FQHC and RHC adding Home Telemonitoring Services

08/05/2024

House Bill (H.B.) 2727, 88th Legislature, Regular Session, implements for effective dates of service on or after September 1, 2024, for Federally Qualified Health Centers and Rural Health clinical providers performing home telemonitoring services to bill and be reimbursed for HCPCS code G0511 as an add-on procedure code.

Blue Cross and Blue Shield of Texas advised that the home telemonitoring fees should not be included in any cost reporting that is used to calculate a prospective payment system or alternative prospective payment system for FQHC and All-Inclusive Rate PPS for RHC per visit encounter rate.

Our providers who provide home telemonitoring services through FQHC or RHC should be reminded to review the new policy on September 1, 2024.

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The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. Any questions regarding those organizations should be addressed to them directly. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.