header=\"\" data-wpr-animation-duration=\"\" data-wpr-sticky-type=\"sticky\" class=\"elementor-element elementor-element-281f44e8 e-con-full wpr-sticky-section-yes e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"281f44e8\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;position_offset&quot;:1,&quot;position_offset_tablet&quot;:0,&quot;position_offset_mobile&quot;:0}\">\n\t\t<div class=\"elementor-element elementor-element-3ddb2155 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"3ddb2155\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-56b6af54 elementor-widget elementor-widget-heading\" data-id=\"56b6af54\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Table of Contents<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-13f9a6a8 elementor-icon-list--layout-traditional elementor-list-item-link-full_width elementor-widget elementor-widget-icon-list\" data-id=\"13f9a6a8\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"Common Reasons\" data-widget_type=\"icon-list.default\">\n\t\t\t\t\t\t\t<ul class=\"elementor-icon-list-items\">\n\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Changing\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">What Is Changing for RHCs and FQHCs?\u200b<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Telehealth\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">New Telehealth Coding Requirement<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Medicare\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">How Will Medicare Payments Work?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Billing\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Why This Matters for Medical Billing Teams<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Background\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Background: Why Is CMS Making This Change?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#RHCs\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">What Should RHCs and FQHCs Do Now?<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#Preparing\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">Preparing for the October 2026 Telehealth Billing Changes<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item\">\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#e-care\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-check-circle\" viewBox=\"0 0 512 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M504 256c0 136.967-111.033 248-248 248S8 392.967 8 256 119.033 8 256 8s248 111.033 248 248zM227.314 387.314l184-184c6.248-6.248 6.248-16.379 0-22.627l-22.627-22.627c-6.248-6.249-16.379-6.249-22.628 0L216 308.118l-70.059-70.059c-6.248-6.248-16.379-6.248-22.628 0l-22.627 22.627c-6.248 6.248-6.248 16.379 0 22.627l104 104c6.249 6.249 16.379 6.249 22.628.001z\"><\/path><\/svg>\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text\">How e-care India Can Help<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-477de4eb e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"477de4eb\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-36aaa017 elementor-widget elementor-widget-image\" data-id=\"36aaa017\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"768\" height=\"421\" src=\"https:\/\/www.ecareindia.com\/blog\/wp-content\/uploads\/2026\/09\/CMS-Update.jpg\" class=\"attachment-full size-full wp-image-2847\" alt=\"cms update about FQHC billling\" srcset=\"https:\/\/www.ecareindia.com\/blog\/wp-content\/uploads\/2026\/09\/CMS-Update.jpg 768w, https:\/\/www.ecareindia.com\/blog\/wp-content\/uploads\/2026\/09\/CMS-Update-300x164.jpg 300w\" sizes=\"100vw\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-234f35dd e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"234f35dd\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6e871df5 elementor-widget elementor-widget-text-editor\" data-id=\"6e871df5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><b>Telehealth billing requirements for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are changing effective October 1, 2026.<\/b><span style=\"font-weight: 400;\"> Healthcare organizations and medical billing teams should review their coding and billing workflows to ensure compliance with the updated Medicare requirements.<\/span><\/p><p><span style=\"font-weight: 400;\">According to the CMS MLN Matters article <\/span><b>MM14468<\/b><span style=\"font-weight: 400;\">, RHCs and FQHCs will need to report the individual CPT or HCPCS code for the specific distant-site telehealth service provided, instead of using HCPCS code <\/span><b>G2025<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-452b6379 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"452b6379\" data-element_type=\"container\" data-e-type=\"container\" id=\"Changing\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4db24b13 elementor-widget elementor-widget-heading\" data-id=\"4db24b13\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What Is Changing for RHCs and FQHCs?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-53dd4fee elementor-widget elementor-widget-text-editor\" data-id=\"53dd4fee\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">For dates of service <\/span><b>on or after October 1, 2026<\/b><span style=\"font-weight: 400;\">, Rural Health Clinics and Federally Qualified Health Centers must bill the <\/span><b>individual CPT or HCPCS code that describes the telehealth service provided<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">This replaces the current approach of reporting <\/span><b>HCPCS code G2025<\/b><span style=\"font-weight: 400;\"> for applicable non-behavioral health distant-site telehealth services.<\/span><\/p><p><span style=\"font-weight: 400;\">The change applies to:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Rural Health Clinics (RHCs)<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Federally Qualified Health Centers (FQHCs)<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">The CMS update was released on <\/span><b>May 27, 2026<\/b><span style=\"font-weight: 400;\">, with an effective date of <\/span><b>October 1, 2026<\/b><span style=\"font-weight: 400;\">, and an implementation date of <\/span><b>October 5, 2026<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-392f819f e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"392f819f\" data-element_type=\"container\" data-e-type=\"container\" id=\"Telehealth\">\n\t\t\t\t<div class=\"elementor-element elementor-element-68553351 elementor-widget elementor-widget-heading\" data-id=\"68553351\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">New Telehealth Coding Requirement\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-374fa6e6 elementor-widget elementor-widget-text-editor\" data-id=\"374fa6e6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Under the updated requirements, RHCs and FQHCs should report the appropriate <\/span><b>CPT or HCPCS code corresponding to the telehealth service performed<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">CMS also specifies that RHCs and FQHCs must report the appropriate revenue code with one of the following modifiers:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>93<\/b><span style=\"font-weight: 400;\"> \u2013 Synchronous Telemedicine Service Rendered via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>95<\/b><span style=\"font-weight: 400;\"><span style=\"font-weight: 400;\"> \u2013 Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System\u00a0<br \/><br \/><\/span><\/span><p><span style=\"font-weight: 400;\">This means billing teams will need to pay close attention to the <\/span><b>type of telehealth service delivered and the corresponding code and modifier<\/b><span style=\"font-weight: 400;\"> when submitting claims.<\/span><\/p><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4a60535a e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"4a60535a\" data-element_type=\"container\" data-e-type=\"container\" id=\"Medicare\">\n\t\t\t\t<div class=\"elementor-element elementor-element-786bf66f elementor-widget elementor-widget-heading\" data-id=\"786bf66f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">How Will Medicare Payments Work?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a09c3f6 elementor-widget elementor-widget-text-editor\" data-id=\"3a09c3f6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The CMS update also provides guidance on payment for <\/span><b>non-behavioral health distant-site telehealth services<\/b><span style=\"font-weight: 400;\"> provided by RHCs and FQHCs.<\/span><\/p><p><span style=\"font-weight: 400;\">According to the update:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Payment rates will be <\/span><b>updated annually<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Payment rates will be based on the <\/span><b>average amount for all PFS telehealth services on the telehealth list, weighted by volume<\/b><span style=\"font-weight: 400;\">, for services reported under the Physician Fee Schedule.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Payment rates will <\/span><b>not be adjusted based on geographic locality<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Patient <\/span><b>coinsurance and deductibles<\/b><span style=\"font-weight: 400;\"> will apply to RHC services.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Patient <\/span><b>coinsurance<\/b><span style=\"font-weight: 400;\"> will apply to FQHC services.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coinsurance will be based on the <\/span><b>lesser of the payment rate or submitted charges<\/b><span style=\"font-weight: 400;\">.\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coinsurance and deductibles will be <\/span><b>waived for preventive services<\/b><span style=\"font-weight: 400;\">.<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-1174bc97 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"1174bc97\" data-element_type=\"container\" data-e-type=\"container\" id=\"Billing\">\n\t\t\t\t<div class=\"elementor-element elementor-element-40c47205 elementor-widget elementor-widget-heading\" data-id=\"40c47205\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Why This Matters for Medical Billing Teams\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4450ebe0 elementor-widget elementor-widget-text-editor\" data-id=\"4450ebe0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The transition away from G2025 means RHCs and FQHCs will need to ensure their billing processes are ready for <\/span><b>service-specific telehealth coding<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">Medical billing teams should review their workflows for:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5580189 elementor-widget elementor-widget-heading\" data-id=\"5580189\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">1. CPT and HCPCS Code Selection<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5a85b98 elementor-widget elementor-widget-text-editor\" data-id=\"5a85b98\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Billing staff should identify the appropriate individual CPT or HCPCS code for each eligible distant-site telehealth service rather than defaulting to G2025.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-105128f4 elementor-widget elementor-widget-heading\" data-id=\"105128f4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">2. Modifier Reporting<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-34200312 elementor-widget elementor-widget-text-editor\" data-id=\"34200312\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The appropriate telehealth modifier should be reported based on whether the service was delivered through:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Audio-only telecommunications, or\u00a0<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Real-time interactive audio and video.\u00a0<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-25dfee42 elementor-widget elementor-widget-heading\" data-id=\"25dfee42\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">3. Revenue Code Reporting\n<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc8a30d elementor-widget elementor-widget-text-editor\" data-id=\"cc8a30d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">RHCs and FQHCs should ensure the appropriate revenue code is included alongside the applicable telehealth coding requirements.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-532879e2 elementor-widget elementor-widget-heading\" data-id=\"532879e2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">4. Billing System Updates<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c7e29e0 elementor-widget elementor-widget-text-editor\" data-id=\"3c7e29e0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Healthcare organizations should review their billing and practice management systems before the October 1 effective date to ensure that outdated G2025 workflows do not result in incorrect claims.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-791b88b7 elementor-widget elementor-widget-heading\" data-id=\"791b88b7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">5. Staff Training<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7ae127 elementor-widget elementor-widget-text-editor\" data-id=\"7ae127\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Medical coders, billers, and revenue cycle teams should be informed about the change and understand how the new coding requirements affect claim submission.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-7eca8c35 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"7eca8c35\" data-element_type=\"container\" data-e-type=\"container\" id=\"Background\">\n\t\t\t\t<div class=\"elementor-element elementor-element-47995a97 elementor-widget elementor-widget-heading\" data-id=\"47995a97\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Background: Why Is CMS Making This Change?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-61f90565 elementor-widget elementor-widget-text-editor\" data-id=\"61f90565\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">The update follows provisions in the <\/span><b>Consolidated Appropriations Act, 2026<\/b><span style=\"font-weight: 400;\">, which extended telehealth flexibilities allowing RHCs and FQHCs to provide services as distant-site telehealth providers through <\/span><b>January 1, 2028<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">The Social Security Act also requires payment for distant-site telehealth services at rates similar to national average payment rates for comparable telehealth services under the Physician Fee Schedule.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Previously, RHCs and FQHCs billed Medicare Part B for applicable non-behavioral health distant-site telehealth services using <\/span><b>HCPCS G2025<\/b><span style=\"font-weight: 400;\">. The new requirement moves billing toward reporting the individual code that describes the service actually provided.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-4a5aa832 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"4a5aa832\" data-element_type=\"container\" data-e-type=\"container\" id=\"RHCs\">\n\t\t\t\t<div class=\"elementor-element elementor-element-34c350db elementor-widget elementor-widget-heading\" data-id=\"34c350db\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">What Should RHCs and FQHCs Do Now?\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-26614ab1 elementor-widget elementor-widget-text-editor\" data-id=\"26614ab1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">With the effective date approaching, healthcare organizations can take several practical steps to prepare:<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ea3fb10 elementor-widget elementor-widget-heading\" data-id=\"3ea3fb10\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Review current billing workflows<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-416ba075 elementor-widget elementor-widget-text-editor\" data-id=\"416ba075\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Identify where G2025 is currently being used for distant-site telehealth services.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7a4315cd elementor-widget elementor-widget-heading\" data-id=\"7a4315cd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Update coding guidelines<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-712474e9 elementor-widget elementor-widget-text-editor\" data-id=\"712474e9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Make sure billing teams have access to the appropriate CPT and HCPCS codes for eligible telehealth services.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-233797a4 elementor-widget elementor-widget-heading\" data-id=\"233797a4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Review modifiers and revenue codes<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71c2bda1 elementor-widget elementor-widget-text-editor\" data-id=\"71c2bda1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Work with your billing or RCM technology provider to ensure system configurations support the new requirements.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c42590e elementor-widget elementor-widget-heading\" data-id=\"c42590e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Update billing software<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-40b876ed elementor-widget elementor-widget-text-editor\" data-id=\"40b876ed\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<span style=\"font-weight: 400;\">Identify recurring denial patterns and address root causes. Automated claim tracking and reporting tools can improve efficiency while reducing manual workload.<\/span>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-217f0dcb e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"217f0dcb\" data-element_type=\"container\" data-e-type=\"container\" id=\"Benefits\">\n\t\t\t\t<div class=\"elementor-element elementor-element-7e9db9e elementor-widget elementor-widget-heading\" data-id=\"7e9db9e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Train your billing team<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e6e2152 elementor-widget elementor-widget-text-editor\" data-id=\"e6e2152\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Conduct training before October 1, 2026, so coders and billers understand the changes.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8a3fe7 elementor-widget elementor-widget-heading\" data-id=\"f8a3fe7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Monitor claims after implementation<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f4041b4 elementor-widget elementor-widget-text-editor\" data-id=\"f4041b4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">Review claim acceptance and denial trends after implementation to identify potential coding or configuration issues.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3422cf47 elementor-widget elementor-widget-heading\" data-id=\"3422cf47\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"Preparing\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Preparing for the October 2026 Telehealth Billing Changes<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-78a7f97 elementor-widget elementor-widget-text-editor\" data-id=\"78a7f97\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">For RHCs, FQHCs, and their medical billing partners, the upcoming change highlights the importance of keeping billing workflows aligned with evolving Medicare requirements.<\/span><\/p><p><span style=\"font-weight: 400;\">Starting <\/span><b>October 1, 2026<\/b><span style=\"font-weight: 400;\">, applicable distant-site telehealth services should be reported using the <\/span><b>individual CPT or HCPCS code describing the service<\/b><span style=\"font-weight: 400;\">, rather than HCPCS G2025.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Preparing billing systems, coding processes, and staff ahead of the implementation date can help healthcare organizations reduce avoidable billing issues and maintain accurate claims processing.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-395c1c87 e-con-full e-flex wpr-particle-no wpr-jarallax-no wpr-parallax-no wpr-sticky-section-no wpr-column-slider-no wpr-equal-height-no e-con e-child\" data-id=\"395c1c87\" data-element_type=\"container\" data-e-type=\"container\" id=\"e-care\">\n\t\t\t\t<div class=\"elementor-element elementor-element-648e3976 elementor-widget elementor-widget-heading\" data-id=\"648e3976\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">How e-care India Can Help<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-468ae345 elementor-widget elementor-widget-text-editor\" data-id=\"468ae345\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p><span style=\"font-weight: 400;\">At <\/span><b>e-care India<\/b><span style=\"font-weight: 400;\">, we understand the importance of keeping medical billing operations aligned with changing payer and CMS requirements. Our medical billing and revenue cycle management services can support healthcare organizations with <\/span><b>medical coding, claim submission, payment posting, denial management, and overall RCM operations<\/b><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">As telehealth continues to evolve, having a billing team that closely monitors regulatory and coding changes can help healthcare providers maintain efficient revenue cycle operations.<\/span><\/p><p><b>Need support with your medical billing and RCM operations? Connect with e-care India today.<\/b><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"wp_plus_one_button\" style=\"margin: 0 0 8px 8px; float:right; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div><!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<div class=\"wp_plus_one_button\" style=\"margin: 0 8px 8px 0; float:left; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/\" callback=\"wp_plus_one_handler\"><\/g:plusone><\/div><p>CMS Updates Telehealth Billing Requirements for RHCs and FQHCs Effective October 1, 2026 Table of Contents What Is Changing for RHCs and FQHCs?\u200b New Telehealth Coding Requirement How Will Medicare Payments Work? Why This Matters for Medical Billing Teams Background: Why Is CMS Making This Change? What Should RHCs and FQHCs Do Now? Preparing for the October 2026 Telehealth Billing Changes How e-care India Can Help Telehealth billing requirements for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are changing effective October 1, 2026. Healthcare organizations and medical billing teams should review their coding and billing workflows to ensure compliance with the updated Medicare requirements. According to the CMS MLN Matters article MM14468, RHCs and FQHCs will need to report the individual CPT or HCPCS code for the specific distant-site telehealth service provided, instead of using HCPCS code G2025.\u00a0 What Is Changing for RHCs and FQHCs? For dates of service on or after October 1, 2026, Rural Health Clinics and Federally Qualified Health Centers must bill the individual CPT or HCPCS code that describes the telehealth service provided. This replaces the current approach of reporting HCPCS code G2025 for applicable non-behavioral health distant-site telehealth services. The change applies to: Rural Health Clinics (RHCs)\u00a0 Federally Qualified Health Centers (FQHCs)\u00a0 The CMS update was released on May 27, 2026, with an effective date of October 1, 2026, and an implementation date of October 5, 2026.\u00a0 New Telehealth Coding Requirement Under the updated requirements, RHCs and FQHCs should report the appropriate CPT or HCPCS code corresponding to the telehealth service performed. CMS also specifies that RHCs and FQHCs must report the appropriate revenue code with one of the following modifiers: 93 \u2013 Synchronous Telemedicine Service Rendered via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System\u00a0 95 \u2013 Synchronous Telemedicine Service Rendered via a Real-Time Interactive Audio and Video Telecommunications System\u00a0 This means billing teams will need to pay close attention to the type of telehealth service delivered and the corresponding code and modifier when submitting claims. How Will Medicare Payments Work? The CMS update also provides guidance on payment for non-behavioral health distant-site telehealth services provided by RHCs and FQHCs. According to the update: Payment rates will be updated annually.\u00a0 Payment rates will be based on the average amount for all PFS telehealth services on the telehealth list, weighted by volume, for services reported under the Physician Fee Schedule.\u00a0 Payment rates will not be adjusted based on geographic locality.\u00a0 Patient coinsurance and deductibles will apply to RHC services.\u00a0 Patient coinsurance will apply to FQHC services.\u00a0 Coinsurance will be based on the lesser of the payment rate or submitted charges.\u00a0 Coinsurance and deductibles will be waived for preventive services. Why This Matters for Medical Billing Teams The transition away from G2025 means RHCs and FQHCs will need to ensure their billing processes are ready for service-specific telehealth coding. Medical billing teams should review their workflows for: 1. CPT and HCPCS Code Selection Billing staff should identify the appropriate individual CPT or HCPCS code for each eligible distant-site telehealth service rather than defaulting to G2025. 2. Modifier Reporting The appropriate telehealth modifier should be reported based on whether the service was delivered through: Audio-only telecommunications, or\u00a0 Real-time interactive audio and video.\u00a0 3. Revenue Code Reporting RHCs and FQHCs should ensure the appropriate revenue code is included alongside the applicable telehealth coding requirements. 4. Billing System Updates Healthcare organizations should review their billing and practice management systems before the October 1 effective date to ensure that outdated G2025 workflows do not result in incorrect claims. 5. Staff Training Medical coders, billers, and revenue cycle teams should be informed about the change and understand how the new coding requirements affect claim submission. Background: Why Is CMS Making This Change? The update follows provisions in the Consolidated Appropriations Act, 2026, which extended telehealth flexibilities allowing RHCs and FQHCs to provide services as distant-site telehealth providers through January 1, 2028. The Social Security Act also requires payment for distant-site telehealth services at rates similar to national average payment rates for comparable telehealth services under the Physician Fee Schedule.\u00a0 Previously, RHCs and FQHCs billed Medicare Part B for applicable non-behavioral health distant-site telehealth services using HCPCS G2025. The new requirement moves billing toward reporting the individual code that describes the service actually provided. What Should RHCs and FQHCs Do Now? With the effective date approaching, healthcare organizations can take several practical steps to prepare: Review current billing workflows Identify where G2025 is currently being used for distant-site telehealth services. Update coding guidelines Make sure billing teams have access to the appropriate CPT and HCPCS codes for eligible telehealth services. Review modifiers and revenue codes Work with your billing or RCM technology provider to ensure system configurations support the new requirements. Update billing software Identify recurring denial patterns and address root causes. Automated claim tracking and reporting tools can improve efficiency while reducing manual workload. Train your billing team Conduct training before October 1, 2026, so coders and billers understand the changes. Monitor claims after implementation Review claim acceptance and denial trends after implementation to identify potential coding or configuration issues. Preparing for the October 2026 Telehealth Billing Changes For RHCs, FQHCs, and their medical billing partners, the upcoming change highlights the importance of keeping billing workflows aligned with evolving Medicare requirements. Starting October 1, 2026, applicable distant-site telehealth services should be reported using the individual CPT or HCPCS code describing the service, rather than HCPCS G2025.\u00a0 Preparing billing systems, coding processes, and staff ahead of the implementation date can help healthcare organizations reduce avoidable billing issues and maintain accurate claims processing. How e-care India Can Help At e-care India, we understand the importance of keeping medical billing operations aligned with changing payer and CMS requirements. Our medical billing and revenue cycle management services can support healthcare organizations with medical coding, claim submission, payment posting, denial management, and overall RCM operations. As telehealth continues to evolve, having a billing team that closely monitors regulatory and coding changes can &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;CMS Updates Telehealth Billing Requirements for RHCs and FQHCs Effective October 1, 2026&#8221;<\/span><\/a><\/p>\n<p><!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n<div class=\"wp_plus_one_button\" style=\"margin: 0 0 8px 8px; float:right; \"><g:plusone href=\"https:\/\/www.ecareindia.com\/blog\/rhc-and-fqhc-telehealth-billing-2026\/\" 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