Medicare Telehealth Coverage for FQHCs in 2025: What to Expect and How to Bill for Services
Telehealth has revolutionized healthcare delivery, expanding access to care and improving outcomes for patients nationwide. For Federally Qualified Health Centers (FQHCs), Medicare telehealth coverage has been instrumental in bridging care gaps—particularly in underserved and rural communities. However, with temporary flexibilities set to expire after March 31, 2025, FQHCs must prepare for potential shifts in reimbursement and billing procedures.
This guide outlines Medicare's 2025 telehealth policies for FQHCs, the billing guidelines to follow, and how to ensure financial sustainability in a changing regulatory landscape.
What Telehealth Services Will Medicare Cover for FQHCs in 2025?
Non-Behavioral/Mental Health Telehealth Services (Covered Until March 31, 2025)
Until March 31, 2025, FQHCs can continue to serve as distant site providers, offering non-behavioral telehealth services to Medicare beneficiaries. However, without additional legislative action, this coverage will expire, meaning FQHCs will no longer be reimbursed for most medical telehealth services.
Behavioral and Mental Health Telehealth Services (Permanently Covered)
FQHCs will permanently be reimbursed for telehealth-delivered behavioral and mental health services, including substance use disorder treatments.
Key benefits of this permanent coverage:
✔ No Geographic Restrictions – Patients can receive care from their homes.
✔ Audio-Only Services Allowed – Ensuring access for patients without internet or video-enabled devices.
✔ Delayed In-Person Visit Requirement – The rule requiring an in-person visit within six months of initiating behavioral telehealth services and annually thereafter is now postponed until January 1, 2026. (Telehealth.HHS.gov).
Billing Guidelines for Medicare Telehealth Services in 2025
Billing for Non-Behavioral Telehealth (Available Until March 31, 2025)
Billing for Behavioral and Mental Health Telehealth (Permanently Covered)
Key Considerations for FQHCs
✔ Prepare for Policy Changes – If Congress does not extend non-behavioral telehealth flexibilities, FQHCs must adjust their service offerings by April 1, 2025.
✔ Educate Patients About In-Person Visit Requirements – While postponed until January 1, 2026, FQHCs should begin preparing workflows to meet these requirements in the future.
✔ Advocate for Telehealth Policy Extensions – Legislative action could extend Medicare reimbursement for non-behavioral telehealth. FQHC leaders should engage with policymakers and monitor CMS updates to push for long-term coverage.
✔ Maximize Telehealth Before Expiration – While eligible, FQHCs should continue leveraging telehealth services to expand patient access and maintain high-quality care.
✔ Ensure Financial Stability – If your FQHC relies on telehealth revenue, planning ahead is crucial. Synergy Billing specializes in FQHC revenue cycle management, helping health centers optimize reimbursements and claims processing to stay financially sustainable.
Conclusion: Stay Proactive and Prepared
Medicare’s telehealth coverage for FQHCs is changing. While behavioral health telehealth services remain permanently covered, non-behavioral telehealth services may no longer be reimbursed after March 31, 2025, unless Congress takes further action.
By staying informed, optimizing billing strategies, and advocating for policy extensions, FQHCs can continue delivering essential care to their communities.
Need Help Maximizing Your FQHC’s Reimbursement?
At Synergy Billing, we specialize in FQHC revenue cycle management—helping health centers navigate Medicare billing, optimize reimbursements, and stay financially strong in an evolving healthcare landscape.
📞 Contact us today to ensure your FQHC is prepared for the changes ahead!
Stay Updated on Telehealth Policies:
📌 Telehealth.HHS.gov
📌 CMS Telehealth Policy Updates
📌 National Law Review on Telehealth Extensions
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