Join Us in Asking Governor Cuomo to Allow Facilities to Bill the "Facility Fee" when Providing Home-Based, Direct-To-Consumer Telehealth Services

The widespread use of Home-Based, Direct-To-Consumer Telehealth during the Covid-19 emergency has resulted in enormous gains in treating health conditions in the United States. Its widespread use has broadened the range of illnesses treated with Home-Based Telehealth, including serious illnesses such as congestive heart failure, epilepsy, obstructive pulmonary disease, and even cancer. In addition to helping to reduce Covid-19 infection rates by allowing people to receive needed medical care at home thereby reducing their exposure to infection and reducing those who are infected from infecting others, the widespread use of Home-Based Telehealth has significantly reduced the number of people using emergency room services (a critical goal of Value Based Payment programs), increased family and caregiver’s involvement in the treatment and care of patients, increased coordination and collaboration with local health providers, emergency services and primary care physicians, increased the sharing of patient health information stored in electronic health record (EHR) systems, and increased people’s comfort with receiving Home-Based Telehealth services.

Home-Based Telehealth’s proliferation was made possible through waivers enacted at the federal and state level. Designed to assist practitioners (hospitals, clinics, doctor’s offices, community health centers, etc.) during the Covid-19 emergency, the waivers allow practitioners to defer the cost associated with using best practice administrative, technical and security procedures when delivering Telehealth services to patients in their home. Ordinarily, when patients are located at a facility rather than their home while receiving Telehealth services, the cost associated with implementing administrative, technical and security procedures is recouped by billing a Facility Fee (Q3014). However, when patients receive Telehealth services at their residence, the Facility Fee cannot be billed. Without the waivers, practitioners would have been burdened with the cost of developing and implementing these requisite administrative procedures, hampering their ability to quickly deploy Telehealth to treat patients in their home.

As we enter the post-emergency phase of the Covid-19 pandemic and an end to the waivers, we run the risk of losing the gains made by Telehealth. With the end of the waivers, providers of Home-Based Telehealth services will have to implement the required administrative, technical and security procedures and cover their associated cost without the benefit of billing a Facility Fee. This will likely lead to providers discontinuing delivery of Home-Based Telehealth services or severely cutting back.

To avoid this likely outcome, we are asking you to join us in asking Governor Cuomo to preserve the gains in Telehealth by allowing practitioners to bill Facility Fee Q3014 when providing Home-Based, Direct-To-Consumer Telehealth services. Support for billing administrative expenses when providing Home-Based Telehealth has already been acknowledged at the federal level. Since February 2019, Federally Qualified Health Centers (FQHC) have been able to bill an “off-site” service code (4012) to recoup administrative expenses incurred during the delivery of Telehealth services to patients in their home. More recently, in direct response to the Covid-19 emergency, FQHC have been given permission to bill the off-site service code to recoup expenses when using a telephone to deliver Telehealth services to patients in their home. With this in mind, we are asking you to join us in requesting the Governor show a similar level of support at the state level by allowing practitioners to bill Facility Fee Q3014 for Home-Based Telehealth services once the waivers end.

For more information about the Preserve the Gains in Telehealth campaign, please go to our website at:  

fama-usa.com/petition.html.