FQHC & RHC RPM Reimbursement Changes in the 2024 CMS Final Rule

FQHC & RHC RPM Changes in the 2024 CMS Final Rule

The healthcare landscape in 2024 is poised for significant changes, directly impacting Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). In the final rule of the 2024 Medicare Physician Fee Schedule issued on November 2, 2023, Medicare introduced vital changes that warrant attention. This article delves into the implications of the 2024 CMS RPM reimbursement changes for FQHCs and RHCs.

Key Changes in the 2024 CMS RPM Reimbursement

  1. Reimbursement for Remote Patient Monitoring: Medicare will start reimbursing FQHCs and RHCs for remote patient monitoring (RPM) from January 1, 2024. Providers can bill for two remote health monitoring services under code G0511, at a rate of $72.98 per patient per month. Both services can be provided to the same patient in the same month.
  2. Multiple Billing for G0511: FQHCs and RHCs can bill the G0511 code multiple times per month for the same patient, given they meet the minimum requirements for each subcategory code. This enables providers to bill for various services within the same month.
  3. Reduction in G0511 Reimbursement Rate: While multiple billing is permitted, the reimbursement rate for G0511 drops from $77.94 in 2023 to $72.98 in 2024. However, this reduction should be considered within the context of improved patient care and access to vital services.

Impact on FQHCs and RHCs

The changes empower FQHCs and RHCs to provide a comprehensive approach to patient care, combining real-time monitoring and long-term management of chronic conditions. Providers can earn over $300 per patient per month through various billing codes for CCM, RPM, and BHI, bolstering patient care.

These changes offer a sustainable means for providers to fund RPM programs, making it an exciting opportunity for service expansion and potential earnings of $440,000 for every 500 patients enrolled in an RPM program.

Impact on Patients

Remote patient monitoring allows patients to conveniently track their health at home, leading to timely interventions and improved control of vital signs, such as blood pressure and A1c levels. Increased access to behavioral health services enhances the management of conditions like depression, anxiety, and substance use, addressing the comprehensive needs of patients.

ReimburseRPM: Supporting Providers Through Change

ReimburseRPM is ready to assist FQHCs and RHCs in navigating these transformative changes. Our solution is tailored to the unique needs of Medicare, Medicaid, and dual-eligible patients, covering CCM, RPM, and BHI to enhance patient outcomes and deliver high-quality healthcare services.

The 2024 CMS RPM reimbursement changes represent a significant leap forward for providers, enabling comprehensive and accessible care for patients. With the potential for increased revenue and improved patient outcomes, FQHCs and RHCs are better equipped to fulfill their long-standing aspiration of delivering top-tier healthcare services.

For more information on how ReimburseRPM can support your organization, please feel free to contact us by emailing sales@reimburserpm.com or setting up a discovery call.

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