2024 Reimbursement Updates for FQHCs and RHCs

There are exciting changes happening in the healthcare community! Medicare will now allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to bill multiple instances of general care management code G0511 per patient per month, starting January 2024. Within this rule change, the door will now be open for FHQCs and RHCs to be reimbursed for providing their patients with RPM services. The applicable billing codes are outlined below:

Code G0511 - General care management: This is a general care management code that will reimburse $72.98 per patient per month (applied January 2024). This can be billed multiple times in one month and covers remote patient monitoring, chronic care management and even behavioral health integration.

Providers will have the ability to bill for the following two services under code G0511:

99454: This code applies to reimbursement for connected devices that transmit patient readings through to a digital platform. To fulfill the requirements for reimbursement under this code, a patient must complete 16 readings per 30-day period.

99457: Reimburses for 20 minutes of clinical monitoring; this can include reviewing patient data or working directly with the patient.

These reimbursement changes will have a significant impact on remote healthcare communities and allow for more accessible healthcare. At Impilo, our goal is to allow providers to focus on providing the best, most accessible care possible while we handle the messy parts of Remote Patient Monitoring Programs. If you are interested in starting or growing your FQHC RPM Program or RHC RPM Program, we are here to make it as easy as possible for you. Reach out to us at sales@impilo.health!