Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

April 28, 2023

Public Health Emergency Ends May 11th – Implications for Rural Health Clinics

The COVID-19 Public Health Emergency (PHE) initially declared on January 27, 2020, will conclude on May 11, 2023. Please note: this is a separate emergency declaration from the COVID-19 National Emergency declared by the President that can be ended via a joint resolution from Congress. For a full explanation of these provisions please review the recent NARHC webinar.

RHC Specific Waivers

The conclusion of the PHE will end the below waivers:

Certain Staffing Requirements. 42 CFR 491.8(a)(6)

  • During the PHE, CMS waived the requirement that a NP, PA, or CNM be available to furnish patient care services at least 50% of the time the RHC is operating.

Temporary Expansion Locations. 42 CFR §491.5(a)(3)(iii)

  • During the PHE, CMS waived the requirement that RHCs be separately considered for Medicare survey and certification if services were expanded into more than one permanent location, including areas that would not typically meet RHC location requirements. Upon termination of the PHE, these expanded locations will be subject to location requirements and separate survey and certification.

Bed Count for Provider-Based RHCs

  • During the PHE, CMS permitted provider-based RHCs subject to their clinic-specific, grandfathered upper payment limit to increase their hospital bed count to 50+ without losing their grandfathered status. At the conclusion of the PHE, grandfathered RHCs must lower their bed count or lose their grandfathered payment status.

Nursing Home Visits

  • During the PHE, CMS removed the requirement that RHCs in an area without a current home health area shortage needed a written request and justification in order to provide home nursing services.

Virtual Communication Services

  • During the PHE, CMS allowed for online digital evaluation and management services (99421, 99422, and 99423) to be reimbursed under G0071. After the PHE, G0071 should only be used for G2012 and G2010. This was one of the first telecommunications flexibilities granted to RHCs during COVID, but the passing of the CARES Act allowed many more services to be done via telehealth during the PHE and beyond.

Read More