Summary & Overview
HCPCS G2025: Telehealth Distant Site Service for RHCs and FQHCs
HCPCS Level II code G2025 designates payment for a telehealth distant site service when the distant provider is located in a rural health clinic (RHC) or a federally qualified health center (FQHC). As telehealth continues to be a central channel for outpatient access, this code specifies the billing pathway for RHCs and FQHCs acting as distant sites and clarifies eligibility for facility-based telehealth reimbursement. Nationally, clear use of this code affects facility revenue streams and supports access in underserved areas.
The analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise summary of payer coverage approaches, typical modifiers and billing considerations, and the clinical context underpinning telehealth distant site services in community clinic settings. The publication includes benchmarks where available, summaries of relevant policy updates affecting facility telehealth payments, and practical coding considerations for RHCs and FQHCs.
This briefing is intended for billing managers, compliance officers, and policy analysts seeking a national view on how HCPCS Level II code G2025 is applied and reimbursed for telehealth services originating from community-based clinic distant sites.
Billing Code Overview
HCPCS Level II code G2025 represents payment for a telehealth distant site service furnished by a rural health clinic (RHC) or federally qualified health center (FQHC) only. The service type is telehealth distant site service, indicating a clinician or facility is providing a virtual encounter or consultation from the distant site. The typical site of service is an RHC or FQHC acting as the distant site, meaning the clinic or health center is the location where the clinician is located while furnishing the telehealth service.
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Clinical & Coding Specifications
Clinical Context
A patient presents to a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC) for an established chronic condition follow-up. The patient is a 67-year-old with type 2 diabetes mellitus and hypertension who lives in a medically underserved rural area and requests a remote visit due to limited transportation and mobility. The clinic schedules a synchronous telehealth visit at the distant site where the patient is physically located at the FQHC/RHC and the clinician connects from a separate location. During the visit the clinician reviews medications, assesses glycemic control, reviews recent home glucose logs, adjusts antihypertensive therapy as needed, and documents medical decision-making. The clinic documents the encounter as a telehealth distant site service to be billed under G2025 when applicable, including the appropriate place of service and any required modifiers to indicate telehealth, rendering circumstances, or professional roles. Typical workflow steps include patient check-in at the FQHC/RHC, verification of identity and consent for telehealth, vitals collection by on-site staff, connection to the remote provider, encounter documentation in the EHR, and billing submission using G2025 for the clinic’s distant-site payment when payer policy permits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
95 | Synchronous telemedicine service rendered via real-time interactive audio and video |