FQHCs and RHCs Can Now Bill for Remote Patient Monitoring

Starting in January of 2024, the Centers for Medicare and Medicaid Services (CMS) have affirmed that Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) can now bill for Remote Patient Monitoring (RPM) under new global coding. 

This is a significant step forward for these providers of care, who have long seen the benefits of RPM but have had no sustainable path for long term implementation. 

In the harsh reality of the American healthcare system, access to care often becomes a matter of financial privilege, leaving behind those who are most in need - individuals with high poverty rates and social vulnerabilities. Amidst the chaos of the pandemic, however, pathways to better care opened up. Many organizations received funding to implement RPM solutions, and the positive impact on patient outcomes was undeniable. Unfortunately, when the Public Health Emergency ended, funding rollbacks made it impossible for many FQHCs and RHCs to sustain their RPM programs. 

With this new rule, FQHCs and RHCs —  the primary organizations delivering care to the underserved — now have a secure path to implementing and maintaining RPM programs, enabling them to immediately improve the quality of care for existing patients and creating opportunities to expand services to a greater number of patients. 

Why this is important for underserved communities: 

Meeting the high demand for healthcare services in underserved communities can be challenging. Often, FQHCs and RHCs struggle to accommodate the volume of patients seeking care. Many patients struggle to access care at all due to social factors such as housing instability, food insecurity, and lack of transportation.

RPM reduces the need for physical touch points. With tools like Babyscripts myBloodPressure, for example, patients can record their blood pressure and report symptoms from anywhere, ensuring that their care provider is receiving all of their data even if they are unable to make it to an appointment. This participation in care has the added benefit of empowering the patient to understand and manage their own health, with the security of a provider-connection and oversight. 

Data collection outside of the clinic gives care providers deeper insight into the patient’s health outside of an appointment, enabling them to take a more proactive approach to care and manage complications before they become costly emergencies.

[Read more: Babyscripts for Federally Qualified Health Centers]

The rule went into effect on January 1, 2024, and enables FQHCs and RHCs to bill for RPM and remote therapeutic monitoring (RTM) in the general care management HCPCS code G0511.

Interested in learning more about how Babyscripts works with FQHCs? Watch the discussion between Babyscripts and Variety Care, an Oklahoma-based FQHC, on the strategies, challenges, and opportunities in maternal digital health at federally qualified health centers; including engaging a diverse patient population and driving enrollment across sites.