H.R. 5496

119th CONGRESS 1st Session

To amend title XVIII of the Social Security Act to provide for permanent payments for telehealth services furnished by federally qualified health centers and rural health clinics under the Medicare program.

IN THE HOUSE OF REPRESENTATIVES · September 18, 2025 · Sponsor: Mr. Thompson of Pennsylvania

H.R. 5496
- SEC. 1. Short title
- SEC. 2. Providing for permanent cost-related payments for telehealth services furnished by federally qualified health centers and rural health clinics under the Medicare program and permanently removing originating site facility and location requirements for distant site telehealth services furnished by such centers and such clinics

SEC. 1. Short title

This Act may be cited as the or the .

(a) Coverage of audio-Only telehealth services
- (1) In general
  - Section 1834(m)(4) of the Social Security Act () is amended by adding at the end the following new subparagraph: 42 U.S.C. 1395m(m)(4)
    - (G) Telecommunications system
      - Except as provided in paragraph (1), the term means a two-way, real-time interactive communications system, whether by audiovisual or audio-only communications. telecommunications system
- (2) Required implementation steps
  - Not later than 60 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall—
    - revise section 410.78(a)(3) of title 42, Code of Federal Regulations (or a successor regulation) to define the term in accordance with the amendment made by paragraph (1); and interactive telecommunications system
    - revise section 405.2463 of such title (or a successor regulation) to provide that, for purposes of distant site telehealth services furnished by federally qualified health centers and rural health clinics under section 1834(m)(8) of the Social Security Act (), a visit includes any two-way, real-time interactive communication between an individual and the distant site Federally qualified health center provider or rural health clinic, whether by audiovisual or audio-only communication. 42 U.S.C. 1395m(m)(8)
(b) Permanent telehealth payments
- Section 1834(m)(8) of the Social Security Act () is amended— 42 U.S.C. 1395m(m)(8)
  - in subparagraph (A), in the matter preceding clause (i), by striking During the emergency periodand all that follows through and inserting 2025—; and
    - (B) Payment
      - (i) A telehealth service furnished by a rural health clinic or a federally qualified health center serving as a distant site to an individual shall be deemed to be so furnished to such individual as an outpatient of such clinic or facility (as applicable) for purposes of paragraph (1) or (3), respectively, of section 1861(aa) and payable as a rural health clinic service or federally qualified health center service (as applicable) under section 1833(a)(3) or under the prospective payment system established under section 1834(o), respectively.
      - (ii) Costs associated with the delivery of telehealth services by a federally qualified health center or rural health clinic serving as a distant site pursuant to this paragraph shall be considered allowable costs for purposes of the prospective payment system established under section 1834(o) and any payment methodologies developed under section 1833(a)(3), as applicable.
  - by striking subparagraph (B) and inserting the following new subparagraph:
(c) Elimination of originating site requirements for telehealth services furnished by FQHCs or RHCs
- (1) In general
  - Section 1834(m) of the Social Security Act (), as amended by subsection (b), is further amended— 42 U.S.C. 1395m(m)
    - in paragraph (4)(C)(i), by striking and (7)and inserting (7), and (8); and
      - (C) Nonapplication of originating site requirements
        
        The geographic and site requirements described in paragraph (4)(C) shall not apply with respect to telehealth services furnished by a federally qualified health center or a rural health clinic serving as a distant site.
    - in paragraph (8), by adding at the end the following new subparagraph:
- (2) Special payment rule for originating sites with respect to telehealth services furnished by an FQHC or RHC
  - Section 1834(m)(2)(B) of the Social Security Act () is amended— 42 U.S.C. 1395m(m)(2)(B)
    - in clause (i), by striking clause (ii)and inserting clauses (ii) and (iii); and
      - (iii) No facility fee shall be paid under this subparagraph to an originating site with respect to telehealth services furnished by a federally qualified health center or rural health clinic serving as a distant site unless such originating site is a site described in any of subclauses (I) through (IX) or (XI) of paragraph (4)(C)(ii).
    - by adding at the end the following new clause: