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Home Telemonitoring Services Adding Federally Qualified Health Centers and Rural Health Clinics

Date: 07/15/24

Superior HealthPlan would like to inform providers House Bill (H.B.) 2727, requires the Texas Health and Human Services Commission (HHSC) to add Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) as providers of home telemonitoring services.

The bill clarifies the following:

  • The term “home telemonitoring services” is synonymous with “remote patient monitoring”.
  • Requires home telemonitoring providers to establish a plan of care with outcome measures for each patient.
    • Requires providers to share the plan and outcome measures with the patient’s physician.
  • FQHC practitioners may be employees of the FQHC or contracted with the FQHC.
  • RHC practitioners may be employees of the RHC or contracted with the RHC.

Effective for dates of service on or after September 1, 2024, FQHC and RHC providers performing home telemonitoring services should note the following:

  • Providers may bill and be reimbursed for Healthcare Common Procedure Coding System (HCPCS) code G0511 as an add-on procedure code.
  • The fee for home telemonitoring should not be included in any cost reporting that is used to calculate a Prospective Payment System (PPS) or Alternative Prospective Payment System (APPS) per visit encounter rate.
    • RHCs should not include the home telemonitoring fee in any cost reporting that is used to calculate the RHC All Inclusive Rate (AIR) PPS per visit encounter rate.
  • If an FQHC or RHC is eligible for the payment of both an encounter fee and a home telemonitoring fee for the same client on the same date of service, the FQHC or RHC must submit a claim for the home telemonitoring fee separately from the claim that was submitted for the encounter.

For questions, please contact your designated Account Manager. To access their contact information visit Find My Account Manager.